This article was originally published on the blog of Medelita Scrubs & Lab Coats:

South Korea is commonly known for being a tastemaker, making innovative contributions that include technology, fashion, television, music and even trends in physical appearance. A $5 billion dollar a year industry, South Korea has the highest rate of plastic surgery per capita in the world, even offering tourists a (10%) off incentive to get the work done.

As a result of harsh political agendas and extreme traditional biases stemming from the North Korean famine of the 1990s, many North Korean refugees often times risk their lives while trying to defect to South Korea, for a fresh start and a new chance at living a happy self-fulfilled life. Repatriation is the last thing any refugees want, facing more abuse, torture, and even execution, adding to the compelling argument for plastic surgery in a land where status and beauty reigns supreme, as seen in this CBS report.

Police departments in South Korea are charged with helping provide health services to former North Koreans after they resettle in the South. Often held captive, tortured, or even killed, many North Koreans refugees seek these procedures to hide or mask scars or marks from a previous life. Kim Kyeong-suk, a police captain in Seoul, began a pro bono plastic surgery program in 2014 through her work with defectors:

“You have to manage and care for North Korean defectors and make sure they’re protected,” said Kim.

The surgery program pairs Seoul’s top surgeons with North Korean defectors who want to remove the literal scars of their past lives but cannot afford to go under the knife for plastic surgery procedures. Dr. Hong Jung Geun, chief surgeon at Metro Plastic Surgery in Seoul’s affluent Gangnam district, plays an active role in the 2-year-old program.

“There are many ways a doctor can contribute to society. One of them is donating talent,” says Dr. Hong Jung Geun, chief surgeon at Metro Plastic Surgery in Seoul’s affluent Gangnam district.

With such a competitive landscape, where everybody has the good grades and all the necessary credentials to win good jobs, plastic surgery has become a common practice in improving appearance and possibly landing the dream career among South Koreans. But for North Korean refugees, plastic surgery is a last resort for removing the scars of their haunted past.