When most women get ready in the morning, they reach for lipstick, mascara and concealer. For Caroline (not her real name), 29, the makeup routine also includes glue, a brush and a mini-fork. It's not an emergency fondue kit. She's a Chinese-American hellbent on forcing a crease, or a fold, onto her eyelids and these are her tools. First she sweeps the glue above her eyes, then uses the fork to hike up her eyelid, and presses it into place. The skin stays folded for most of the day. She says it makes her eyes look bigger, prettier, and as some might argue, more Caucasian.
Sound unusual? Hardly. In Japan and Taiwan, stores sell tubes of eyelid glue and pre-cut tape that women use to create a fold. Other girls, says Caroline, "hold their eyelids back with toothpicks to 'train' them into place." But for those who balk at sticking toothpicks and forks in their eyes (visions of "A Clockwork Orange") there is a third option -- plastic surgery -- where a permanent crease is stitched into place and excess fat is sucked out of the eye socket.
While the procedure, formerly called blepharoplasty (from the Greek "blepharo" for eyelid, and "plasty" which means to shape) has been around since the '70s, more and more women -- and increasingly, men -- are having it done. According to the American Academy of Facial, Plastic and Reconstructive Surgery (AAFPRS), 167,000 blepharoplasty procedures were performed in 1998. Asian-Americans represented 7.5 percent of all patients undergoing facial cosmetic surgery in 1998.
Plastic surgeons say it is the most common procedure elected by Asian-Americans (and Asians in the Orient), followed by rhinoplasties and breast augmentation. Although the surgery is casually known as "the Asian eyelid surgery" it is not undergone solely by Asians. It's basically a good old-fashioned "eye lift," which gives the eye a fresher, younger appearance by pulling the skin up and back. The surgery isn't always done for cosmetic reasons. Normal aging can cause eyelids to droop and obscure vision; in some cases a blepharoplasty can be a necessity.
Naturally, the Asian eyelid surgery is a sticky issue and questions posed about it are often met with silence, a blast of anger or both (some critics call it "barfoplasty" because it makes them so sick.)
Carrie Chang, a 29-year-old Stanford graduate, is so horrified by the surgery that it inspired her to launch Monolid magazine in December. "Asians are becoming pro-assimilation and monolid is a buzzword for yellow power and not being ashamed of it. It says 'I don't want the surgery,'" says Chang. Monolid's premiere issue featured a profile of the band "Superchink" and a poem called "Recipe for Round Eyes" by Janice Mirikitani.
And while no one interviewed said they had the surgery to look more Caucasian, discussing it inevitably dissolves into a game of semantics. "People say, 'I want to look prettier, I want to look more awake.' But what does pretty mean? How does it come to mean a Western eye? As a historian, we have to look at how words come to mean what they mean," says Elizabeth Haiken, assistant professor at the University of British Columbia and author of "Venus Envy: The History of Plastic Surgery."
The word used by most of the women interviewed for this article was "makeup." They cited a problem with eye makeup as their primary incentive for having the surgery. Others said they simply wanted to look more "awake" or have a larger eye because it's universally prettier.
"I've never had a patient come in and specifically say, 'I want to look Caucasian,'" says Dr. Marc Yune, a Korean-American plastic surgeon and spokesman for the AAFPRS. "In fact, they specifically say, 'I don't want an American eye, I don't want a round eye.'" Dr. James Penoff says the number one factor that drives women to his Honululu office is complaints they can't wear false eyelashes.
The surgery creates the indention of the eyelid right on top of the eyeball that makes it stand out -- where women normally put eye shadow. As Penoff, a spokesman for the American Society of Plastic and Reconstructive Surgery explains, roughly 50 percent of Asians do not have the crease because they lack the levator muscle that holds the crease up, kind of like a window shade. As a result, the Asian eye has a smooth, solid look. But there's more to the surgery than appearance. There is also the functionality issue, says Yune, because the smooth lid can cause entropion, when the eyelashes point down and poke in. And without a crease, you're more apt to have sagging skin that can hang down and obscure vision.
The surgery is quick but expensive -- about $3,500 -- and the recovery, as with most plastic surgeries, can be painful. Hie Shun, a recovery room nurse in her 30s who had it done last year, says she had to sleep in a semi-standing position and "when you lay down, it feels like the swelling is burying you." While some people truly require eye surgery for drooping eyelids that can obscure vision, why go through all this?
Mary Andres, a clinical psychologist and professor at the University of Southern California, offers two explanations. Altering the eyelids is one way for Asians to distinguish themselves from their peers. "If you're Asian and work in an all-Asian office and you dye your hair blond, it's going to make you look different from everyone else. So you're not necessarily trying to make yourself look Caucasian."
Another theory, says Andres, is that the surgery is an indicator of internalized racism. "This surgery is the antithesis of self-esteem, when you don't like who you are and how you look." She pauses for a moment. "You know, I really don't see why people are doing this. It's not like they have a goiter they have to hide from the world."
But some may feel they do. The eye is the Asian feature most often reduced to a caricature in popular culture. "Think of Charlie Chan movies or the Mickey Rooney character in 'Breakfast at Tiffany's,'" says Haiken, the author of "Venus Envy." "Those were awful, so it's not surprising that eyes are the one feature that Asians want to change. Most people probably don't have a conscious desire to look white, but there's such a history of racism and prejudice against Asians in this country."
