Anesthesiologists remain rare at beauty clinics offering general anesthesia
Of the 2,777 clinics registered as plastic surgery or dermatology practices, only 84 had an anesthesiologist on staff as of July — approximately 3 percent.
Signs for plastic surgery clinics in a street in Seoul on Jan. 28, 2024YONHAP
Plastic surgery and dermatology clinics now commonly use general anesthesia on patients, but just 3 percent of them have an anesthesiologist on staff.
At one plastic surgery clinic near Sinsa Station in southern Seoul on Wednesday, a staff member recommended sleep-inducing anesthesia — an additional 110,000 won ($81) per procedure — for a skin booster treatment, which involves injecting substances into the skin to improve its appearance.
“Because the treatment involves injections directly into the skin, many patients find it painful, so we usually put them under anesthesia,” the worker said.
When asked whether an anesthesiologist was on staff, the clinic’s consultation manager said, “The doctor does it. This is something that [a plastic surgeon] can handle alone.”
While a growing number of cosmetic clinics put patients under to reduce any pain during cosmetic procedures such as skin boosters and lifting treatments, very few had an anesthesiologist on staff.
Of the 2,777 clinics registered as plastic surgery or dermatology practices, only 84 had an anesthesiologist on staff as of July, according to data from the Health Insurance Review & Assessment Service, submitted to Democratic Party lawmaker Seo Young-seok on Wednesday. That amounts to approximately 3 percent.
Among 1,231 clinics registered as plastic surgery practices, 69, or 5.6 percent, had an anesthesiologist on staff. Just 15, or 1 percent, of 1,546 dermatology clinics did.
The number of plastic surgery and dermatology clinics rose 11.8 percent from 2,485 in 2021 to 2,777 this year. But the share with an anesthesiologist on staff remained virtually unchanged, edging up from 2.6 percent to 3 percent during the period.
Cosmetic clinics offering general anesthesia are not hard to find. All 20 plastic surgery and dermatology clinics reviewed in southern Seoul advertised anesthesia as an option for their cosmetic procedures. The clinics advertised the feature with phrases such as “Undergo a comfortable treatment without worrying about pain with anesthesia!” and “Pain-free procedures with anesthesia.”
But none had an anesthesiologist on staff.
A representative of one plastic surgery clinic said, “The doctor performs procedures alone,” adding, “But it is safe.”
However, a single doctor being responsible for both administering general anesthesia and performing the procedure can be dangerous. Drugs commonly used for anesthesia, including propofol and midazolam, can suppress breathing at higher doses and require patients to be monitored throughout the procedure, with the depth of sedation adjusted as necessary. The Korean Society of Anesthesiologists also says that anesthesia should be administered by an anesthesia provider who can monitor the patient’s condition.
But clinics with only a small number of doctors often struggle to employ a dedicated anesthesiologist. Current medical laws also do not require sleep-inducing anesthesia to be administered by an anesthesiologist.
Signs for plastic surgery and dermatology clinics on the exterior of a building in Gangnam District, southern Seoul, on May 14, 2020NEWS1
“General anesthesia is usually handled by a doctor alone. For major operations requiring anesthesia, freelance anesthesiologists often do it as they move from hospital to hospital like grasshoppers,” one anesthesiologist said. “Proper monitoring is difficult under this kind of system.”
Deaths related to anesthesia have also been concentrated at clinics. Of the 50 deaths related to cosmetic procedures between 2016 and 2024 analyzed by the National Forensic Service, 23 were related to anesthesia, the largest category. Of those, 22 occurred at clinics.
In April, a woman went into cardiac arrest while undergoing a lifting procedure under sleep-inducing anesthesia at a plastic surgery clinic in Gwangju.
“The problem is that clinics recommend anesthesia even for procedures where it isn’t really necessary, leading patients to think of it as something minor,” a doctor with experience working at cosmetic clinics said.
A sign for a dermatology and plastic surgery clinic in Seoul on Jan. 28, 2024YONHAP
Hong Sung-jin, a professor of anesthesiology and pain medicine at Bucheon St. Mary’s Hospital, said that “anesthesia is commonly used for procedures such as endoscopies.”
The professor added that it can be difficult to respond immediately to unexpected situations without dedicated personnel monitoring the patient and warned of the risk of cardiac arrest.
The extent to which sleep-inducing anesthesia is used for cosmetic procedures is also difficult. Such procedures are not covered by national health insurance and therefore do not appear in insurance claims statistics.
“The government should investigate the use of general anesthesia in cosmetic procedures and establish safety standards, including personnel other than the doctor performing the procedure to monitor patients, monitoring and emergency equipment and anesthesia records,” Rep. Seo said.
This article was originally written in Korean and translated by a bilingual reporter with the help of generative AI tools. It was then edited by a native English-speaking editor. All AI-assisted translations are reviewed and refined by our newsroom.
