This article outlines the long-term historical development of body modification in East (Northeast and Southeast) Asia, from the intentionally transformative practices of prehistory, such as tattooing and tooth blackening, to the "naturalistic" practices of the 20 th century, such as cosmetic surgery, which aim to leave no visible evidence of change. Attention is also paid to the recent postmodern revival of transformative body fashions. Asian developments are discussed in global context, and comparative international statistics are provided on cosmetic surgery prevalence. The remainder of the article addresses important questions of interpretation. To what extent does Asia's current cosmetic surgery boom reflect universal processes and experiences of modernity, and to what extent culturally specific desires and developments? To what extent are current Asian beauty ideals and practices, notably the almost universal desire for fair skin, variations on indigenous traditions, legacies of colonialism, products of Western cultural hegemony, or consequences of a broader, cosmopolitan globalisation? A final section asks whether the recent expansionary trend in cosmetic body modification is likely to continue undiminished, or encounter effective forces of opposition in Asian societies.