Medicine: Gaining Face in Japan

Clip-clopping on high heels, a smartly dressed girl turned into a narrow alley behind Tokyo’s famed Ginza one morning last week, passed half a dozen tawdry sake shops and headed for a three-story building with an imposing marble entrance lettered in gold: “Jujin Hospital.” Smaller but more significant was the legend: “Home of the Japanese Society of Cosmetic Medicine.” By going to Jujin, patients can not only gain face but new faces.

The girl was pretty, but like most Asians she had a heavy-lidded look. At their widest, her eyes did not appear to open as wide as a Caucasian’s; half-closed, her lids showed no crease or fold running across them, and her lashes always pointed down. Like other Japanese girls, she had been impressed by the postwar flood of U.S. movies and magazines. Instead of the traditional Japanese ideal of beauty—sloe-eyed, smooth-featured, flat-chested—many of them want to be more like their Western cousins with high noses, round eyes, curly lashes and prominent busts.

Roll Back the Lid. It was 10 a.m. when Tomiko took her place in the busy waiting room. Within 15 minutes she was explaining to a doctor that she would like a double eyelid operation. Examination showed no reason why the girl should not have the operation (technically, blepha-roplasty). A nurse rubbed a local anesthetic ointment onto her eyelids. By 10:45 she was in the operating room.

With a small hypodermic, the surgeon injected a second anesthetic, procaine, into the upper eyelid. A nurse peeled the lid back. The surgeon gripped the muscle on the inside of the eyelid with pincers, pulled it out slightly, and clamped it to the skin near the roots of the lashes at the edge of the lid. Then, with hair-thin nylon thread, he stitched the muscle down. The eyelid was rolled back, covered with a cold cloth as the surgeon went to work on the other eye. Total operating time: five minutes.

Tomiko waited half an hour in the recovery room for the anesthetic to wear off, was again examined by the surgeon. He explained that her eyes would be puffy for a day or two, asked her to return each of the next two days for a check. At 11:30 the girl walked to the cashier’s window in the lobby, paid $8.33 —full price of the operation. The change in Tomiko’s face was marked.

Rounder & Bigger. What Westerners think of as the slanting set of Orientals’ eyes cannot be entirely changed by minor surgery, but it becomes less conspicuous after the eyelid operation; by exposing more of the eyeballs, the operation makes the eyes seem rounder and bigger, also forces the eyelashes from slanting downward to pointing upward. Within a couple of days, Tomiko was telling her friends: “You’ve got to go, too. It’s so simple, it’s almost unbelievable.”

Had the patient been her mother’s age, with bags under her eyes, she could have had these removed for $13.88. Building up the bust, sometimes done with tissue injections of which U.S. surgeons strongly disapprove, costs $55 to $83. The Jujin surgeons’ success is attested by the fact that they do 20,000 cosmetic operations a year—70% on the eyelids, 20% to build up the bridge of the nose, often with a plastic insert (which costs.$27.77).

The Jujin’s eyelid surgery technique was devised by the hospital’s director, Dr. Fumio Umezawa, 52, who got into plastic surgery after his own child was disfigured in an accident, needed extensive reconstruction. “The thing I like best,” says Umezawa, “is to stand at the door and watch the faces of the patients as they leave. The happiness they feel enhances the work we have done for them. They look beautiful!”