South Korea occupies a singular position in global cosmetic surgery statistics: it is widely regarded as having among the highest per-capita cosmetic surgery rates in the world, while the International Society of Aesthetic Plastic Surgery’s 2022 global survey ranks it among the leading countries by total procedure volume and plastic-surgeon count. Double eyelid surgery (blepharoplasty) and rhinoplasty are commonly given as graduation gifts, and cosmetic procedures are openly discussed in mainstream Korean workplaces and social media in ways that would be unusual in most other countries. In this context, the decision to undergo surgery is less purely elective and more a response to a structured social norm: not modifying one’s appearance carries a visible and documented social cost in specific demographic segments, particularly among women in their 20s in Seoul and other metropolitan areas. A 2014 Korea Consumer Agency survey of 1,000 cosmetic surgery patients found that 32.3 percent were dissatisfied with their results, with 17 percent reporting adverse physical outcomes including asymmetry, scarring, and infection. A peer-reviewed study in Aesthetic Plastic Surgery (2018/2019) found that 37.6 percent of sampled Korean women in their 20s had already undergone at least one cosmetic procedure — most commonly eyelid surgery (90.5 percent of surgical cases) — at a mean first-procedure age of about 21.8 years, and that acceptance of cosmetic surgery correlated negatively with appearance satisfaction while social comparison and appearance-related pressure predicted the decision to undergo surgery.
The inaction side of this decision is documented through Korea’s appearance-discrimination (woemo jisangjuui, or “lookism”) research rather than through direct regret surveys. A 2017 study in the International Journal for Equity in Health (Lee, Son, Yoon and Kim) analysed 2,973 Korean emerging adults aged 18 to 25 and found that 8.3 percent reported lifetime appearance discrimination — 2.5 percent “repeated” and 5.8 percent “incident” — and that those reporting discrimination had roughly three to four times the odds of poor self-rated health (repeated OR 3.70, incident OR 3.10). Women reported more discrimination than men, and the demographic most exposed overlaps with the cohort facing the highest pressure to undergo cosmetic procedures. The approximately 8 percent inaction-side estimate is the prevalence of reported appearance discrimination in that study, used here as a proxy for the social cost borne by those who do not conform to surgical beauty norms; it measures discrimination experience and its health correlates, not decision regret directly.
The Gilovich action-dominance pattern here holds, with a regret delta of 0.24. Both sides nonetheless carry real costs: surgery under social pressure introduces measurable risks of outcome dissatisfaction and procedural harm (roughly a third of patients in the 2014 survey called their results unsatisfactory), while declining surgery in a norm-saturated environment exposes a minority to documented appearance discrimination and its associated health burden. The construct on each side is a proxy — outcome dissatisfaction on the action side, discrimination prevalence on the inaction side — rather than a direct decision-regret survey, so the delta should be read as indicative rather than precise. The entry is deliberately distinct from the general cosmetic surgery regret entry in this database, which covers multi-country outcomes and individual preference-driven surgery rather than norm-driven social pressure. The Korean context changes the calculus because with cosmetic surgery normalized enough that 37.6 percent of sampled women in their 20s had already undergone a procedure, non-participation is a deviation from peer norms rather than a neutral default, which shifts the psychological framing in ways captured neither by international cosmetic surgery outcome data nor by general Korean surveys that do not distinguish norm-driven from preference-driven procedures.