Across Japan, the most common surgical procedure isn’t liposuction or breast augmentation — the two most popular plastic surgeries worldwide — but eyelid surgery.

According to new data from the International Society of Aesthetic Plastic Surgery, Japan and other Asian countries accounted for more than a fifth of the 1.3 million eyelid procedures performed worldwide.

The trend has grown steadily over the past decade, and it’s led some experts to claim that Asian patients are using the procedure, known formally as blepharoplasty, as a way to turn the Asian “monolid” into the double eyelid of Europeans.

“They want a Caucasian-looking eyelid with a fold or a crease of the upper eyelid, as opposed to the classic Asian lid which doesn’t have what we call a tarsal crease,” Dr. Daniel Maman, a plastic surgeon in New York City, told Business Insider.

Dr. Maman said that roughly 2 to 3% of his patients getting eyelid surgeries are Asian clients looking for the procedure, so it is still rare overall. But every single one that he has referred to a specialist trained in the procedure — he doesn’t perform that specific procedure himself — has cited the desire to look more white as their reason for wanting it done.