And on the playground. "The first thing kids do in school is make fun of your eyes," says Chang of Monolid. "They'll stick their fingers under their eyes and pull them until they're slanted. In books, heroines always have big eyes and the villains always have small, piggy eyes. These little things do affect you."
All of which can consciously -- or subconsciously -- inspire someone to get plastic surgery. As Heather, 21, explains in halting English: "Sometimes Asian eyes look cold or hard. I look warmer after surgery. My family likes it. I look smooth. My friends have done it and they really like it. We don't want to be American. We just want to have bigger eyes."
In many Asian communities, the surgery is seen almost as a rite of passage for teens and young adults. Or as Haiken puts it, it's the Asian equivalent of Jews getting nose jobs for their 16th birthday. Many choose to go abroad to Taiwan or Korea to have it done. Yune says 90 percent of his blepharoplasty clients are female, with the majority of high school or college age. Likewise, the number of blepharoplasties he performs jumps during winter break and the summer. And more often than not, it's accompanied by subtle -- or not so subtle -- pressure from parents.
Natalie [not her real name], a 29-year-old Korean-American, had the eyelid surgery done her junior year of high school, largely because of nudging from her mother, who had it done as a child in Korea, and feeling insecure about her eyes. "In Korea, once you reach a certain age, you just do it. It was more encouragement than pressure from my mother, but I wouldn't have considered plastic surgery myself." Then later she concedes, "Well, it could be considered pressure because she told me it would make my eyes look prettier." She didn't tell any of her friends she had the surgery, and now, long out of high school, most of her friends have only known her looking one way. "It's not a very p.c. thing to be making your image more Western."
It's also not a very p.c. thing to discuss eyelid surgery in Asian communities, although it's heatedly whispered about and tips are traded back and forth. When Asians whisper "Does she or doesn't she?" they are talking not about hair color, but eyelid surgery. "After a while, you can tell who's had it done," says Caroline, "and people will say things like, 'Go to Taiwan, it's cheap!' Or, 'Don't go to Korea, they botch it!'"
Some, like Hie Shun, are thrilled it's a topic of conversation. "God, it's great to talk about this because you can't talk about these things with other Koreans, and my American friends just don't get it. When I got it done, my hairdresser, who's Korean, yelled at me, 'Who did this to you?' But a couple of weeks later, once my eyes 'settled,' she loved it."
Hie Shun, who is in her 30s and lives in Atlanta, says when she was younger, she wanted to change the shape of her eyes but eventually "got over it." Then it became largely an issue of makeup. "God, when I think about all the money I spent on makeup. I've never been able to wear mascara because my lashes point down and it would leave me with raccoon eyes."
Hie Shun says the surgery was "no big deal" and compares it to having a mole removed, or getting a makeover. "People think plastic surgery is going to hugely change you, but it won't. My mother was really worried that my face would change so much that people wouldn't recognize me. But it's a subtle subtle change. My boyfriend, who's American, can't even tell the difference."
While plastic surgeons are aware that the eyelid surgery is a topic of hot debate, they don't think that patients are trying to make themselves look more Caucasian, or trying to pass themselves off as Westerners. "The Asian eye is beautiful and they're only trying to enhance it. People have always wanted to accentuate their eye -- think of the Egyptians with their heavy kohl eyeliner and gold masks," says Dr. Robert Harvey, a board certified plastic surgeon and member of American Society of Aesthetic Plastic Surgery.
Yune says it is a misunderstoond procedure. "People think they're trying to change their culture but they're only trying to change their look." He says he is interested in having the surgery himself to "open up his eyes," but quips, "I haven't found a plastic surgeon that I completely trust!"
But Chang says changing your look is tantamount to erasing your culture. "The surgery is trying to get rid of something that is so distinctly ethnic. They're not trying to wipe out a race but a racial characteristic." In the premiere issue of Monolid, she wrote an essay about being confronted -- and subsequently horrified -- by relatives in Taiwan who urged her to get the surgery done. She wrote: "Just whose dictates of beauty were these anyway? ... Never has self-loathing been so utterly transformed into the sine qua non of the Asian aesthetic."
For Soo-Young Chin, an assistant professor of anthropology at the University of Southern California, having the eyelid surgery done at birth, as some parents choose to do to their children, is no different than circumcision or a clitorectomy. "When I was studying in Korea, I saw a lot of women with double lids. I asked one woman why, and she said it was because her whole generation was born that way. Obviously her mother had had it done to her at birth, and never told her. Well, she'll figure it out when she has kids of her own."
But she is also quick to point out that adults should be allowed to do whatever they want to their bodies. "It's not like the eradication of the surgery is going to cause racial tolerance. But I am critical of people who do the surgery ignorantly, without thinking of the consequences."
When I ask Chin if she would ever have it done, there is a long pause.
"Why?" she snaps. "Is there something wrong with my face? I think it's silly to think there is only one standard of beauty. And let's face it, most people aren't beautiful, they're just mediocre."
Caroline, who still greets most mornings with glue and a fork, reports that one of her eyes "flipped" on its own, so that she now has one fold. "When my eye spontaneously flipped, I loved it. I was so happy. Some days when my eyes are puffier the crease will be temporarily gone and I freak out. Then I lie down and put cold pads on my eyes to reduce it."
But after a lot of thought and some nudging from her mother ("Your cousin got it done, so-and-so got it done and they look great"), she decided not to have the surgery. "Sure I'd like another fold, a matched set. But as time goes on, you get used to your face. And having lived with my eyes for this long, it doesn't matter anymore. What you see is what you get it. And I'm just glad I'm 100 percent me."