As South Korea draws visitors chasing beauty, dodgy practices pose risks | Business and Economy News

Seoul, South Korea – When Alex looked at the price difference between rhinoplasty, known as a “nose job,” in the United States and South Korea, she thought traveling to the Asian country for surgery was a no-brainer.

Alex, who asked not to be referred to by her real name, told Al Jazeera: “$30,000 or $6,000, the choice was clear,” describing her decision to undergo the procedure in the country “known as number one in plastic surgery.”

But less than a year later, the artist found herself suffering from serious complications.

The implant from the surgery began to protrude through her skin, necessitating its emergency removal back in the United States.

“If I knew what I know now, I would never do it,” she said, sounding sad as she described her ongoing struggle with complications, including a crooked nose and a visible piercing that required corrective surgery.

“I don’t think I will go back to Korea for surgery because of this.”

South Korea has the highest rate of plastic surgery procedures per capita in the world, according to Expert Market Research, with a market worth $1.7 billion in 2023.

The sector is expected to grow to $5.19 billion by 2032, driven by the global popularity of Korean pop culture, or Hallyu, which has popularized Korean beauty standards and increased interest in Korean cosmetic procedures around the world.

In the capital, Seoul, the upscale Gangnam area is full of clinics and hospitals specializing in cosmetic procedures and surgery, offering everything from double eyelid surgery to facial contouring, liposuction and breast augmentation.

While they also cater to local customers, international patients represent a very profitable part of their business.

Last year, South Korea attracted 605,768 non-resident foreign patients for medical services, according to the Ministry of Health and Welfare, with the highest numbers coming from Japan, China, the United States and Thailand.

Plastic surgery represented 16.8% of operations – more than 114,000 surgeries – making it the second most in-demand medical specialty after dermatology.

But with glossy marketing and social media videos attracting medical tourists from around the world, foreign patients face a plethora of barriers to accessing information, misinformation and deceptive practices, putting their health at risk, an Al Jazeera investigation has found.

One of the biggest challenges facing medical tourism is the language barrier.

In major markets such as China and the United States, potential patients often turn to a variety of online platforms for advice, including open chat groups, Reddit pages, and even specialist forums ostensibly dedicated to topics such as designer handbags.

These murky digital spaces are filled with anonymous users discussing procedures while exchanging clinic and doctor recommendations, procedure tips, so-called blacklists and translator contacts.

The abundance of unverified information and lack of accountability makes it difficult for users to distinguish real experiences from potentially biased accounts or covert ads.

It is also a hunting ground for illegitimate brokers who can earn large commissions for simply referring clients.

While soliciting foreign patients is legal, it requires a government license. Eligible companies must have a registered office address in Korea, maintain a specified share capital and carry insurance.

Hospitals face more stringent requirements to be able to legally accept foreign patients, including having at least one specialist per medical department and higher levels of medical malpractice insurance.

Posing as a potential patient on a number of platforms, Al Jazeera was contacted within minutes by anonymous facilitators who admitted they did not have the required certification.

In 2020, the dangers of the industry were highlighted when Bonnie Evita Lo, heiress to a Hong Kong fashion empire, died while undergoing liposuction at a Seoul clinic.

The law was reportedly introduced to the hospital through an illegal intermediary.

The operating surgeon, who later turned out to be an orthopedic specialist and not a plastic surgeon, was charged with professional negligence resulting in death. The outcome of the case has not been revealed publicly.

While only certified specialists can officially name their practices as “plastic surgery clinics,” any licensed doctor in South Korea can legally perform plastic surgery because Korean medical law does not restrict doctors to only work in their field.

In a more recent case, a Chinese woman died in January shortly after undergoing liposuction surgery at a clinic in Gangnam.

The problem of Chinese plastic surgery patients falling victim to unscrupulous and unsafe practices has become so widespread that in January the Chinese embassy in Seoul issued a notice warning its citizens to “be wary of advertisements and risks” and “choose intermediary agencies carefully.”

The Ministry of Health and Welfare, through the Korea Health Industry Development Institute (KHIDI), operates a reporting center for illegal solicitation of foreign patients.

The number of reports has increased significantly – from 11 cases in 2021 to 16 cases in 2022, and then to 59 cases last year.

A KHIDI official, who spoke on condition of anonymity, said, “Cases that are treated as suspected violations are subject to follow-up measures such as fines and penalties.”

“Those who are confirmed to be illegal lures are administratively disposed of by local governments in accordance with the law,” the official said.

However, when pressed for details on how many cases had actually been investigated or handled, the official did not provide figures, merely stating that the number would “inevitably be lower” than the number of cases reported.

Kang Ki-yeon, a lawmaker from South Korea’s ruling People Power Party, last year raised concerns about the lack of clarity around the handling of the cases, suggesting that despite the increase in reports, there appeared to have been little follow-up action.

