What Is Ghost Surgery in Korea? How to Protect Yourself

In 2016, a college student named Kwon Dae-hee died during a jaw surgery procedure at a plastic surgery clinic in Gangnam, Seoul. An investigation revealed that the lead surgeon, the one the patient had consulted with and consented to, had left the operating room during the procedure. A different, less experienced doctor completed the surgery. Kwon died from excessive bleeding. He was 23 years old.

This case became the catalyst for Korea’s national reckoning with ghost surgery (대리수술, daeri susul), the practice of substituting surgeons during a procedure without the patient’s knowledge or consent. It exposed a practice that had been an open secret in Korea’s cosmetic surgery industry for years.

Ghost surgery is not unique to Korea. It happens in the US, Brazil, Turkey, and every country with a high-volume cosmetic surgery market. But Korea’s massive plastic surgery industry (the highest per capita rate in the world) and its culture of patient awareness have made it a more visible and more actively combated issue here than anywhere else.

This guide explains what ghost surgery is, why it exists, how common it actually is, what the Korean government has done about it, and, most importantly, how you can protect yourself as an international patient.

What Exactly Is Ghost Surgery?

Ghost surgery occurs when a surgeon other than the one the patient consulted with and consented to performs all or part of a surgical procedure, without the patient’s knowledge or informed consent.

There are several variations:

Full Substitution

The consulting surgeon is not present at any point during the operation. A completely different doctor performs the entire procedure. The patient is under general anesthesia and has no way to know this happened.

Partial Substitution

The consulting surgeon begins the procedure and then leaves the operating room, transferring the surgery to another doctor who completes it. Sometimes the consulting surgeon returns for the final steps (closing, for example) so they’re present when the patient wakes up.

Simultaneous Surgeries

The consulting surgeon has two or more patients under anesthesia at the same time in adjacent operating rooms. They move between rooms, performing the most critical steps on each patient while assistants or other surgeons handle the rest. The patient consented to have this specific surgeon perform their surgery, not to share that surgeon with other patients.

Training Substitution

A resident, fellow, or junior surgeon performs the procedure (or significant portions of it) as training, supervised loosely by the attending surgeon, who may or may not be scrubbed in. This is common in teaching hospitals worldwide and is often disclosed in consent forms. It becomes ghost surgery when it’s not disclosed and the patient believes the senior surgeon is operating.

Why Does Ghost Surgery Happen?

The motivations are straightforward and consistent across countries:

1. Financial Incentive (The Primary Driver)

A high-profile surgeon can charge premium fees. Their name draws patients. But there are only so many hours in a day and only so many surgeries one person can perform. Ghost surgery allows a clinic to book 8-12 surgeries per day under one surgeon’s name while that surgeon performs only 3-4 of them personally.

The math is simple: if a surgeon’s name brings in $80,000/day in booked procedures and they can personally perform $30,000 worth of those procedures, the “ghost” approach generates an additional $50,000/day in revenue, performed by lower-cost associate surgeons.

2. Volume-Based Business Models

Some Korean clinics, particularly in the Gangnam district, operate on a volume model. They market aggressively (social media, YouTube, broker networks), attract high patient volumes, and process patients through standardized procedures. The consulting surgeon (often the clinic’s “face”) cannot physically operate on every patient. Junior surgeons handle the overflow.

3. Surgeon Fatigue and Scheduling

Even well-intentioned surgeons can over-schedule. When a surgery runs longer than expected, the next patient is already prepped and under anesthesia. Rather than delay and potentially cause complications from extended anesthesia, the clinic may substitute another surgeon to start or complete the next case.

4. Teaching Hospital Norms

In academic medicine, residents and fellows performing procedures under supervision is standard training methodology. This is not inherently ghost surgery. It becomes problematic only when the patient isn’t informed that a trainee will be involved.

How Prevalent Is Ghost Surgery in Korea?

Quantifying ghost surgery is inherently difficult because it is, by definition, hidden. But several data points indicate scope:

Government Investigations

• 2016-2018: Following the Kwon Dae-hee case, the Korean Ministry of Health and Welfare conducted inspections of over 200 clinics. Violations were found at approximately 10-15% of inspected facilities.
• 2020-2022: The Korean Medical Association (KMA) reported receiving over 300 complaints related to ghost surgery or surgeon substitution annually.
• 2023-2024: Continued government crackdowns resulted in dozens of clinics being fined or having licenses suspended.

Patient Surveys

A 2019 survey by the Korean Consumer Agency found that 7.2% of cosmetic surgery patients suspected they had experienced ghost surgery, based on indicators like the consulting surgeon’s apparent absence during recovery or inconsistencies in post-operative information.

The actual prevalence is likely higher. Most ghost surgery goes undetected because:
– The patient was under general anesthesia and has no direct knowledge
– If the outcome is satisfactory, the patient has no reason to investigate
– International patients return home and have no mechanism to verify

Which Procedures Are Most at Risk?

