SEOUL, South Korea — In Gangnam, Seoul’s commercial and luxury shopping district, designer boutiques and flagship shops line the streets alongside plastic surgery clinics with polished signs and shimmering facades.

With hospital names like “Top Class,” “Fresh,” “Grand,” and “Cinderella,” plastic surgery is as fashionable as it is commonplace in South Korea. With one for the world’s highest rates of plastic surgery per capita, South Korea is also a major medical tourism destination for Chinese visitors.

“In Korea, you often see Chinese patients walking around with bandages on their faces after their surgery,” said Joy Kang, chief executive officer of Eunogo, a plastic surgery concierge service. “During their recovery time, patients spend some time shopping and sightseeing.”

Over the past few years, Chinese visitors have represented the majority of medical tourists in Korea, with seven out of  10 visitors reported to be visiting from China in 2014, according to the government.

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However, given current diplomatic tensions between Seoul and Beijing, experts worry that their numbers will decrease. Figures for 2016 have yet to be released, but a 26 percent drop in Chinese tourists was reported between last July to October.

Since last year, China has taken a strict stance against South Korea’s deployment of the THAAD antiballistic missile system.

“Currently, 40 percent of my patients are from China,” said Dr. Park Jong-lim, a board-certified plastic surgeon at Banobagi Plastic Surgery Hospital in Seoul. “Chinese patients used to represent a larger portion, but recently they are decreasing perhaps because of the political issues.”

In the long run, China’s plastic surgery industry also poses major competition. “Chinese doctors will catch up with their technical skills and [visiting] Chinese patients may decrease in the long-term,” said Park.

With the plastic surgery industry on the rise in China, more and more Chinese surgeons come to South Korea to learn the latest surgical innovations, and bring them home, added Park. “There are many training programs in [South] Korea for the Chinese surgeons [to learn from our techniques]. They come over and observe surgeries, and attend lectures.”

However, despite purported political tensions and growing competition in China, Chinese patients continue to make up a major percentage of medical tourists in Korea.

According to data released by China-based travel web site Ctrip, 100,000 Chinese tourists visited South Korea for medical tourism in 2016.

The travel giant also reported that Chinese medical tourism spending abroad increased by five times over the past year. Ctrip reported an average spending of U.S. $7,194 per trip for 2016.

At her medical tourism firm, Joy Kang said her clients spend on average U.S. $15,000 on plastic surgery, and between U.S. $200-1000 on skin-care procedures.

The most popular procedures among Chinese patients are double eyelid surgery for creating epicanthal folds, and augmentation rhinoplasty to raise and lengthen the nose bridge. While facial contouring or jawline reduction resulting in a “V-shaped” jawline, breast augmentation, liposuction and face lifts for older patients, are also among top requests.

While these surgeries are routine operations for surgeons in South Korea, doctors say Chinese clients favor different styles of features. “There’s a difference between the beauty cultures among different countries,” said Dr Park. “In Korea and Japan, a smaller and slightly retruded chin represents a younger look, and younger means cuter and prettier.”

“In China, they prefer a more adult, feminine look. A lot closer to Western standards,” explained Park. “Chinese patients prefer a more exaggerated look. They want a higher nose, and a bigger and pointier chin,”

Chinese patients are also becoming more knowledgeable about the limitations of plastic surgery. “Four to five years ago, a lot of Chinese patients would bring us photographs of celebrities, saying they want ‘this face,’” said Park. “But of course such results are not achievable.”

“These days, most people still bring photographs, but they ask for something specific,” said Park. “For example, I like this [part of this] person’s look, or I like this feature of her nose. They understand that the expectations of the surgery [need to be realistic].”

Many Chinese patients have already been under the knife. “We have a large percentage of clients coming for revision surgery, which means they already had surgery in their own country,” said Joy Kang. “For example, maybe their [silicone] nose implant moved, or their nose shape changed after surgery [and they need to fix this].”

“For revision surgeries, people need very skilled doctors because they can be even more complex than the first surgery,” said Kang. “[South] Korean doctors are not only very experienced, but also used to working with picky [South] Korean patients. So people fly over for this experience.”

While South Korea is known for its mastery of groundbreaking new procedures including “smile surgery” and inner canthoplasty or “eye enlargement surgery,” Dr. Park Jong-lim said the industry’s biggest breakthrough in recent years has been a reduction in patient recovery time.

“Many surgeries and techniques have evolved to give patients more convenience and less pain.” said Park.

The rise of “petit surgeries” or simple non-surgical procedures, has played a big role in part in reducing downtime. For instance, patients can get opt for non-surgical face-lifts, through a “thread-lifting” technique invented a few years ago, which produces the same results as surgical facelifts.

While such procedures are semipermanent and last about six months to a year, compared with five to six years for surgical facelifts, the big advantage is that they do not require downtime, and are relatively painless and bloodless.

“In the past, most Chinese patients went under the knife for up to three procedures at the same time,” said Park. “Nowadays, they prefer the simpler procedures.”

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