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31 Jan 2013

Keeping abreast of the news – It was via a somewhat circuitous route that I ended up reading this post on the Marmot’s Hole: “North Koreans Don’t Like Women With Big Boobs: Report.” The circuitous route began with a post by a friend on a message board I frequent, linking to an article on the Fox News website, “Not everyone likes big boobs—for example, North Korea.” This doesn’t really surprise me, in the same way that waking up tomorrow morning and finding out that North Korea was laying claim to the creation of the universe would not surprise me. The Fox News article, though, piqued my curiosity... although not for the reasons you might suspect.

“Heh. Boobs.”

Early in the article, we see this sentence: “The bigger your breasts, the more likely you'll be considered a slut, the women reportedly said, because you're seen as strutting your stuff — as if morality determines that development.” Now, this is not going to be the main focus of my entry today, but I would like to start by pointing out that, while it is a bit ridiculous to make assumptions about someone’s morality based on their physical features, this is not a new idea, nor is it limited to North Korea. In the Wife of Bath’s Prologue, the Wife describes herself thus: “Gat-tothed I was, and that bicam me weel; I hadde the prente of seinte Venus seel” (Gap-toothed I was, and that became me well; I had the print of holy Venus’s seal). In other words, in the 14th century, having a gap between one’s front teeth was a sign of lustfulness and promiscuity. Not to let North Korea off the hook here, of course. I just thought it was a bit disingenuous to snarkily point and laugh at North Korea for something that is a basic human tendency. Seriously, there are a ton of other, more legitimate things we could mock North Korea for.

(Of course, this was a completely unnecessary excursion into 14th century English literature, because everyone knows that people make, have always made, and probably will continue to make character judgments based on physical appearance. I just wanted to convince myself that a major in English literature is not an entirely useless thing. At the time of writing I am telling myself that I succeeded.)

What really caught my eye, though, and led me on a mad chase down a rabbit hole filled with numbers, was this line: “‘Boob jobs’ are popular in South Korea, where the people are the most cosmetically enhanced in the world, Cain said, who is based in Seoul, and they're also becoming a hot item for the new affluent women of China, Vietnam and Indonesia.” Now, for the purposes of today’s entry, I would like to ask you to ignore the awkwardness of construction. There’s a lot to unpack here, but we can break this down into three basic statements:

  1. South Korea’s population is the most cosmetically enhanced in the world.
  2. Breast augmentation is a popular cosmetic procedure in South Korea.
  3. Breast augmentation is also becoming more popular in other Asian countries, such as China, Vietnam, and Indonesia.

Before I take you down the rabbit hole (or you could just take the blue pill and stop reading), I will point out that none of these points are demonstrably false. Some of them are, however, very hard to quantify, and their relationships with each other can produce some misleading conclusions. For example, when I first read this sentence, my initial thought was: “Oh, South Korea must have an inordinate number of ‘boob jobs’ compared to the rest of the world.” (My second thought was, “Heh. Boobs.” Or maybe it was the other way around.) The sentence does not explicitly say this, but I don’t think it is an unreasonable conclusion to draw, at least at first glance. The question, though, is: is it true?

Before we continue, I need to address the terminology we will be using. For starters, I am going to stop using the term “boob job,” partly because I am a guy and thus genetically predisposed to giggle or smirk every time I write the term, but also because it is too vague. There are actually three major procedures that can be performed on breasts: breast augmentation, breast reduction, and breast lift—roughly put: bigger, smaller, or higher. If we use a term like “boob job,” it is not clear what we are referring to. I am going to assume, however, that most people are thinking of breast augmentation when they use this term, and that is the procedure I will be focusing on for the rest of the entry.

(Incidentally, I can only imagine the search queries that are going to be leading people to this entry. I feel particularly sorry for those coming here looking for “North Korean boobs”—so sorry, in fact, that I will post a photo of a pair of lovely North Korean boobs at the end of this entry. Don’t pretend you’re not going to scroll down to the bottom this very instant. In fact, you’re probably not even reading—ah, forget it.)

OK, back to the matter at hand. The first statement above, unlike the second and third, is in fact rather easy to quantify. Does South Korea have the most “cosmetically-enhanced” population in the world? The answer is yes. In terms of total number of procedures, the United States proudly leads the world by a rather significant amount, but when you break down the numbers by population, South Korea is at the head of the pack. My research led me to a chart in the Economist that shows the number of plastic surgery procedures per 1,000 population for 2010. As you can see, South Korea is right there at the top of the list, leading Greece in the second spot (where, the article informs us, “penis enlargements are performed ten times more often than average”) by a healthy margin.

