Like other Kyrgyz women, Madina* has often dreamed of having deep-set eyes. After a few months pondering, the 57-year-old decided to fulfill her dream and signed up for a “blepharoplasty” procedure, or double eyelid surgery.

“I have been embarrassed about my eyes my whole life. Because of them, I don’t feel confident talking to people,” she told openDemocracy a few minutes before the procedure.

Madina hopes that, after 90 minutes under the knife, her eyes will look more “European” and “expressive”, boosting her self-confidence.

A popular procedure in Kazakhstan and South Korea for years, blepharoplasty consists of changing the eye shape by removing some of the skin around it and adding an upper eyelid crease to Asian eyes. In Kyrgyzstan, a traditionally Muslim country with a secular state, so-called “euro-eyelids” are booming, especially among younger women.

“When I was young, there were no such operations, but today it has become more accessible,” Madina explains. While there were only a few surgeons available at the beginning of the 2000s, their number has now jumped to around 25 in Kyrgyzstan’s capital, Bishkek, where Madina lives, making it easier for patients to change their look for a price ranging from 200 to 500 USD. On Instagram, by far the most popular social network in the country, a dozen clinics in Bishkek advertise their work with appealing before and after photos.

“Some patients can do it to alleviate physical discomfort because their lids bother their sight, but most women come for aesthetic reasons,” says doctor Shamil Salpagarov, the surgeon who performed Madina’s operation.

There is no official data on the number of people who undergo surgery in Kyrgyzstan, but Salpagarov’s clinic alone performs about a thousand a year, 80% of which are blepharoplasties. These statistics would surprise many, given that the average monthly wage is approximately 230 USD. According to the World Bank, only 29% of the population in Kyrgyzstan is financially secure, while the remaining 71% is considered either poor or vulnerable to poverty.

According to Davlatbegim Mamadshoeva, a gender studies researcher at Bielefeld University, the boom in plastic surgery illustrates the growth of a globalised urban elite with individualised concerns. “Plastic surgery is more widespread in the north of the country not because it’s more accepted, but because it’s more accessible and people are ready to invest in it there,” she explains. Blepharoplasty is relatively affordable compared to other types of plastic surgeries like breast augmentation, which costs around 2,000 USD.

Competing narratives on beauty

“European eyes are big, they make your expression seem more open. They’re beautiful, they can’t be compared to Asian eyes,” Madina said before entering the operating theatre.

While Blepharoplasty is quite common in Bishkek, Madina decided not to tell her relatives about it, fearing their reaction. She feels the procedure is more accepted among women, especially younger women, because, she claims, “there is a mutual understanding. Women want to improve themselves and look more beautiful.”

Among Madina’s friends and family, only her daughter Bermet* was aware she was having surgery. A 24-year-old marketing specialist, Bermet underwent the same procedure last year, after four months on a waiting list. Now, she says she feels more confident and often goes out without wearing make-up.

“At the beginning, my mom was against it, she was saying that ‘natural beauty is better’,” Bermet recalls. “But after I went behind her back and did it, she decided that she wanted it too.” The women’s relatives have become accustomed to their new eye-shapes, and are enthusiastic in their approval.

The patients and surgeons openDemocracy talked to agreed that the Kyrgyz public opinion is divided on plastic surgery. “There are so many competing narratives on how you should look and invest in your look as a Kyrgyz woman,” Mamadshoeva points out. She says women are pressured to choose between contradicting narratives in terms of beauty standards: the new Muslim beauty standard, which is booming with the growth of Muslim fashion, the ethnicised “traditional beauty” narrative, and the “globalised modern beauty” model.

Blepharoplasty falls into the last category. Since Kyrgyzstan gained independence in 1991, women’s bodies and appearance have become important sites for negotiating national identity in contentious political and social debates. “In the more conservative spheres of society, the rural bride’s ‘natural’ beauty’ is often contrasted with urban women in Bishkek, who are considered to be spoiled and fake,” Mamadshoeva argues, adding that plastic surgery is considered haram, or forbidden, in Islam.

“The fact that women don’t talk very openly about their surgeries might mean that they want to allow themselves the space to fit into those nationalist narratives on ‘natural beauty’ and not be judged,” says Mamadshoeva.

Beauty standards, self-improvement and Instagram

Born and raised in Bishkek city centre, Jannat, a dentist, was pushed hard to undergo blepharoplasty at the age of 23 by her aunts. Without asking her permission, Jannat’s aunts signed her up for a first appointment.

