KATHMANDU: Four years ago, Aastha Rai, who asked her real name to be withheld and is now 24 years old, feared that her unusually prominent chin would jeopardize her prospects for marriage. As her confidence steadily eroded under the weight of her facial insecurities, she ultimately chose to pursue cosmetic surgery in a bid to reclaim her sense of self and reshape her future.

The surgeon who reshaped Rai’s appearance was Dr. Manish Bajracharya, an orthodontist at Bir Hospital. He explains that her chin protrusion was so pronounced that the procedure required a comprehensive reconstruction of her facial architecture, including adjustments to the teeth and chin. “After the surgery, her confidence soared. She married soon after and even visited me again following the birth of her child,” he recalled.

During her treatment, Rai showed Dr. Bajracharya a photograph of a Korean actress and asked him to model her transformation accordingly.

A similar fascination with Korean pop culture influenced Niroj Karki, who also asked that his real name be withheld. At 19, inspired by a Korean drama, he tattooed a teardrop beneath his eye. By the time he turned 30 and began thinking about marriage, the tattoo had become an unwelcome reminder of youthful impulsiveness. Seeking a solution, he consulted Dr. Eliz Aryal, a dermatologist at Kathmandu Medical College in Sinamangal, who removed the tattoo through a cosmetic procedure.

Rai and Karki are part of a growing wave of young Nepalis captivated by K-pop idols and Korean entertainers. Many men aspire to emulate members of BTS, while young women aim for the refined aesthetics of Blackpink.

As social media amplifies global beauty standards, young people increasingly chase idealized facial structures and curated looks. Cosmetic surgery and noninvasive enhancement treatments have stepped in to meet this demand, offering the ability to refine eyebrows, reshape noses and lips, adjust teeth and chins, alter ears, and modify nearly any feature, with or without surgery, to approximate their desired appearance.

Cosmetic treatments now offer a wide spectrum of enhancements, from removing moles, warts, and acne scars to repairing torn earlobes and filling post-acne depressions in the cheeks. According to Dr. Bajracharya and Dr. Aryal, such procedures offer a profound psychological lift, helping individuals feel beautiful and bolstering their self-confidence. This, they say, explains the growing appeal of cosmetic correction across age groups.

In Nepal, standard noninvasive procedures include skin tightening, wrinkle and dark-circle reduction, volume enhancement, and overall facial rejuvenation. More structural alterations, such as removing excess skin or fat (excluding the eye area), permanently reshaping the lips, or reconstructing nasal, dental, and chin bones, require surgical intervention. Dermatology addresses concerns of the skin, hair, and nails; rhinology refines the nose; blepharoplasty reshapes the eyelids; and maxillofacial surgery corrects the bones and musculature of the face, mouth, and teeth.

Doctors report that cosmetic surgery and aesthetic treatments are most commonly sought by people between 15 and 50 years old. Many visit clinics to remove facial or upper-lip hair, sculpt or fill eyebrows, tighten sagging skin, or enhance facial radiance. Dr. Aryal notes that treatments such as Botox, fillers, chemical peels, and PRF have become routine in Nepal. “A decade ago, Nepalis had to travel to Bangkok or Mumbai for Botox. Today, better and more affordable services are available here than abroad,” she said.

Social media trends have also shaped demand. Youth between 15 and 25 often seek the so-called ‘glass face’ or ‘baby face,’ while clients above 25 come with diverse aesthetic concerns. Those around 40 increasingly seek age-related corrections. With falling prices and wider accessibility, Botox and fillers have entered the mainstream, extending beyond celebrities to middle-class and lower-middle-class individuals, including artists, media professionals, and influencers, among others.

Dr. Bajracharya adds that the rising availability of high-quality yet economical treatments has drawn an uptick in both domestic and international clients. “Bir Hospital provides excellent care at a low cost, which has attracted foreign nationals as well. This year alone, two Koreans, an American, and a Hong Kong resident sought treatment here,” he said.

Dr. Aryal notes that Nepalis living abroad also seek these services when returning home because the procedures are faster and more affordable. “Botox and fillers are hugely popular among Nepalis who come from overseas. Many bring photos of Aishwarya Rai, Madhuri Dixit, or Gauri Khan and request a baby face. Their luminous complexions, too, are the result of Botox and fillers,” she explained.

Pervasive pressure of social media

Apart from congenital issues or accidents, cosmetic services sought to look beautiful are voluntary. Such voluntary cosmetic treatments have no limits. Dr. Bajracharya’s assessment is that this is increasing dissatisfaction among people regarding the measurements and features of their faces and various body parts. “The definition and standard of beauty depend on the individual’s perspective. For some, a wide gap in the teeth is fine, while for others, even a small gap requires treatment,” he says. “Sometimes, clients with no actual problem come in saying that one side of their face is slightly crooked and needs correction. We try to explain things to such clients by providing psychological counseling.”