So the first statement above is true. I think the problem, however, is how this statement relates to the second statement—that breast augmentation is a popular procedure in South Korea. This proposition is a bit trickier and raises a number of questions: how do you quantify “popular,” is breast augmentation more popular in South Korea than elsewhere, etc. We need more precise figures for this, but before we leave the Economist, even a quick look at that chart shows that breast procedures (presumably including all three types mentioned above) are a much smaller percentage of the whole than most of the nations at the top of the list. It is not until we get down to Taiwan and Japan that we see countries with fewer breast procedures per 1,000 population, and France, in ninth place overall, appears to have roughly the same number as Korea.

Anything beyond this, though, is guesswork—we need some hard data. At the very bottom of the chart, we see the “International Society of Aesthetic Plastic Surgery” listed as a source. After some more rummaging through the internet, I came up with the “ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2010” (the link goes straight to a PDF). Yes, numbers! More numbers than you can shake a silicon implant at! Much of the document consists of tables listing the top countries or procedures in various categories, but the real meat is at the end, on pages 11 and 12, in the table entitled “Total Procedures for Top 25 Countries.” If you’re looking at the PDF now, you’ll see that it lists total procedures for each country and breaks the figures down into numerous categories. The categories we’ll be focusing on, of course, are breast augmentation, breast lift, and breast reduction (women). (Yes, there is a “male breast reduction” category, but thankfully that is well outside the purview of this entry.)

The first thing that stood out to me when I started looking at the figures was the number of breast reduction procedures compared to breast augmentation procedures in South Korea. I decided to do a few calculations to compare South Korea with the US and Brazil (the top two countries in total procedures), and came up with the following little table.

Breast Procedures by Percentage, 2010

US Brazil ROK
Breast Augmentation 58.8 59.1 54.4
Breast Lift 22.4 21.4 19.1
Breast Reduction 18.8 19.4 26.5

You’ll notice that South Korea has a lower proportion of breast augmentation procedures and a higher proportion of breast reduction procedures compared to the US and Brazil. This seems a little counterintuitive. Conventional wisdom holds that Asian women have smaller breasts than Western women, so you would think that, if anything, those numbers would be reversed: Western women and their massive mammaries should be looking to get a little smaller, while Asian women and their petite poitrines should be thinking about kicking it up a notch. It seems that this might not be the case.

However, these are just a few figures plucked from the table—what I was really interested in seeing was how the numbers stacked up for all 25 countries when comparing the number of breast augmentation procedures to total procedures. That is, exactly how “popular” is breast augmentation among people who go under the knife? So I ran through the table and picked out the figures for total procedures and breast augmentation procedures, and I came up with the following list.

Breast Augmentation as Percentage of Total Procedures (by Country), 2010

  1. Australia: 11.3
  2. Colombia: 10.6
  3. Venezuela: 10.2 (10.19)
  4. US: 10.2 (10.15)
  5. Brazil: 10.0
  6. Argentina: 9.9 (9.93)
  7. France: 9.9 (9.88)
  8. Netherlands: 9.7
  9. UK: 9.6 (9.64)
  10. Canada: 9.6 (9.63)
  11. Russia: 9.6 (9.59)
  12. Romania: 9.5
  13. Germany: 9.4 (9.449237)
  14. Spain: 9.4 (9.449235)
  15. Mexico: 9.3
  16. Italy: 9.2
  17. Greece: 9.0
  18. Thailand: 4.9
  19. Turkey: 4.6
  20. Saudi Arabia: 4.5
  21. India: 4.4 (4.446)
  22. South Korea: 4.4 (4.441)
  23. Taiwan: 4.4 (4.406)
  24. China: 4.4 (4.378)
  25. Japan: 4.2

(Note: the primary results have been rounded to one decimal place; the figures in parentheses, though, have been truncated to the minimum decimal place necessary to show the relationship between two adjacent figures.)

The perceptive among you (which is all of you, actually, because all my readers are brilliant) will have noticed something right away. But because a graphical representation can sometimes be more effective, and because I really like making charts, here is a bar graph of the same data that I whipped up just for you.