Ghost surgery is most common in:

1. Rhinoplasty. High volume, high demand, complex procedure that takes 2-4 hours. Clinics that book 5+ rhinoplasties per day per surgeon are likely substituting.
2. Jaw surgery (orthognathic/contouring). Complex, long procedures (3-6 hours). The case that killed Kwon Dae-hee was jaw surgery.
3. Blepharoplasty (double eyelid surgery). Quick procedure (30-45 minutes), very high volume. Some clinics process 20+ per day.
4. Breast augmentation. Moderate complexity, 1-2 hours, high demand.
5. Liposuction. Often viewed as “simple” and delegated to junior surgeons.

Ghost surgery is extremely rare at:
– University hospitals (Severance, KU Anam, Seoul St. Mary’s): these institutions have oversight structures, academic standards, and far less financial incentive for substitution
– Single-surgeon private practices: if there’s only one surgeon, there’s no one to substitute
– CCTV-monitored clinics (discussed below)

Korean Government Response

Korea has taken ghost surgery more seriously than any other country. The legislative and regulatory response has been substantial:

Medical Law Revisions (2016-2020)

Following public outcry after the Kwon Dae-hee case and other incidents:

• Article 27-2 of the Medical Service Act was amended to explicitly criminalize ghost surgery. A surgeon who allows another doctor to operate in their place without patient consent can face up to 5 years in prison and up to 50 million KRW (roughly $37,000) in fines.
• The law also criminalizes the “ghost” surgeon and the clinic owner/operator who facilitates the substitution.

CCTV in Operating Rooms (2021 Legislation, 2023 Implementation)

In September 2021, the Korean National Assembly passed a law requiring installation of CCTV cameras in all operating rooms at patient request. Key provisions:

• Patients (or their legal guardians) can request CCTV recording of their entire surgical procedure
• Hospitals and clinics must comply with the request
• Recordings are stored for a minimum of 30 days
• Access to recordings requires patient consent or a court order
• Medical professionals who refuse a valid CCTV request face penalties
• The law took effect in September 2023

Implementation status: As of 2025, CCTV is installed in operating rooms at most major hospitals and an increasing number of private clinics. Some clinics have voluntarily adopted camera-monitored ORs as a marketing differentiator. Others have resisted, arguing it invades surgical team privacy and may affect performance. The Korean Medical Association initially opposed the law but compliance has progressed steadily.

For international patients: This is a powerful protection tool. Request CCTV recording of your procedure in writing before surgery. Any clinic that refuses this request in 2025-2026 is either non-compliant with Korean law or has something to hide.

Surgeon Disclosure Requirements

Korean law now requires that the operating surgeon be clearly identified to the patient before the procedure, and any change in surgeon requires:
– Explanation of the reason for the change
– Written patient consent for the specific substitute surgeon
– Documentation in the medical record

How to Protect Yourself: A Practical Checklist

Before You Book

1. Research the specific surgeon, not just the clinic.
A clinic may have 10 surgeons but market under one famous name. Determine who will actually perform your surgery.

2. Ask directly: “Will [Surgeon Name] personally perform my entire surgery?”
Get a clear, unambiguous answer. “Our team” or “our surgeons” is not an acceptable answer. You need a specific name.

3. Get it in writing.
Ask for the operating surgeon’s name to be specified in your consent form or surgical agreement. Some clinics resist this. That resistance is itself informative.

4. Check the surgeon’s credentials.
– Verify board certification with the Korean Society of Plastic and Reconstructive Surgeons (KSPRS) for plastic surgery, or the relevant specialty board for other procedures
– Look up the surgeon’s registration with the Korean Medical Association
– An InKoreaNow coordinator can assist with this verification

5. Assess the clinic’s volume.
If a clinic’s social media shows their star surgeon performing 8+ complex surgeries per day, that surgeon is either superhuman or substituting. A rhinoplasty takes 2-4 hours. Eight rhinoplasties would require 16-32 hours of operating time. The math doesn’t work.

Before Surgery (Day Of)

6. Request CCTV recording.
This is your legal right under Korean law (since September 2023). Submit the request in writing. Ask how to access the recording afterward. A clinic that operates with camera-monitored ORs and embraces this request is demonstrating confidence in their integrity.

7. Confirm the surgeon’s identity.
When you meet the surgeon on surgery day (pre-op), confirm their name and that they will perform the entire procedure. Some patients take a photo with the surgeon before entering the OR.

8. Ask about anesthesia.
A board-certified anesthesiologist should be present throughout the procedure. Ask: “Will a certified anesthesiologist be present for my entire surgery?” Some cost-cutting clinics use nurses for sedation supervision, which is both dangerous and illegal for general anesthesia in Korea.

9. Bring a companion.
A friend or family member waiting at the clinic can serve as an additional set of eyes. They can observe whether the surgeon who went into the OR is the same one who comes out. They can ask staff questions during the procedure. Clinics are less likely to substitute when they know the patient has an alert companion.

