Price, too, is what attracts foreign patients—mainly from Japan, Taiwan and Hong Kong—to Apkujong, a section of Seoul with over 400 surgery clinics. Here, on a busy avenue nicknamed "Plastic Surgery Street," Park Chan Hoon pulls up in his sedan and leads three female passengers into a softly lit lobby decked out in black leather and chrome. A few years ago, the 38-year-old engineering Ph.D. quit a research job to start a travel agency offering plastic surgery tours for the Japanese. Packages include airfare, hotel, sightseeing and, say, a boob job—all for the cost of the procedure alone back home.

Park jokes in fluent Japanese with Satsuki Takemoto, who has traveled to Seoul for shopping and liposuction. The 34-year-old homemaker from Hiroshima pulls out a snapshot of a stunning woman in a red kimono. "That's me 10 years ago," she says. She once weighed 40 kilos; today, after having two children, she's 75 kilos. "My husband says he doesn't care," rasps Takemoto, exhaling cigarette smoke, "but when the kids are mad at me they'll sometimes yell, 'buta'"—pig. Over the years, Takemoto has tried prescription diets, spa treatments, specially-designed slimming underwear—all of which were expensive and none of which worked. Surgery, especially at a decent price, seemed the smart solution. "We told the kids, 'Mommy's in Korea getting her fat sucked out because we don't want her to drop dead from heart failure,'" she says. She takes another drag on her cigarette. "Yeah, they're a little scared."

Kawinna Suwanpradeep, an actress known throughout Thailand for her roles in TV soap operas, wasn't scared. Plastic surgery is no big deal in her line of work, and Suwanpradeep, 32, was less concerned about medical risks than the risk of losing work due to her hefty thighs. When Yanhee Hospital, a Bangkok plastic surgery center, offered her free liposuction in return for a public endorsement, she jumped at the chance. "I figured the doctors were internationally trained, and a lot of stars went there," she says. "I hadn't heard that a lot of things had gone wrong."

She was told she would be able to go home the same day as the operation, "but I had to stay three days," says Suwanpradeep. "I couldn't walk because of the pain and weakness." After the bandages were removed, she noticed wavy patches and scars. The doctor told her they would disappear in a few months, but when they still hadn't healed a year later, she demanded an explanation. "Then his whole tone changed and he said it wouldn't heal—that I would have to have another operation."

Instead, Suwanpradeep went to court: "I can't wear swimsuits. I can't do fashion shoots. And I can't play any sexy characters on television, because at some point they might have to show their legs." The hospital denies responsibility (and declined to comment for this article, citing the pending court case). Disgusted with her courthouse experience, Suwanpradeep is studying for a law degree. "Now," she says, "I'm the poster girl for plastic surgery disaster."

That's a poster that should be plastered around countless back lanes offering cut-rate beauty—especially in Thailand, Indonesia and China, where outdated laws offer scant protection against crooks and incompetents. In Indonesia, a thriving underground of beauty parlors and door-to-door salesmen cash in on perhaps the most rampant and dangerous procedure available in Asia: silicone injections, which are strictly regulated in the U.S. In Asia, silicone is still hawked to plump up noses, breasts and even sex organs like the labia or penis. It works at first, but liquid silicone can't escape the laws of gravity, resulting eventually in an unsightly droop. It can also cause swelling, tissue decay, and—if it enters the bloodstream—death. Transsexuals are often both perpetrators and victims. Two years ago, a transsexual in East Java died after injecting silicone into her breasts. What's more, the injectable silicone typically used among transsexuals is industrial grade—much cheaper and more toxic than medical-grade silicone. "To make even more money," adds Dede Oetomo, a Surabaya-based anthropologist and gay activist, "they heat the substance and mix it with cod-liver oil, lard or frying oil."

Saleha, now 33, received her first silicone injection in 1995 from a fellow transsexual who owned a beauty parlor in Surabaya. Tall, slender and dressed in a tight, white top and matching miniskirt, Saleha would be attractive if not for her ruined nose and chin. After her first cosmetic injection, she wound up with a nose "like Bozo the clown's," she says. So she visited another beautician who pinched and tweaked her nose into shape, then treated her with more injections than Saleha can now count. "I was totally broke after a while," says Saleha, who at the time sold noodles and moonlighted as a prostitute. Gradually, as the silicone shifted, her whole face began to sag and her chin withered. When she speaks, her large hands flutter constantly to her face to perform a furtive, futile massage.

Part of the problem is that it's much harder to exact legal retribution in Asia than in the West, where medical malpractice suits often yield enormous settlements. Most Asian lawyers avoid malpractice cases, since so few result in victory and financial payoff. Above all, though, it's the bargain-hunting instinct that leads patients astray, tempting them to use unqualified cosmetic practitioners. "At the end of the day, the government will have to make a decision on whether to restrict surgery to specialists," says Dr. Woffles Wu, a plastic surgeon at the Camden Medical Center in Singapore. "This is a time bomb waiting to go off."

It may seem reckless to undergo medically unnecessary operations that could disfigure or even kill you. But who's to say that good looks aren't worth the risk? "The Japanese have a saying: 'It's not the face, it's the heart,'" says television producer Koji Kaneda. "But when I asked around, everyone acknowledged appearances count—often more than anything." With that in mind, Kaneda dreamed up a show called Beauty Colosseum that launched last fall. Each week, women pour forth tales of woe, and a panel of beauty experts offers makeover advice. The most desperate cases are referred to the show's "miracle doctor of beauty," Toshiya Handa, a surgeon at the Otsuka Academy of Cosmetic & Plastic Surgery, a chain of 13 clinics across Japan. The regular appearance of tanned, telegenic Handa on Beauty Colosseum has inspired a flood of young TV viewers to sign up for surgery at Otsuka. In 2001, 64% of the patients there were in their teens or 20s.

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