“It is a national shame that foreigners seeking world-class medical technology in our country fall victim to unethical practices by some medical institutions,” Kang said, calling for stricter management of such cases.

The deceased Hong Kong heiress, who spoke on condition of anonymity, expressed concern about the risks associated with surgeries abroad.

“With social media highlighting the beauty industry in Korea, people are treating surgical procedures in Korea as casually as cosmetic treatments. They should be aware of the risks and difficulties of resorting to asylum if complications arise,” Al-Siddiq told Al Jazeera. .

Another concern is the spread of misleading and potentially illegal reviews.

While the Korean Medical Advertising Law prohibits the use of influencers for testimonial marketing, the practice is widespread, especially with regard to foreign patients, which complicates implementation.

Al Jazeera reviewed a contract requiring a foreign influencer to produce multiple promotional videos and social media content about a plastic surgery clinic in exchange for free surgery, with the clinic dictating specific positive language to be used in posts.

The clinic required the influencer to produce content before the final results of the surgery were known, required that he review all content before releasing it, and included confidentiality terms that effectively prevented the sponsored nature of the surgery from being revealed.

The influencer provided the requested content but expressed reluctance to use specific positive language required by the hospital because she was not satisfied with the results of the surgery.

The hospital claimed that she had not fulfilled her agreement and demanded that she pay for the surgery and other associated costs, including the airfare.

However, according to her lawyer’s correspondence, these threats suddenly stopped when the hospital was reminded of the illegality of such practices under medical advertising laws.

“Conveyor belt”

The case is not isolated

Al Jazeera spoke to three patients who claimed they received discounts in exchange for positive reviews.

It is possible to seek damages for a “medical incident” where “damage is caused to a person’s life, body or property by reason of the medical practice of a health care provider” through dispute mediation, but both sides need to agree to arbitration.

Alternatively, a lawsuit can be filed, but the process can be long and expensive.

Many large clinics boast on their websites that they are “accident free.”

Such claims are difficult to verify, because patients who share their negative experiences publicly may face legal consequences under South Korea’s defamation laws, which can punish even true statements.

Alex, an American who traveled to South Korea to undergo rhinoplasty, said she found herself rushing to undergo the surgery within an hour, despite reservations and the absence of an internal translator.

After surgery, she suffered serious complications, including disfigurement due to the implant protruding through her skin, necessitating emergency surgery for removal in the United States.

“I felt abandoned, as if I was on a conveyor belt,” she said.

“Once they did the surgery, they didn’t want to deal with me anymore. They kept saying I was still recovering when they knew something was very wrong.

Frustrated by inadequate aftercare and unable to get a refund, Alex wrote a photo review on the Gangnam Unni app, a popular plastic surgery review platform marketed as Unni outside of South Korea.

Eager to avoid negative publicity, the hospital offered a full refund, but only after she agreed to delete the review and signed a confidentiality agreement.

The document, which Al Jazeera viewed, prevents it from discussing the contents of the agreement and testing it on any platform, and failure to adhere to it leads to the imposition of financial penalties on it.

On Gangnam Unni, users can only sort reviews by ‘Recent’ or ‘Recommended’, with no option to filter from lowest to highest rated, making it difficult to find negative reviews.

Al Jazeera reached out to Healing Paper, the company behind the app, for comment on its handling of negative reviews and putting pressure on patients to remove critical comments, but received no response.

Although risks exist, many patients have positive experiences with plastic surgery in South Korea, and efforts are being made to improve safety and transparency in the industry.

One such initiative is the Gangnam Medical Tourism Center, run by the Gangnam District Office in Seoul.

As a public entity, the Center does not receive commissions or provide referrals, but instead aims to help foreigners navigate the system and connect with professional, licensed medical translators.

The center maintains a list of vetted medical institutions, providing an additional layer of security for foreign patients looking for reliable care.

As part of its audit, the center verifies that hospitals are registered to treat foreign patients, have specialists in each department, maintain appropriate malpractice insurance, and have adequate facilities and staff to handle emergency situations.

The center also conducts field inspections of partner institutions and provides training for medical translators.

An official at the center stressed the importance of careful study when requesting medical procedures abroad. “We advise patients to prioritize their health and safety above all else.”

“Although cost is an important factor, it should not be the primary consideration when choosing a medical service provider or procedure,” the official told Al Jazeera, requesting anonymity.

Jeet Dhindsa, who runs a licensed medical tourism facilitation company that has also helped patients who have fallen prey to illegal brokers and deceptive practices, stressed the importance of doing due diligence. “It is important to verify the credentials of medical facilities and any intermediaries involved in the process,” Dhandsa told Al Jazeera.

“It’s always best to contact people who are transparent about who they are.”

“Make sure you have someone who can advocate for you if things don’t go as planned,” Alex said, reflecting on her experience.