After Surgery

10. Review your records.
Korean law entitles you to a copy of your medical records, including the operative report. The operative report should name the surgeon, assistant, anesthesiologist, and nurses present. If the operating surgeon’s name on the report differs from who you consented to, you have evidence of ghost surgery.

11. Access the CCTV recording.
If you requested recording, view it or have a trusted medical professional view it. You don’t need to watch your entire surgery. Just confirm the surgeon’s identity at key points (start, during, and close).

University Hospitals vs. Private Clinics: A Safety Comparison

University hospitals like Severance Hospital and Korea University Anam Hospital have institutional structures (department heads, academic review, resident oversight committees) that make ghost surgery functionally impossible. The trade-off is typically higher cost and longer scheduling lead times.

Private clinics range from excellent single-surgeon practices to high-volume operations where the star surgeon is a marketing asset rather than the actual operator. The challenge for international patients is distinguishing between these.

InKoreaNow’s Vetting Process

This is the core of what we do for plastic surgery patients. Our vetting process for clinics and surgeons includes:

Surgeon Verification

• Board certification confirmed with the Korean specialty board
• Hospital or clinic affiliation verified
• Professional history and training background reviewed
• Malpractice history checked through available Korean medical disciplinary records

Clinic Assessment

• On-site visit by our team
• CCTV policy confirmed (camera-monitored ORs preferred)
• Anesthesiologist staffing verified (board-certified, present throughout procedure)
• Patient volume assessed relative to surgeon staffing (is the math realistic?)
• Emergency protocols reviewed (what happens if a complication occurs? Is there a hospital transfer agreement?)
• International patient experience assessed (English communication, informed consent process, post-op support)

Ongoing Monitoring

• Patient feedback after every procedure
• Regular communication with clinic management
• Immediate investigation of any complaint or concern

What We Won’t Recommend

We will not refer patients to clinics that:
– Refuse CCTV recording requests
– Cannot confirm the specific operating surgeon in advance
– Operate on a high-volume model inconsistent with single-surgeon practice
– Lack board-certified anesthesiologists for general anesthesia procedures
– Have documented ghost surgery violations or unresolved complaints

Our partner for plastic surgery procedures, NANA Plastic Surgery, operates with 26+ professionals, camera-monitored operating rooms, and a single-surgeon model for each procedure. Their CCTV policy isn’t reluctant compliance. It’s a core operating principle.

What to Do If You Suspect Ghost Surgery

If you believe ghost surgery was performed on you:

Immediate Steps

1. Request your medical records. You are entitled to these under Korean law.
2. Request CCTV footage if recording was activated
3. Document everything: dates, surgeon names (consulted vs. suspected operating), communications
4. Do not sign any documents waiving your rights or accepting settlements without legal advice

Legal Recourse

• Korean Medical Dispute Mediation and Arbitration Agency (KMDMAA): A government body that mediates medical disputes, including ghost surgery cases. Filing is free.
• Korean police report: Ghost surgery is a criminal offense under Article 27-2 of the Medical Service Act. You can file a police report.
• Civil lawsuit: Korean courts have awarded damages in ghost surgery cases ranging from 10 million to 300+ million KRW ($7,500 to $225,000+) depending on the harm caused.
• Korean Consumer Protection Board: For consumer complaints related to cosmetic surgery services.

For International Patients

Legal proceedings in Korea are conducted in Korean and can be lengthy. If you suspect ghost surgery:

1. Contact InKoreaNow. We can assist with initial investigation and communication with the clinic.
2. Consult a Korean attorney specializing in medical law (we can recommend qualified firms)
3. Contact your embassy in Seoul. They can provide a list of English-speaking attorneys and assist with documentation.

The Bottom Line

Ghost surgery is a real risk in Korea’s cosmetic surgery market. It’s not universal. The majority of Korean surgeons are ethical professionals who would never substitute without consent. But the financial incentives in high-volume cosmetic surgery create conditions where it occurs, and international patients are particularly vulnerable because of language barriers, unfamiliarity with the system, and limited ability to follow up after returning home.

The protections available to patients in Korea (CCTV legislation, criminal penalties, government inspections, surgeon verification systems) are stronger than in most countries. The key is using them:

1. Request CCTV recording (it’s your legal right)
2. Confirm your specific surgeon in writing
3. Work with a facilitator who has vetted the clinic and surgeon
4. Trust the math. If a surgeon’s schedule doesn’t add up, the marketing isn’t honest.

Need Help Choosing a Safe Clinic?

We vet every clinic and surgeon in our network for credentials, safety protocols, and operating room integrity. We don’t accept referral fees from clinics. Our incentive is your safety and satisfaction, not volume.

Tell us what procedure you’re considering, and we’ll recommend verified surgeons and clinics, with full transparency about their credentials, CCTV policies, and patient track records.

Talk to Our Team →