Editors’ note: We have used the made-up name of Linda to protect the identity of the main source of this story.

Linda lay rigid on the operating table, the stark gray room illuminated by the garish glow of two overhead panels of fluorescent lights. Although her eyelids were covered in numbing cream, Linda winced as her surgeon injected a potent anesthetic into the base of her left eyelid. After a few minutes, a dull, lingering pain replaced the sharp sting inflicted by the needle. Linda tried to relax. In just an hour and a half, she would have bigger eyes to last her a lifetime.

“I was awake the entire time,” Linda said. “The surgery didn’t hurt, but I could feel everything that was happening, so it was really unnerving.”

Linda, a Class of 2015 alumna, underwent a blepharoplasty procedure, more commonly known as a double-eyelid surgery, last year in Taiwan, where she spent a semester off before attending university. Blepharoplasty is a cosmetic surgery that creates the palpebral fold, or the upper eyelid crease a few millimeters above the lash line, that gives the appearance of larger eyes. Those who have this crease are said to have a “double eyelid,” while those whose eyelids naturally lack the crease are said to have “monolids.”

“My mom wanted me to get my eyes done ever since I was born,” Linda said. “When she brought up the question again before I turned 18, which is how old you have to be to get the surgery, I spent a lot of time thinking and ultimately decided to go through with it.”

Linda, a Korean American, said her motivation for the operation did not arise from a desire to emulate a Western aesthetic standard, pointing out that big eyes are universally appealing.

“I didn’t get the surgery to fit in, but I just felt that double eyelids make a person look more alive and that I would look better with them,” Linda said. “The examples set by Korea made me more comfortable in making my decision.”

According to the International Society of Aesthetic Plastic Surgery, the United States still leads the globe in the annual number of plastic surgeries, but South Korea has boasted the highest rate of operations per capita in the world since 2009. In 2014 alone, nearly a million operations were performed there — the equivalent of about 20 procedures per 1,000 people.

And those are just the surgeries that were recorded; statistics in this loosely regulated industry are far from exact. Many patients, like Linda, whose procedure was done by a surgeon recommended to her by her mother’s friend, visit private doctors who often do not keep official records.

The heart of the global plastic surgery industry is in Seoul, South Korea. Seoul’s high-end Gangnam district, dubbed the “Improvement Quarter” by the plastic surgery community, is home to more than 500 aesthetic centers packed within a square mile. According to one report by the BBC, between one-fifth and one-third of women in Seoul have had at least one operation. But it’s not just women. Men comprise 15 to 20 percent of the market, including former South Korean President Roh Moo-hyun, who underwent the double-eyelid surgery while in office.

“The classic surgeries in Korea are the double eyelid surgery, the jaw line-thinning procedure and the nose lift,” Linda said. “Koreans really like the look of having a slim face with big doll eyes.”

In an interview with Tech Insider, Dr. Hang-Seok Choi, a plastic surgeon and director at JK Plastic Surgery, one of South Korea’s leading cosmetic centers, explained that double-eyelid surgery is by far the most popular operation there.

“Unlike Westerners, many [East] Asians have monolids, which can make them look fatigued,” Choi said. “Some see the double lid as a sign of beauty, though others argue it comes from an idealization of Western norms.”

Choi said the surgery is also a popular procedure because it requires a shorter recovery time and is cheaper than other operations.

According to Linda, double-eyelid surgeries in Asia are often performed for a third of their cost in the United States. Linda’s total procedure, which included a double-eyelid surgery and an inner eye corner lift, cost around $2,300, with just the double-eyelid portion costing $1,515.

During the two weeks following the operation, Linda focused on recovery. To subdue the pain and reduce the swelling for the first few days, Linda alternated between placing a warm bag of water and an ice compress over her eyes.

“[My eyelids] were really swollen for the first couple of days, but they only hurt for the first night,” Linda said. “I had to take painkillers on the first night, but after that I was OK.”

Instructed not to allow water to touch her sensitive eye area, Linda had to carefully wash her face with a towel and frequently visit the salon to have her hair washed.

After two weeks, her stitches were removed. To aid the healing process, Linda’s doctor prescribed an antibiotic ointment to be applied twice daily to the scarring area. According to Linda, it took around six months for the eyelid swelling to completely subside. Going into the operation, Linda was aware of how lengthy the recovery process would be, but she felt the procedure was worthwhile because it was a lifetime investment.

“Since I was leaving Taiwan shortly after the surgery, I took a picture about a month following the procedure and sent it to the doctor to update him on my progress,” Linda said. “After about two months, I looked normal, but there was still some swelling on the centers of my eyelids. As of now, I’m no longer using the ointment, and there's only a small mark left.”

Although Linda’s experience was positive, surgical operations are not without their risks. According to the Korean Consumer Agency, one third of plastic surgery patients in South Korea were dissatisfied with their results, and 17 percent suffered negative side effects. For blepharoplasties, the possible complications include eye infection, noticeable scarring, a temporary inability to completely close one’s eyelids, malaligned eyelids or even permanent vision loss from retrobulbar hemorrhage. In rare instances, patients can die from anaesthesia-related accidents during the operation.

Despite the risks, one reason Linda believes plastic surgery is so central to the Asian culture is that in many Asian countries, people are packed closely together, allowing images in the media to wield considerable influence. For example, around half of South Korea's population lives in Seoul, the city with the sixth highest population density in the world.

In a society where people are constantly bombarded with images of Korean stars, many of whom have had plastic surgery done to look more “perfect,” it is unsurprising that a typical high school graduation gift for a Korean teenager is either a nose job or a double-eyelid surgery.

At her initial consultation, Linda paged through the “Look Book” of testimonials featuring photographs of former patients. In the “before” pictures, downcast women with drooping eyes, low-bridged noses and unshapely jaw lines stared blankly back at her. In their after pictures, these same women smiled broadly, showing off their new facial structures. The captions below  their transformations showcased statements like, “This is why celebrities are confident without makeup.”

“Looking through the pictures, I noticed a huge difference in the before and after shots,” Linda said. “The sharp contrast helped me make my decision.”

For those who wish to create the appearance of double eyelids or to even out their eyelids without surgery, sophomore Angela Lee suggests double-eyelid tape, an alternative designed for those who have either monolids or double eyelids.

Lee applies “D-UP Wonder Eyelid” tape, which costs around $12 per pack, every morning in order to “even out” her eyelids.

“I already have double eyelids, but one of my eyelid creases is lower than the other, so to achieve a more symmetric look, I put double-eyelid tape on my right eye to raise the crease,” Lee said. “With practice it has become easy, fast and effective for me.”

Ultimately, there are different options available for people to achieve the look they desire. Linda is happy with the results of her operation, which she reiterates was not a rejection of her heritage, but a way to fulfill her own ideals of beauty.

“I definitely liked the surgery, and I would recommend it to people considering it,” Linda said. “I'm certainly more confident. My monolids never bothered me that much, but I do like how my eyes look right now a lot more.”