“I didn’t resist much because it was the kind of age when you have a lot of insecurities, when you want to change something but you don’t know what,” Jannat told openDemocracy in a cafe near her house. “It was the right moment for them to push me.”

The next day, the shape of Jannat’s eyes was completely different after a painful 40-minute surgery. Usually, a double eyelid surgery lasts at least an hour.

“I guess they thought I would feel better and more confident,” Jannat says, adding that her mother had died a few years earlier and her father “didn’t want to meddle in this ‘beauty stuff’”. When asked if she is resentful towards her aunts for the surgery, Jannat says that she tries “not to be too negative” about it because “anyway, it’s already done.” After her blepharoplasty, her last remaining aunt with natural eyes and her sister underwent eyelid surgery, too.

In Bishkek, local feminist organisations try to warn against plastic surgery. According to Guliaim Aiylchy, president of Bishkek Feminist Initiatives, plastic surgery is the tip of the iceberg when it comes to problems of self-confidence among women.

“I believe that if a woman wants to do something with herself, it is her right,” Gulaim explains. “But I would like them to understand why they want this. What is the purpose? To become prettier? By what standards are they evaluating beauty? We must work to ensure women begin to value themselves and ask themselves these questions.”

Not all Asians lack an upper eyelid crease. But, it is especially common in Korea, China, Japan, Kyrgyzstan and Kazakhstan. Plastic surgery has been on the rise in these countries and some Western scholars and media outlets like The New Yorker and CNN attributed it to the fact that Asians want to look ‘white’. But according to doctor Isken Kachkinbayev, one of the first plastic surgeons to work in Bishkek, this theory doesn’t explain the motives behind Kyrgyz women’s decision to have surgery.

“People who undergo surgery here don’t want to become European, they just want to improve themselves because they are given the opportunity to,” Kachkinbayev told openDemocracy.

This is a shared view among scholars researching the topic in South Korea, where it is estimated around 30% of women in their 20s have had some kind of plastic surgery. “Receiving plastic surgery can be an attempt to live a Westernized life - that is, a modern, affluent life - rather than to have a Caucasian body itself. Beauty is a significant resource for social mobility, and plastic surgery is a technology of self-improvement,” Korean scholar So Yeon Leem argued in an article about plastic surgery in Seoul.

As in most countries, beauty in Kyrgyzstan can be considered “a commodity you can invest in, especially to have better luck in the marriage market,” Mamadshoeva points out.

Indeed, both doctors Salpagarov and Kachkinbayev agree that it is common for women to have blepharoplasty in order to get married. However, self-improvement in terms of beauty does not just mean plastic surgery. Skin whitening products (unanimously considered dangerous by experts), eyelid tapes, and fake eyelashes are selling well in Bishkek cosmetic shops. According to Aiylchy, of Feminist Initiatives, Korean culture plays a great role in this trend. “Our women give in to the influence of Korean models because the external resemblance makes it easier for us to identify with them,” she suggests.

But for Jannat, the reason for the increasing number of blepharoplasties can be summed up in one word: Instagram. “I feel like every time I open it, it’s just make-up,” she says, irritated. “It’s so frustrating. You see all these influencers and models, and you can’t reproduce their make-up because of your eye shape.”

The platform was launched in Kyrgyzstan six years ago and now has 1.7 million active users, 80% of which live in Bishkek, according to the most recent statistics. “Before, we used to get in touch with patients through phone and ads in the press,” recalls doctor Kachkinbayev, who has been in the business for 18 years. Now, instead, he promotes his posts and receives daily messages from clients on WhatsApp and Instagram, where his professional account has more than 35,000 followers.

“Clinics have discovered that Instagram is the cheapest and most effective way to advertise themselves,” says Marina Kim, a blogger and communication specialist who also believes that the boom of plastic surgery is closely linked to social media. Bishkek clinics are so popular that patients fly over from other parts of the country or even from abroad to undergo blepharoplasty procedures.

While doctors and nurses have one of the lowest paying jobs in Kyrgyzstan’s public sector, plastic surgery can be very lucrative. One doctor has now even started performing them in Osh, in the country’s more conservative south.

Meanwhile, back in Bishkek, I spoke to one student who has no doubt about her specialisation at medical school. “It’ll be plastic surgery,” she says, “because in the healthcare field, that’s where you can make the most money.”

*These names have been changed to protect identities on request.