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Kylie Jenner has a face that launched a thousand luscious lips and her sister Kim Kardashian has a behind that launched a thousand Brazilian butt lifts (BBL).

In this B-Side episode, Dr. Patrick W. Hsu, the plastic surgeon responsible for Filipino actress Michelle Madrigal’s breast implant removal, talks to BusinessWorld reporter Patricia B. Mirasol about the evolving standards of beauty in the age of Instagram.


Beauty standards are evolving: the derriere is now as important as the face. 

“Asian cosmetic surgery ten years ago was mostly focused on facial aesthetics,” said Dr. Hsu, pointing out the popularity of procedures that make the nose pointier and the eyes more deep-set. 

“Now, it’s also about a body that’s curvier.”  

South America was an early adopter of Brazilian butt lifts (BBL), a procedure that augments the derriere with fat removed from other parts of the body. 

“They were more into having round buttocks; Americans were more into breast augmentation,” he said. This has since changed within the last five to ten years, with BBLs now also gaining popularity in both the US and Asia.   

The global plastic surgery market is expected to grow at a compound annual growth rate of 3.5% during the forecast period of 2022–2029, per Data MIntelligence, a market research and consulting firm. While North America has the largest market share, the Hyderabad-based firm projects Asia Pacific to be the fastest-growing segment because of less stringent regulations, an increasing awareness on plastic surgery, and a growing population. 

Dr. Hsu, who practices in Houston, Texas, charges $15,000 for a BBL. He plans to expand to either Manila or Singapore because of the number of clients from Asia who opt to fly to his US clinic for such a procedure. 

“The ideal patients are a bit overweight, so you can suction off the fat — typically the torso — and inject it to the buttocks,” he added. 

Instagram influencers like the Kardashians play a role in how people perceive beauty… 

Love them or hate them, but this trend of wanting a fuller behind is “mostly driven” by the Kardashian family, who shot to fame through their reality TV series, according to Dr. Hsu. 

BBLs are gaining popularity in Asia because a round buttocks isn’t typical in the Asian physique, he said. 

“Look at lip fillers,” he added. “Kylie Jenner [the youngest of the Kardashian family] spawned that.” 

Dr. Hsu estimates that 95% of his business is generated from Instagram; clients have to wait more than a year to see him.

“Instagram … has given me a worldwide reach. It’s elevated everybody’s game, [because] you post your results there. You can’t hide behind marketing anymore.” 

… and these social media comparisons can heighten anxieties. 

Social media has its pitfalls, acknowledged Dr. Hsu. 

“A lot of mental health is tied into social media,” he said. “People paint these perfect lives. It’s a fantasy world they’re portraying … and yet young people look at it and think it’s normal.” 

Social media, moreover, can be a challenge for individuals already suffering from Body Dysmorphic Disorder (BDD), a mental health condition characterized by obsessive thoughts of one’s perceived physical flaws. 

The main difference between insecurity and BDD is that the latter affects one’s life, Dr. Hsu said. It’s about having an unrealistic expectation of how one looks. 

“If you’re insecure, you might be shy about your toes or your hair, but it doesn’t affect your life,” he said. A person with BDD, on the other hand, might have an “almost perfect nose” and still think it’s not a good enough nose. 

“It’s consuming their life, and [the flaw] is so slight,” said Dr. Hsu. 

Recorded remotely in August 2022. Produced by Joseph Emmanuel L. Garcia, and Sam L. Marcelo.

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