Why Everyone Needs To Calm Down About "Korean Perma-Smile" Surgery

Nicole Karlis on 5 Sep 2013 at 9:00am

The MD behind the so-called 'Smile Lipt' surgery explains it (and himself). Oh, and by the way -- a US doctor started doing it years ago.

The usual media wags got their noses out of joint last week expressing the same tired outrage about the latest (supposedly new) cosmetic procedure from South Korea, the "Smile Lipt" -- a surgical procedure designed to lift the corners of the mouth to give dour Korean mouths at least the hint of a smile. 

Slate called it a "facial straightjacket." Quartz said it was "plain terrifying" and likened the procedure to being brutally slashed by Irish gangsters. Business Insider described the results as "Joker-like." 

As with many foreign cosmetic surgeries (see calf implants, eyelid surgery, and chin implants), the understanding of the "Smile Lipt" was merely skin deep.

With the exception of Korea Real Time, no one bothered to talk to the Korean surgeon who does the procedure. And though Dr. Kwon Taek Keun tells RealSelf he has made advancements to the procedure and has patented it, it's actually been done in the US for years -- it's known as valentine anguloplasty and it was pioneered by Dr. Robert Flowers, a Honolulu surgeon who retired in 2009. 

Dr. Kwon, at Aone Plastic & Aesthetic Surgery in Yongin (near Seoul) says, via email, that he performs the surgery on about 45 patients a month -- 10 per week on average, and has been for well over a year. Patients range from women in their 20s to 60s, from all around the world-- including Australia, Indonesia, Kazakhstan, Italy, Japan, and China. Satisfaction, says Kwon, is very high. 

"These days more women want to work and attend social activities,” Dr. Kwon tells RealSelf, adding the trend is rising in popularity in Korea because “the effectiveness is very good.” What's more, says Kwon, “There has been an increase of men receiving this surgery,” he tells RealSelf in an email.

To be clear, the procedure has been done in the US since as long ago as 50 years. A former employee of Dr. Flowers, who worked for him for 18 years, tells us the procedure was very popular and his patients ranged from those in their 20s to 80s.

"Patients loved it. They were happy with it. If they had downward-turned corners of the mouth, it was a great procedure to do," his former employee says.

Facial plastic surgeon Dr. Michael Ondik, who practices in Langhorne, Penn., tells us he’s never had a patient ask for the procedure.

“The procedure I’m seeing described now is not something that patients are coming and asking for yet. It’s fairly new to elevate lip corners to this degree. The lips, like the eyebrow, are very stylistic and subject to trends,” says Dr. Ondik.

Dr. Ondik points out fixing the corners of the mouth is a procedure that’s associated with anti-aging in the United States, too. 

“We do frequently improve the corners of the mouth, using Botox and filler to elevate the corner. However, we are usually treating someone who has downturned corners, usually from aging," he says. “This is a trend in [South Korean] younger patients. They’re not fighting aging, they’re looking for a very stylistic appearance.”

However, Dr. Chase Lay, a facial plastic surgeon whose cosmetic practice is 90 percent Asian, doesn’t see this as an example of plastic surgery innovation.

"This seems like it may be more experimentation than innovation.  Procedures similar to this have been performed multiple times in recent history with mixed results," he says. "I would definitely want to see more information about how the procedure is performed before I would recommend it to my patients."

Dr. Lay says he wouldn't do the procedure and says, in particular, scarring is a risk patients need to consider.

Kwon responds to his critics, both media and medical, by saying they're not seeing the entire picture.

“This criticism is being received because only the mouth is looked at," he says. "If you look at the whole face, you can see that their image becomes softer and brighter." And Kwon understands why American doctors and consumers might raise an eyebrow: "Usually, people think things are strange when they first encounter it. However, as time goes by, people will know it as a unique procedure."

Beverly Hills surgeon Dr. David M. Alessi, like Dr. Lay, says he hasn’t had patients ask for this surgery -- but that doesn’t mean it can’t be done, or won’t be a trend we’ll see in the future.

“We do smile corrections all the time with Botox," says Dr. Alessi. "For some of our Botox patients ... they request a more permanent solution where we remove the muscles that Botox targets. There is no reason it can’t be done."