Dr. Inku Shrestha, an ENT specialist at Nepal Medical College, states that some clients are still unsatisfied even after undergoing cosmetic correction repeatedly. “One man had rhinoplasty to fix the shape of his nose. He was not satisfied with the first treatment and had a second one done. He came in a third time too,” she says. “That time, we did not treat him; we sent him away after psychological counseling.”

Doctors providing cosmetic services say that the beauty filters on TikTok, Instagram, Reels, and Snapchat are increasing people’s dissatisfaction with their faces and bodies, and the desire for artificial beauty over natural beauty is rising. The pressure and desire to modify the facial template and shape to look good on social media have also increased. Beauty features and filters available on various apps offer only a temporary solution to the anxiety of looking beautiful in videos. Social media’s ‘filter culture’ intensifies the desire for cosmetic improvements by widening the gap between artificial looks and reality. Dr. Shrestha says, “I feel that TikTok, among social media, has influenced many, especially teenage girls. The number of boys is also not small.”

In this era of social media, the psychology of seeking praise and social acceptance from others dominates users worldwide. This is seen even deeper in physical beauty. As a result, cosmetic correction is becoming an important part of the lifestyle of the younger generation.

Dr. Aryal feels that the notion of living in the present has strengthened among the youth generation after the COVID pandemic. She also sees the influence of photos and videos showing people enjoying themselves on Facebook, Instagram, and TikTok in strengthening this concept. What to eat and what movie to watch used to be important; now, fashion and makeup have become crucial subjects. Nowadays, due to imitation, questions about which cream or removal technique to use and which style to adopt are taking precedence. She says, “Nowadays, even parents cannot say no to their children’s desires and mention they had to come because the children insisted. The desires of the youth have increased psychological and financial pressure on parents as well.”

Even for simple ‘hair removal,’ one must visit a hospital or clinic for seven to eight sessions. Regular visits naturally make it expensive. Despite this, the attraction towards beauty and appearance does not seem to diminish.

Social media has given birth to many media persons and social influencers. Many men and women working in professional fields like glamour and media, or in front-desk roles, feel pressured to undergo cosmetic correction. “Many such social media persons and influencers are our clients. They feel pressured to look good in videos,” says Dr. Purnima Rajkarnikar, oculoplastic surgeon at Tilganga Hospital.

Posts that show ‘before’ and ‘after’ on social media and various beauty filters are changing the standard of beauty itself. Sometimes the Korean beauty trend of ‘Glass Face’ catches on, and sometimes it’s Bollywood’s ‘Baby Face.’ The commercial interest of influencers advertising products is also linked to spreading such trends.

Not everything that appears on social media is true; people who post false and misleading information and advertisements for various selfish interests and gains are also there. Falling into the trap of misleading information and advertisements leads many people to be cheated, and some even experience health complications. “One person used a chemical to remove a mole from their body after watching on TikTok, and when they came to me, their skin was burned,” says Dr. Aryal. “No chemical or lotion suits everyone.”

According to her, people used to come only for limited types of treatment before; now, due to social media, there is a demand for new and varied treatments.

Dr. Bajracharya notes that the surge in demand for cosmetic procedures has also fueled the rise of unregistered clinics and unlicensed practitioners across the market. He warns that this proliferation poses serious risks for both clients and legitimate providers. “Many individuals come to Bir Hospital after suffering complications from improper treatments performed at unauthorized centers. Because this field is extremely delicate, strong government oversight and regulation are essential,” he said.

While philosophy often claims that true beauty is internal, the expanding field of cosmetic correction reveals a parallel truth: many individuals feel compelled to pursue external beauty with increasing urgency. For those who perceive themselves as unattractive or are made to feel so by others, the psychological toll can be severe. This emotional burden drives people to invest extraordinary effort, time, and money to alter their appearance in pursuit of acceptance, confidence, or societal validation.

Yet beneath this drive lies a fundamental question: How sustainable are these escalating efforts to meet ever-shifting standards of beauty?

Dr. Shrestha cautions that undergoing cosmetic surgery or corrective procedures solely to increase one’s prospects for marriage can later destabilize the marital relationship itself. Motivation rooted in external pressure, he notes, often leads to long-term emotional strain.

Dr. Aryal describes cosmetic treatment as less of a necessity and more of an emerging dependency. She explains, “The enhanced facial radiance that appears during treatment begins to fade the moment the procedures stop. With that decline, self-confidence also diminishes.”

Consequently, her counsel is that individuals should invest minimal resources in superficial adornment and prioritize maximizing their investment in education and skill development, which she believes yields far greater long-term benefits for both the individual and society at large.