A South Korean billboard advertising double-jaw surgery at a subway station in Seoul. Picture: AFP

The most cosmetically enhanced people on the planet can be found in South Korea, where plastic surgery is regarded as “natural and harmless” and is believed to be the key for better employment prospects and a happier life.

The country’s capital, Seoul, has also become the world’s capital of plastic surgery. There, more than 4000 clinics nip and tuck about 650,000 people per year — including a growing number of overseas visitors, including those from Japan and China.

“So many people have surgery, it’s just like wearing make-up,” a young Korean man told Al Jazeera in its new expose of South Korea’s plastic surgery boom.

“Plastic surgery is natural and harmless because everyone does it.”

The majority of people going under the knife are women in their late-teens and early twenties hoping to “improve” the appearance of their face, although breast augmentation surgery is still popular. Men are believed to make up about 15 per cent of the cosmetic surgery market, according toThe New Yorker.

Among the hordes of young Korean women signing up is student Ahn Min Yung, who told Al Jazeera she wanted cheekbone reduction surgery to narrow the shape of her face.

“At first I wondered if I really needed the surgery, but these days so many people have surgery,” she said.

“They don’t even consider an eye or nose job as surgery but just a ‘cosmetic procedure’, so I’ve changed my mind a lot. I used to think plastic surgery was bad but today everyone gets it.

“Korean society is infatuated with beauty. The first impression is very important. In any job interview they look at your face first.

“Let’s be honest: everyone likes pretty girls.”

Women undergoing plastic surgery in South Korea are generally driven by a similar ideal of beauty: large, round eyes, a pointed nose, a pleasant smile, a V-shaped chin and a slim jaw.

Double-eyelid surgery — which creates an eyelid fold that many north Asian people are born without — and procedures that narrow the shape of the face are among the most requested operations.

While Seoul’s Gangnam region is best known to most of the world via the Psy song, it is better known in South Korea as the plastic surgery “beauty belt” where streets are lined with ultra-modern cometic clinics and plastic surgeons are treated as demigods.

K-Pop is in fact driving many young people’s fascination with getting cosmetically enhanced, Gangnam-based plastic surgeon Dr Rhee Se Whan told AAP.

Many K-Pop stars have openly admitted to their cosmetic procedures.

“K-Pop stars and Korean celebrities have influenced the younger generation (to get plastic surgery),” he said.

“For example, if you look at the before and after photos of K-pop stars you’ll see they have gotten prettier. When people see this change, they want to be pretty as well, they want to look as good as them.

“During school holidays, half the class would come in and get surgery done and when they go back to school, their friends would see that they’ve become prettier so in the next break you would have the other half of the class coming in.”

But professor of psychology Yang Yoon told Al Jazeera plastic surgery was about more than just the pursuit of facial perfection.

“While plastic surgery may seem like a tool for looking better, it’s actually all about comparing one’s self to others,” he said.

“Koreans always strive to be better than their peers.”

This is not the only way in which Korean society is super competitive.

Education is also so highly valued in South Korea that its school system has been described as overly stressful, authoritarian, brutally competitive and meritocratic.

“To be a South Korean child ultimately is not about freedom, personal choice or happiness; it is about production, performance and obedience,” Yale academic See-Wong Koo said.

The competition between students at school, which extends to adults looking for work, has led to bottlenecks in the labour market, according to the Economist.

Similarly, South Korea’s booming plastic surgery business is coming at a significant cost.

The rise in the number of cosmetic procedures has also brought about a rise in the number of botched surgeries, where patients are left with painful and disfiguring conditions as a result of going under the knife.

While South Korea’s plastic surgery is heavily regulated, it is also littered with fake positive reviews of clinics, where a dodgy third-parties are paid — sometimes in the form of free cosmetic procedures — to leave phony online reviews or even lure people into procedures through internet fouls or blogs.

“I fabricate information that customers want to hear and post pictures of realistic, dramatic and successful surgeries,” one of these brokers said under the condition of anonymity.

Medical malpractice lawyer Shin Hyun Ho told Al Jazeera said another potential problem was that anaesthetic was often not administered by anaesthesiologists but by nurses or surgeons themselves, which could lead to the patient experiencing shock.

He said while many patients won malpractice cases, the payouts were small, especially compared to the United States.

One of the industry’s alleged victims is So Yi Yoon, a young woman who had her face and jawline narrowed and underwent eyelid correction surgery.

She was left with a sagged chin, permanent mouth lacerations and was unable to close one of her eyes.

“Other people wish to be rich but for me I didn’t want more money,” she said.

“I just wanted to be pretty.

“But now when I look at myself in the mirror I feel sad. Now my eyes are uneven and I hate seeming my eyes like that. And the fact that I can’t close one of my eyes, it makes me feel like a disabled person.”