The series is based on a webtoon of the same name published by Naver in 2016, and its title refers to the derogatory Korean term 'gangnammiin' used for people who look like they've had extensive plastic surgery to achieve a pretty face or hot body.

The show was written by Choi Soo-young, who had previously written the series Cunning Single Lady (2014).

The first script reading took place on May 30, 2018, at the JTBC building in Sangam-dong, Seoul, South Korea.

In an example of stunt casting, actress Lee Young-ae and mountaineer Um Hong-gil made special appearances playing themselves as alumni of Korea University, in the departments of German literature and physical education respectively.

The drama was praised for its portrayal of South Korean society's superficial beauty standards and discrimination based on physical appearance, as well as for its thoughtful depiction of the main character's childhood.

As a reward for the show's success, the cast and staff went on a vacation to Cebu, Philippines, for four nights and five days starting October 19, 2018.

A Japanese adaptation of the series, titled I'm a Cosmetic Surgery Beauty, was set to premiere on December 26, 2024, starring Kyoya Honda and Anna Ishii in the lead roles.

Lead actor Cha Eun-woo contributed to the original soundtrack by singing the track 'Rainbow Failing', released as Part 7 on August 31, 2018.