I have used the two-letter abbreviations for the country names—if you’re not sure about them, just check the list above. The colors are based on the countries’ respective colors in the game of RISK: purple = Australia, orange = South America, yellow = North America, blue = Europe, and green = Asia. Why RISK? Because... why not? It’s no more or less arbitrary than any other color scheme. Of course, a few caveats are in order. For starters, Australia is a bit of an odd duck, because it identifies politically and economically with the Asia-Pacific region, but culturally it has always been a primarily “Western” nation (not counting the indigenous peoples, of course). Turkey and Russia are tricky as well. 97% of Turkey’s landmass is located in Asia, although 12% of its population lives in the 3% of land located in Europe. These days, at least, Turkey identifies with Europe, but I went by where the majority of its land and people are. Most of the landmass of Russia is in Asia, but a vast majority of its population lives in Europe, so I went with Europe for Russia.

The above assumptions are not unassailable (especially the one about Turkey—I love you, wonderful citizens of Turkey! Please don’t send me hate mail!), but if I can be allowed them, the graph shows a pretty striking trend: namely that European and North and South American countries have a much higher percentage of breast augmentation procedures than Asian nations. That wasn’t really what surprised me about the figures, though. Despite my feigned surprise above at the results in the first table, I had already suspected that breast augmentation was a much bigger thing in the West than it is in the East; the focus on large breasts in the West leads to more women being dissatisfied with their breast size, even if the perception is that Western women have larger breasts than Asian women. (I keep hedging on this because I have no solid data, but empirical evidence from my own field work would seem to support this idea.)

Instead, what I found surprising was the grouping of the data: with the exception of large-breast–loving Australia, all of the “Western” nations fall within the 9-10 percent range, and all of the Asian nations fall in the 4 percent range—and there is no in-between. Granted, this table only shows data for the top 25 countries in the world in terms of total procedures, so a more exhaustive study might turn up countries in that 5-8 percent range, but it’s still pretty interesting that there is such a stark gap between the cultural regions.

More important to the matter at hand, though, is the fact that South Korea does not stand out from the crowd when it comes to breast augmentation. It is 22nd out of the top 25 countries, and even among the Asian nations it is roughly in the middle at number five out of eight. So while it may be true to say that breast augmentation procedures are popular in Korea, we should not assume that they are more popular than anywhere else, or even other Asian nations. It would be more accurate to say that plastic surgery as a whole is more popular in Korea than in other nations.

Finally, we are left with the third statement: that breast augmentation is also becoming more popular in other Asian countries, such as China, Vietnam, and Indonesia (specifically, as in the original: “they’re also becoming a hot item for the new affluent women of China, Vietnam and Indonesia”). When I read this statement, I immediately made an assumption: that breast augmentation procedures are more popular in Korea than in China, Vietnam, or Indonesia, but the latter three were catching up. Now, we don’t have data on either Vietnam or Indonesia, but we do have data for China—and at this point I’m getting a little shell shocked, so we’ll just deal with China. As we’ve already seen, breast augmentation was not any more popular in Korea than it was in China two years ago. South Korea’s percentage is slightly higher than China’s but they are roughly the same.

In terms of raw figures, China had more breast augmentation procedures done in 2010, at 55,400; Korea had 34,328. Of course, if you take into account the populations of the two countries, Korea had far more procedures done. In 2010, China’s population was 1,338,300, while Korea’s was 48,875 (another PDF). When you crunch the numbers, you see that Korea had roughly 17 times more breast augmentation procedures. There are other factors to take into consideration, though. According to the World Bank, the GNI per capita figures for Korea and China, respectively, were $19,890 and $4,260 (yet another PDF), meaning that China’s GNI per capita was only 21.4% of Korea’s. Using the PPP method gives China more of a boost, but the GNI per capita is still only 26.1% of Korea’s. Simply put, Koreans on average have higher incomes than Chinese, which means more money to spend on things like cosmetic plastic surgery. The difference in GNI (roughly four to five times) still doesn’t account for the difference in breast augmentation procedures per capita (roughly seventeen times), but once again it would probably be more accurate to talk about plastic surgery as a whole rather than singling out breast augmentation. What we can say is that a roughly equal percentage of all procedures performed in both countries are breast augmentation procedures, and these figures are consistent with the region, so I am dubious of claims that breast augmentation in particular is becoming more popular in China, as opposed to this simply being the result of plastic surgery as a whole becoming more popular. That is, I would expect the above percentages to not change too much even as the raw figures change.

But if we really wanted to determine popularity trends we would need more than one set of data, and I am not about to start rummaging through the internet and crunching more numbers to add to what is essentially a nearly 3,000-word entry on boobs.

Oh, speaking of boobs, I promised you a photo of a pair of North Korean boobs. Here you go:

By the way, I’m going to be out of town for the next two weeks and mostly without an internet connection, so if for whatever reason you decide to comment on this entry and I don’t get back to you right away, don’t take it personally.

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