Surge in Cosmetic Medical Complications: Doctors Warn of Severe Consequences, Including Death

People ranging from their teens to their 80s are suffering

Please first take a look at the photo above. The painful scars on this woman, who appears to be a victim of a traffic accident, are actually caused by the aftereffects of cosmetic surgery. The woman sought treatment for her aftereffects at the Nihon Medical University Hospital’s Cosmetic Surgery Aftereffects Outpatient Clinic, where many patients visit daily for consultation. Dr. Rintaro Asahi, a specialist in plastic surgery, is at the forefront of this clinic and explains:

“This is a complication following hyaluronic acid injections. Hyaluronic acid is a popular treatment for improving wrinkles and sagging, but in rare cases, a complication called vascular occlusion occurs. This happens when hyaluronic acid enters a blood vessel, blocking blood flow, which can result in serious complications such as blindness and skin necrosis.”

In recent years, cosmetic medicine has exploded in popularity. Influencers openly confess to having surgery, and glamorous advertisements from cosmetic doctor’s flood social media. While more people are casually seeking cosmetic treatments, there is also an increase in individuals suffering from aftereffects and medical accidents.

Dr. Asahi mentions, “The number of patients has increased more than fivefold in the last five years.”

“Patients range from their teens to their 80s. There are cases where eyelids won’t close, noses are deformed, chronic pain and numbness following liposuction, necrosis from injections These are failures or complications that occur even with treatments or surgeries that are considered simple, and it’s difficult to predict a pattern in the aftereffects of cosmetic surgery.”

“Normally, the best approach would be to receive treatment at the clinic where the cosmetic procedure was performed, but that isn’t always the case. Patients end up coming to our clinic after much deliberation. This has become an inevitable situation,” he says.

At first glance, this might seem like a new medical field, but the Cosmetic Surgery Aftereffects Outpatient Clinic actually has a long history.

“At Nihon Medical University Hospital, we have had this clinic as part of our plastic surgery department for about 30 years. Fifteen years ago, it was specialized as an outpatient service. Since 2020, I have been in charge, responding to consultations from across the country. The Cosmetic Surgery Aftereffects Outpatient Clinic is not for acute cases directly related to life-threatening situations but for patients with chronic symptoms that persist after their procedures.”

“Many of the patients we see have had their surgeries or procedures 2-3 years ago. They were told by the cosmetic surgeon that ‘it will get better eventually,’ but they continue to suffer without improvement, and that’s when they come to us for consultation. The number of such patients is growing.”

While progressing with aftereffects treatment, contacting the original surgeon is essential, but even this basic step has its issues.

“Of course, we get the patient’s consent, but we try to contact the surgeon who performed the operation as much as possible. However, the reality is that many clinics are reluctant to provide the necessary medical records,” Dr. Asahi explains.

Under Japanese medical law, patient records should be disclosed unless there is a valid reason not to.

“Transparency is important. However, sometimes there are no records, or the records show completely different procedures were done. So, it’s not as simple as just having a system for information disclosure that would solve everything. When treating aftereffects from cosmetic surgery, it’s most important to assess the patient’s condition and provide the most appropriate response for each individual patient.”

Doctors Who Cannot Handle Irregularities

Cosmetic surgery complications can sometimes be fatal. In fact, serious accidents have occurred repeatedly in the past.

• 2009, Toshima Ward, Tokyo – A 70-year-old woman underwent abdominal liposuction, and the suction tube damaged her intestines. She died after surgery. The doctor was convicted of negligent manslaughter.

• 2011, Chūō Ward, Tokyo – A woman in her 30s who had nose surgery was put into a vegetative state due to a misintubation after the procedure. She died about two years later, and the Tokyo High Court ordered the hospital to pay compensation.

• 2023, Osaka City, Osaka – A 48-year-old man underwent facial liposuction and suffered bleeding. He died the next day due to inadequate treatment. The doctor was referred for criminal charges of negligent manslaughter.

“Although rare, there are cases that can be life-threatening. Doctors who lack qualifications in plastic surgery or have little experience may fail to respond to irregular cases, making the situation worse.

In cases with high urgency, cosmetic emergency care is needed outside of the typical aftercare system. Our clinic collaborates with medical institutions like Haruyama Memorial Hospital to ensure we have a system in place that can rapidly address patients who require immediate intervention.”

When thinking of doctors without qualifications in plastic surgery and limited experience, the term “Naomi” comes to mind. “Naomi” refers to doctors who jump into aesthetic medicine right after finishing their basic medical training. However, basic training is merely the foundation, and it is during advanced training that a doctor develops their skills.

Aesthetic medicine is essentially a specialized field, starting with plastic surgery, requiring high-level knowledge in anatomy, surgical techniques, and handling complications. However, there are doctors who engage in cosmetic surgery without undergoing this crucial advanced training, which poses a significant risk to patients.

Dr. Asahi explains, “It’s difficult to say if Naomi is at fault, but one clear problem is that ‘she struggles with handling irregular cases.'”

“Normally, if an irregular case arises, it would be best to refer the patient to another hospital or consult a specialist. However, instead of doing that, some doctors attempt an easy fix—doing touch-ups—and end up worsening the situation.”

There are calls for improving the training system for Naomi-like doctors.

“While it would be easy to regulate this through a system, I think the real issue lies deeper. We, as senior doctors, are not effectively communicating to young doctors that ‘having a qualification in plastic surgery is a huge advantage, both for them and their patients.'”

This realization comes from Dr. Asahi’s own experience.

“I didn’t start the cosmetic aftercare clinic with a strong ambition. Originally, my career was centered around acute surgery, treating burns and trauma. I intended to work at a general regional hospital as an acute-care surgeon. However, when the previous chief doctor stepped down, I took over the cosmetic aftercare clinic.

I entered this world through the medical office personnel assignments, but as I faced patients in the field, I strongly felt, ‘This is exactly the kind of work the world needs right now.’ Aesthetic medicine has a service industry aspect. When things go well, patients are very happy, but when problems arise, they continue to suffer. I think the cosmetic aftercare clinic is an essential field.”

However, he also notes that training successors is very difficult. The challenges lie in experience, expertise, and financial aspects, making it hard for just anyone to step into this role.

In recent years, the term sensitive doctors have been frequently used in aesthetic medicine advertisements and on social media, but Dr. Asahi firmly declares, “Sense and skill are two different things.”

“Some doctors can copy surgical techniques by watching videos and are called sensitive. But surgery is not like that. If you perform the surgery on 100 people, you won’t get the same result every time. Complications will inevitably happen with a certain probability. What’s important is how you recover from them, and this cannot be solved by sense alone.”

Is there anything we can do to avoid medical errors or complications from cosmetic surgery?

“The key is to properly verify the surgeon’s background and qualifications and evaluate whether the doctor will respond sincerely to any postoperative complications. The more reliable the doctor, the more likely they are to make a proper judgment, saying, ‘I have my limits.'”

Aesthetic medicine is not just built on glamorous success stories.

Now that Japan has become a beauty superpower, it is time to improve the infrastructure for cosmetic aftercare clinics and aesthetic emergency care and establish proper educational systems to guide younger doctors like Naomi.

Dr. Asahi Rintaro graduated from the University of Mie Faculty of Medicine in 2009. He is a board-certified specialist of the Japanese Society of Plastic and Reconstructive Surgery and holds a doctorate in medicine. Dr. Asahi has gained experience in aesthetic surgery and cosmetic medicine aftercare at the Department of Plastic Surgery at Nippon Medical School, as well as at various university hospitals and beauty clinics.