Ideas such as anti-lookism and body positivity have become increasingly widespread, as has the belief that we should learn to love ourselves as we are. At the same time, however, the cosmetic medicine industry continues to grow year by year, while younger generations in particular are becoming less hesitant about surgically altering their faces and bodies.
Even as society embraces the ideal that people should not be judged by their appearance, the desire to change the way we look remains powerful.
Such choices can be a positive step towards greater self-acceptance. But they may also be the result of unconsciously being bound by standards of beauty constructed by society itself.
Premiering on Netflix on September 17, the Japanese series *Downtime* turns its attention to these tensions surrounding beauty and cosmetic medicine.
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Cosmetic Surgery in the Social Media Age
Cosmetic surgery once carried a far heavier stigma. Beyond concerns about safety, there was also the fear of being judged or gossiped about for having work done. For many, there was a moral dimension to it, too: your body was something your parents had given you, and changing it meant somehow disrespecting that gift.
That stigma has not disappeared entirely, but attitudes have shifted as less invasive, relatively low-risk treatments have become more accessible. Cosmetic procedures are increasingly treated as an ordinary option rather than a drastic decision. More parents are willing to listen when their children express an interest in them, and some even bring their children to clinics themselves.
But the idea that we should simply cherish the bodies we were born with can feel increasingly out of step with life in the age of social media. Our faces are constantly on display. Photos and videos can be taken and shared without our asking, leaving our appearance open to judgment and comparison by others. For someone struggling with the way they look, being told simply to accept themselves can be a difficult thing to hear.
No one else can fully know what it feels like to live with those insecurities. That makes the question of personal choice all the more important—something the Netflix series Downtime brought into sharp focus for me.
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Medicine, Beauty and the Meaning of Care
At the center of Downtime is Aya Numata (Mayu Matsuoka), a gifted plastic surgeon with exceptional surgical skills. While working long hours at a university hospital, she is also struggling to pay off her family’s considerable debts. Firm in her belief that medicine exists to save lives, Aya eventually finds herself forced to leave the hospital after performing an emergency operation in accordance with that principle.
She is then recruited by Rin Toyama (Riisa Naka), a cosmetic surgeon who believes that beauty, too, can save people. Aya has always been skeptical of cosmetic surgery, but financial necessity leads her to take a job at Rin’s clinic, where she begins to encounter the personal struggles behind her patients’ decisions to change their appearance.
The title Downtime refers to the recovery period after a cosmetic procedure, when swelling, bruising and other side effects gradually subside. Rin describes it to her patients as the crucial period before a chrysalis becomes a butterfly—an image that becomes a recurring motif at key moments throughout the series.
Netflix has often turned its attention to worlds rarely seen from the inside: the adult entertainment industry in The Naked Director (2019), for instance, and the world of real-estate fraud in Tokyo Swindlers (2024). With Downtime, it turns its lens on Japan’s booming aesthetic medicine industry.
Japan is often described as the world’s third-largest market for cosmetic procedures, after the United States and South Korea. In 2025, more than 4.33 million cosmetic procedures were recorded in Japan, according to a survey by the Japan Society of Aesthetic Plastic Surgery. Demand for anti-aging treatments such as skin rejuvenation continues to grow, while men’s beauty treatments and the increasingly young age at which people seek cosmetic procedures have also attracted attention. Downtime reflects the latter trend in a scene involving an elementary-school-age YouTuber livestreaming a cosmetic procedure.
South Korea, of course, has long been closely associated with cosmetic surgery. A VAT refund scheme for cosmetic procedures helped attract international patients, including visitors from Japan travelling there for what has come to be known as hada kanri, or skin maintenance. The refund scheme expired at the end of 2025, but the idea of hada kanri has itself helped make aesthetic treatments feel more routine and accessible.
The internet has also played a major role in bringing cosmetic procedures into the mainstream. Instagram and TikTok have made our faces more visible than ever, while influencers—and people who may feel much closer to us—regularly share before-and-after images of their treatments. In the process, procedures that once seemed extreme or remote have come to feel increasingly familiar and accessible.
Concerns about safety have by no means disappeared. Those with firsthand experience often go to great lengths to research doctors they can trust. But the idea of cosmetic procedures as a positive choice — a way of feeling better about oneself — has undeniably become more widespread.
