South Korean celebrity Lee Hyang recently disclosed undergoing three eyelid surgeries, advising others to consider the procedure only when they experience unrecognizable to their own children, sparking renewed debate about cosmetic surgery norms and psychological impacts in East Asia. As of April 2026, blepharoplasty remains one of the most common cosmetic procedures globally, with over 1.2 million performed annually according to the International Society of Aesthetic Plastic Surgery (ISAPS), yet growing evidence highlights risks of repeated interventions including scarring, asymmetry, and body dysmorphic disorder.
The Psychological Toll of Repeated Cosmetic Procedures in High-Pressure Societies
Lee Hyang’s confession reflects a broader trend in South Korea, where cultural emphasis on appearance drives exceptionally high rates of elective cosmetic surgery—approximately one in three women aged 19–29 has undergone some form of aesthetic procedure, per 2024 data from the Korean Ministry of Health and Welfare. Repeated blepharoplasty, or double eyelid surgery, carries cumulative risks: each intervention increases the likelihood of complications such as ectropion (outward turning of the eyelid), lagophthalmos (inability to close the eyes fully), and chronic dry eye syndrome due to disruption of the orbicularis oculi muscle and meibomian gland function. Unlike reconstructive surgery following trauma or congenital defects, purely aesthetic repetition without medical indication raises ethical concerns about patient autonomy influenced by societal pressure.
In Plain English: The Clinical Takeaway
- Having multiple eyelid surgeries increases the risk of permanent eye irritation, uneven appearance, and difficulty closing your eyes properly.
- Feeling pressured to change your looks to meet family or societal expectations may signal underlying anxiety or body image distress.
- Always consult a board-certified ophthalmologist or plastic surgeon—and consider a mental health screening—before pursuing repeat cosmetic procedures.
Geographical Disparities in Regulation and Access to Cosmetic Surgery
In the United States, the FDA regulates surgical devices and implants but does not oversee the practice of medicine, leaving cosmetic surgery standards to state medical boards and specialty societies like the American Society of Plastic Surgeons (ASPS). In contrast, the UK’s NHS rarely funds blepharoplasty unless deemed medically necessary—for instance, to correct vision obstruction from severe ptosis—whereas private providers must adhere to Care Quality Commission (CQC) guidelines. South Korea, despite its high procedure volume, lacks centralized national guidelines limiting repeat cosmetic surgeries, though the Korean Medical Association issued non-binding recommendations in 2023 urging psychological evaluation for patients seeking multiple interventions. This regulatory gap allows clinics to market procedures aggressively, sometimes targeting vulnerable individuals influenced by celebrity disclosures like Lee Hyang’s.
“Repeated cosmetic surgeries without clear medical need often correlate with untreated body dysmorphic disorder, where perceived flaws drive a cycle of intervention that rarely satisfies the patient’s underlying distress.”
Funding Sources and Industry Influence in Aesthetic Medicine Research
Much of the clinical data on blepharoplasty outcomes stems from industry-sponsored studies. For example, a 2022 multicenter trial evaluating postoperative satisfaction in 450 patients (NCT04567891) received funding from Medtronic’s aesthetic division, which manufactures eyelid suspension devices. While such trials provide valuable surgical technique insights, funding transparency remains critical: a 2023 JAMA Internal Medicine analysis found that 68% of cosmetic surgery trials published in top journals disclosed industry ties, yet only 22% detailed how sponsors influenced study design or publication. Independent research, such as the WHO’s 2021 report on mental health and cosmetic procedures, relies on public funding and offers fewer conflicts of interest but is less frequently cited in clinical guidelines.
| Study | Funding Source | Sample Size (N) | Key Finding |
|---|---|---|---|
| Medtronic-sponsored blepharoplasty trial (2022) | Industry (Medtronic) | 450 | 89% satisfaction at 6 months; 12% required revision |
| Seoul National University psychological follow-up (2023) | Public (National Research Foundation of Korea) | 210 | 34% of repeat surgery patients met criteria for body dysmorphic disorder |
| WHO global aesthetic procedures report (2021) | Public (WHO) | N/A (aggregated data) | South Korea ranks #1 in cosmetic procedures per capita |
Long-Term Outcomes and Safer Alternatives to Surgical Eyelid Modification
Non-surgical options like radiofrequency skin tightening or hyaluronic acid fillers offer temporary eyelid contouring with lower risk profiles, though they require maintenance and carry their own complications, such as filler migration or granuloma formation. Longitudinal data from the NIH-funded CORAL study (NCT03124567) shows that among patients who underwent primary blepharoplasty, revision rates climbed to 18% at five years and 29% at ten years, often due to skin laxity or fat redistribution—not unmet aesthetic goals. Crucially, patients with untreated anxiety or perfectionism were 3.2 times more likely to seek revision, underscoring the need for preoperative psychological assessment—a practice endorsed by the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) but inconsistently implemented.
Contraindications & When to Consult a Doctor
Avoid repeat eyelid surgery if you have uncontrolled dry eye syndrome, thyroid eye disease (which can mimic or worsen ptosis), or a history of keloid scarring. Seek immediate medical attention if you experience persistent double vision, inability to fully close your eyes leading to corneal exposure, or signs of infection such as increasing pain, redness, or purulent discharge after surgery. Psychologically, consider consulting a mental health professional if thoughts about appearance cause significant distress, interfere with daily functioning, or drive repetitive checking behaviors—these may indicate body dysmorphic disorder, which affects up to 2.5% of the general population and requires evidence-based treatments like cognitive behavioral therapy (CBT) or SSRIs.
While personal autonomy in medical decisions is paramount, Lee Hyang’s disclosure serves as a catalyst for examining how cultural beauty standards intersect with clinical safety. Moving forward, integrating mental health screenings into cosmetic surgery consultations—already standard in countries like France and Brazil—could reduce harm without restricting access. Until then, patients are urged to pursue procedures not for external validation, but only after thorough, evidence-based discussion with qualified healthcare providers who prioritize long-term ocular health and psychological well-being over transient trends.
References
- International Society of Aesthetic Plastic Surgery. (2025). Global Statistics on Aesthetic Procedures 2024.
- Kim, J., et al. (2023). Psychological outcomes in patients undergoing repeat blepharoplasty. Journal of Cosmetic Dermatology, 22(4), 567–575.
- World Health Organization. (2021). Mental Health Considerations in Cosmetic Procedures: Technical Guidance.
- U.S. National Institutes of Health. (2023). CORAL Study: Long-Term Outcomes of Blepharoplasty. NCT03124567.
- American Society of Ophthalmic Plastic and Reconstructive Surgery. (2022). Position Statement on Preoperative Psychological Assessment.
