Before meeting up with me for dinner to celebrate my first time in Korea, my Seoul-based friend Jessica got off the plane after a business trip in Los Angeles and drove straight to her dermatologist — or "dermie," as she affectionately calls him — for Botox on her nose and jawline. After our stomachs were filled with dak galbi and soju, I scooted closer to Jessica in our booth and asked her about her latest dermie appointment. She began to list the dozen-plus cosmetic procedures she's tried since moving to Seoul from New York City eight years ago. Botox was her gateway injectable, starting with her jawline for a narrower, V-shaped silhouette. Since then, Jessica's gotten fillers in her forehead, chin, nose, and lips.
She also mentioned the "Chanel" injection, a cocktail of vitamins, minerals, and antioxidants that is supposed to tighten and brighten skin (she didn't notice a difference, though). I listened to all of this slightly slack-jawed. On the other side of Jessica was our friend who grew up in South Korea — he was utterly unfazed. There, the idea of a 33-year-old signing up for regular cosmetic injections is par for the course. An estimated one in three South Korean women between the ages of 19 and 29 has undergone a cosmetic procedure, according to a 2015 Gallup poll.
Earlier in the week, I skipped Seoul's stunning palaces and animal-café tourist traps to go straight to Gangnam. The neighborhood's streets are lined with high-rises filled with full-service, multilevel plastic surgery and dermatology clinics, many complete with in-house pharmacies, stem cell laboratories, and hotel rooms for out-of-towners. Hundreds of people cycle in and out daily for touch-ups and treatments, with the nonchalance of stopping by a salon for a blowout. Inside these buildings, the future of injectables is being determined by a discerning audience of South Koreans who prize flawless skin, small faces, and round, youthful features. To maximize efficacy and move patients along, the spaces are divided by treatment (like the "filler room" in one clinic I visited, where chairs are lined up for patients to receive their injections, one next to the other). And unlike in the U.S., where privacy surrounding cosmetic work is prized, waiting rooms are sprinkled with patients wearing a full face of numbing cream as they stand by for their cosmetic procedures.
In the U.S., we have 32 FDA-approved dermal fillers. It can take many years of testing (and bureaucracy) for a new one to see the light of a doctor's office. In South Korea, however, regulation is less stringent, and a person looking for injectables in Seoul has many more options to choose from. Formulas that the FDA has not approved because of a lack of studies on efficacy and safety or potentially serious side effects, like injectable skin-brighteners spiked with glutathione (an antioxidant that can deactivate the body's melanin-producing enzymes), are used regularly in Korea. And while American doctors certainly use neurotoxins and hyaluronic acid fillers off-label (injecting Botox to lift lips, for example), I met with Korean doctors who spoke very casually of thread-lifting vaginas or injecting Botox into the calves, applications I had never heard of (or even imagined).
When it comes to the latest trends and technology in injectables, Seoul is ahead of the curve. "A lot of Korean [patients] are first-time adopters," says Yongjoon Noh, a plastic surgeon at Banobagi Plastic Surgery & Aesthetic Clinic in Seoul. "New fillers, new materials, new plastic surgery techniques — they want to try them all." A big upside to all this: With so many options available, cosmetic injections are vastly cheaper in Korea than they are in the U.S. Alternatives to Botox, like Medytox and Botulax, can be priced as low as $30 for a treatment (compared to about $400 in the U.S.). "It's common for Koreans to go to the dermatologist weekly, sometimes even daily, for maintenance treatments," says Y. Claire Chang, a New York City-based dermatologist who frequently travels to Seoul to learn about the latest advancements in cosmetic dermatology.
Many of the most popular injectable techniques are specific to Korean beauty standards: plump apples of the cheeks and rounded foreheads, as well as the aforementioned V-shaped jawlines. But other techniques, like using Botox to create the impression of poreless skin, or a thin hyaluronic acid filler to softly upturn the corners of the mouth, are likely to start creeping into practices in the U.S. — in fact, they've already arrived in some. Want to know what's on the horizon? During my week in Korea, these were the procedures I heard about over and over again.
"Glass skin" is the Korean ideal of a poreless, translucent complexion (like a pane of glass). And the key to getting it is meso-Botox (or colloquially, "skin Botox"). For years, Korean celebrities have sworn by these shallow injections, especially before major events, says Shin Hye Won, a dermatologist at Oracle Clinic in Seoul. Just a few miles east, at Thema Dermatologic Clinic, they have 30 to 40 patients a day who undergo the procedure, says dermatologist Lim Ee Seok. The cost? About $300. (In the U.S., Chang offers it for $950 to $1,200.) Rather than being injected into the muscles to prevent and smooth wrinkles, botulinum toxin is placed just below the skin's surface, at about 40 to 50 sites along the jawline, forehead, and undereye areas. As a result, pores tighten, which makes skin appear smoother and brighter, and excessive acne-causing sebum stops forming. The effects last between three and four months.
The fruity nickname is a reference to the lip shape this filler technique creates. In the past, Angelina Jolie's lips were the most requested look in Seoul (just as they were in the U.S.), says Kang Jong Bum, a dermatologist at JY Plastic Surgery & Dermatology in Seoul. But as of 2019, Koreans prefer the more targeted plumping that many K-pop stars are known for. Instead of giving lips an allover fullness, dermatologists administer a hyaluronic acid filler (like Juvéderm or Restylane, or domestic options Yvoire or Neuramis) to the middle areas of the upper and lower lip, enhancing the Cupid's bow. Imagine two double-stemmed cherries on their sides, the stems forming the outline of the edges of your smile. The results last for at least six months and cost about $150 to $250 in Korea.
After the center of the lips are plumped, the same hyaluronic acid filler is often administered just above the outer corners of the mouth — a technique called lift edge filler. As the name suggests, the treatment raises the edges of the lips into a soft smile. As we age, the area around our mouth loses volume, and the outer corners start falling into an unintentional frown. Lift edge filler counters the droop and balances out all that fruity volume in the center of the lips, explains Kang.
My best friend, CJ, who lives in Gangnam and works in the K-pop industry, knows people who get the procedure for other reasons. "It's really popular here for people with resting bitch face," she says. "It helps them look softer." Like other lip injections, lift edge filler lasts about six months to a year; swelling and small bumps can result, usually for two to three days after the injection, before dissolving. Banobagi offers a cherry lip filler and lifts edge filler combination. A permanent smile is also trending in South Korea. One of the coordinators at JY Plastic Surgery & Dermatology mentioned increased requests for surgical smile lifts, where surgeons create incisions in the same areas targeted by lift edge filler, so your face rests naturally with the corners turned up.
My Korean is limited, but I do know the word for thread lift (also, not to brag, egg and grandpa). And that was a good thing because the term came up often in my reporting. At one point, Kang asked if I wanted to try a thread lift myself. I'm 27, with skin that is more plump than saggy, so I was extremely confused by the offer. Thread lifts in Korea, Kang clarified, are not the "facelift lites" that we consider them here.
Sure, the mechanics of thread lifts in Korea are the same as they are in the U.S.: Dissolvable, fine-barbed threads are passed underneath the skin with a large needle. Then, as the needle is pulled out, the barbs grab onto skin and pull it upward, stimulating collagen and tightening and lifting the skin. Korean-style thread lifts, though, are less invasive because finer threads are used; they alter the shape of the face, slimming the jawline or changing the contours of the nose.
"We use thread lifting to make it look like a patient has had a nose job — without actually doing a nose job," says Choi Jun Young, the lead plastic surgeon at JY Plastic Surgery & Dermatology, of his most requested thread lift procedure. The thread is injected between the nostrils, and in about 15 minutes patients can walk out with the bridge and tip of their nose angled higher. The results last around a year or two and run about $250 to $420.
"These days, it's not about fixing a problem but preventing it," says Lim. He believes the future of cosmetic dermatology in Korea is the "booster shot," an injection designed to rev up skin's natural powers of regeneration and moisturize and brighten skin — not to change the contours of your face.
The most sought-after booster shot at JY is Jalupro, a solution of amino acids and sodium hyaluronate (a form of hyaluronic acid) manufactured in Switzerland. Kang says it builds up collagen (to best effect when done as a series of injections over several weeks), so the skin becomes plumper and acne scars start to fade away. Jalupro can be injected all over your face, but Kang likes to target wrinkle-prone areas like the forehead, around the mouth, and around the eyes. It can also supplement laser treatments for stretch marks. My friend Jessica loved the results so much that she got it once a week for three months.
Rejuran — which contains PDRN, short for polydeoxyribonucleotide — is the booster shot that many doctors in Korea believe holds the most promise. PDRN is extracted from a segment of salmon DNA that is a 95 percent match to that of humans. This small DNA chain is known for its anti-inflammatory and tissue-repairing properties. When injected into the skin, Rejuran is said to shrink pores, diminish the appearance of fine lines and wrinkles, even skin tone, and balance oil production. Unlike skin Botox, which focuses on instantly smoothing the surface, PDRN could heal sun damage or acne overtime at the cellular level, based on early in vitro research. Typically, patients get three monthly injections ($100 to $340 each), for results that last up to a year.
Read more about injectables:
- Everything You've Always Wanted to Know About Botox
- A Comprehensive Guide to Every Injectables Term, Defined
- Everything You've Ever Wanted to Know About Facial Fillers
Now, watch a dermatologist’s entire skin-care routine:
