Beyond Surgical Results: How Changing Patient Choices Are Shaping the Next Chapter of K-Beauty Surgery

Having observed the changes in Korean plastic surgery over the past 20 years, one of the things I feel has changed the most is the nationality of the patients I meet in the consultation room.

In the past, the Korean plastic surgery industry developed by rapidly learning and adopting new medical technologies and devices introduced overseas. As Korean surgeons accumulated clinical experience and surgical techniques became increasingly specialized, the industry evolved into a destination attracting patients from around the world.

Today, the term “Korean Plastic Surgery” represents more than just a description of where a procedure is performed.

From 2009, when South Korea began actively promoting international patient services, to 2019, before the COVID-19 pandemic, the number of international patients visiting the country increased by an annual average of 23.5%. Although the figure dropped to approximately 120,000 in 2020 due to the pandemic, it subsequently rebounded to 610,000 in 2023 and reached a record 1.17 million in 2024. Between 2009 and 2024, South Korea welcomed a cumulative total of 5.05 million international patients.

In 2024 alone, patients from 202 countries visited South Korea for medical services. Dermatology accounted for 56.6% of international patient visits, while plastic surgery represented 11.4%.

These nationwide developments are also reflected in clinical practice. According to data submitted to the Korea Health Industry Development Institute (KHIDI), the number of surgical and nonsurgical procedures performed on international patients at VIEW Plastic Surgery in Korea, where I practice, increased by approximately 50% annually on average following the COVID-19 pandemic.

Although these figures are not specific to breast augmentation, they illustrate how patients from increasingly diverse countries are choosing South Korea for aesthetic medical care.

The question now extends beyond how many international patients visit Korea. More importantly, it concerns what these patients are seeking and how Korean medical technologies and clinical practices should evolve to meet their changing expectations.

This should become the next defining question for Korean plastic surgery.

Patients in Korea and Abroad Are Looking Beyond Surgical Results

Breast augmentation remains one of the world’s major aesthetic surgical procedures.

According to the International Society of Aesthetic Plastic Surgery (ISAPS) 2024 survey, approximately 1.66 million breast augmentation procedures were performed worldwide, while the total number of aesthetic breast surgeries reached approximately 3.91 million.

However, the most noticeable change in clinical practice is not simply the number of procedures performed. Rather, it is the criteria patients use when deciding whether and how to undergo surgery.

In the past, breast augmentation consultations primarily focused on implant size, shape, and the anticipated physical appearance after surgery. Today, patients are asking a much broader range of questions.

They want to understand how the procedure is performed, how their existing tissues are handled during surgery, how recovery may differ depending on the surgical technique, and when they can return to their daily routines, including work and exercise.

This shift is not limited to international patients. For domestic patients who balance professional responsibilities, childcare, exercise, and personal interests, life after surgery has also become an important consideration in medical decision-making.

For international patients, these concerns may be even more practical. Traveling to another country for consultations and surgery involves arranging a period of recovery before returning home and resuming everyday life.

Of course, surgical decisions should never be based solely on the desire for a faster recovery. Selecting an appropriate surgical technique must begin with an assessment of the patient’s anatomy and safety.

Nevertheless, medical professionals should recognize that patient priorities are expanding beyond the question of what results can be achieved.

Patients increasingly want to understand how those results are achieved and what the process of returning to their everyday lives may involve.

The Evolution of Breast Augmentation: Looking Beyond the Implant

Breast augmentation in Korea has continued to evolve alongside these changing patient expectations. Advancements in implant shells, surface characteristics, gel properties, and shapes have expanded the options available to surgeons and patients.

At the same time, surgical techniques have become more refined, incorporating individual anatomical characteristics such as chest wall structure, skin, breast tissue, and surrounding soft tissues when determining implant size, placement, and pocket formation.

However, breast augmentation is not a procedure completed simply by choosing an implant. A suitable space must be created for implant placement, requiring surgeons to make careful decisions about how the patient’s existing tissues will be handled during the procedure.

More recently, attention has expanded to another question: How can surgeons achieve the intended surgical outcome while preserving normal anatomical structures to the greatest extent reasonably possible?

In a study published in the Aesthetic Surgery Journal in 2026, Charles Randquist and colleagues retrospectively analyzed their clinical experience involving 330 consecutive patients who underwent Tissue-Preserving Breast Augmentation (TPBA).

The surgical approach aimed to preserve breast-supporting structures, including the circummammary ligament and Cooper’s suspensory ligaments, while using balloon expansion to create a prepectoral implant pocket. The study reported a mean follow-up period of 18 months, with clinical experience extending up to three years.

As a single retrospective observational study, these findings are insufficient to establish the superiority of one surgical technique over another.

Nevertheless, the research raises an important question.

The technical focus of breast augmentation is expanding beyond which implant should be selected and where it should be positioned. Increasing attention is being directed toward how existing tissues are managed during the process of creating the space necessary for implant placement.

Tissue Preservation and Recovery: Ultimately, a Matter of Patient Choice

I do not view these developments merely as the introduction of new surgical techniques. A more meaningful change is that patients increasingly want to understand their surgical options and make informed decisions about their treatment.

Beyond knowing which implant will be used, patients want to understand where it will be placed, how the implant pocket will be created, how existing tissues will be handled, and what they can reasonably expect during recovery.

There is also growing demand for shared decision-making, allowing patients to work with their surgeons to select an appropriate approach based on their anatomical characteristics, lifestyle, and desired outcomes.

The concept of tissue preservation should be considered within this broader context.

No single surgical technique is appropriate for every patient.

Depending on individual anatomy and the extent of the desired changes, conventional surgical approaches may be more suitable for some patients. For others, newer techniques that incorporate tissue-preserving principles may represent an additional option.

What matters is that technological progress can expand the range of choices available to patients.

The role of medical professionals must therefore extend beyond simply offering the latest surgical techniques.

Surgeons should clearly explain the principles and characteristics of each approach and provide patients with sufficient information to make appropriate decisions based on their physical condition, lifestyle, and expectations.

Ultimately, I believe the future of breast augmentation should involve more than developing techniques that achieve desirable aesthetic outcomes. It should also advance toward a model of care that enables patients to make well-informed decisions while considering their bodies and the lives they wish to maintain.

Advancements in Korean Plastic Surgery Strengthen the Competitiveness of Korean Medical Tourism

These developments extend beyond individual surgical specialties. With South Korea welcoming 1.17 million international patients in 2024, aesthetic medicine, including plastic surgery, accounts for a substantial share of the country’s medical tourism industry.

According to KHIDI’s analysis of credit card spending by international patients in 2024, approximately 920,000 international patients who made medical-related purchases spent a combined KRW 3.6647 trillion in South Korea.

Of this amount, spending in the medical sector accounted for KRW 1.4053 trillion. By specialty, dermatology represented KRW 585.5 billion, while plastic surgery accounted for KRW 359.4 billion.

An important point is that medical tourism does not end when patients leave the hospital. The same analysis found that international patient spending extended beyond medical services to shopping, accommodation, and other sectors.

Among patients from the United States, spending patterns reflected a combination of medical services and tourism-related activities, including department store purchases, hotel stays, and air travel.

KHIDI noted that medical visits by international patients tend to generate broader domestic consumption.

The Ministry of Health and Welfare also regards the international patient sector as a high-value industry that integrates healthcare and tourism. Looking ahead, the competitiveness of Korean medical tourism cannot be built solely by attracting greater numbers of international patients.

Patients must have compelling reasons to choose medical care in South Korea. The experience and technical capabilities of medical professionals are fundamental. However, the overall quality of the healthcare experience must also continue to improve, including access to information about different treatment options, informed patient choice, safe clinical systems, and appropriate postoperative care.

For international patients in particular, the medical experience encompasses far more than the surgical outcome itself.

It includes the entire journey of receiving treatment in Korea, recovering after surgery, returning to their home country, and resuming everyday life.

From this perspective, growing interest in tissue preservation and returning to daily activities should not be viewed simply as an isolated surgical trend. Rather, it may reflect how Korean healthcare is responding to the changing expectations of patients worldwide.

From Welcoming the World to Korea to Sharing Korean Medical Experience with the World

Two important factors have driven the development of Korean plastic surgery: the ability to rapidly learn and adopt new technologies, and the extensive clinical experience accumulated by surgeons through treating large numbers of patients.

Looking ahead, another capability will become increasingly important. Korean medical professionals must be able to recognize changing patient expectations, research new treatment options, and transform accumulated clinical experience into scientific evidence that can be shared with the international medical community.

Breast augmentation will not stop evolving with advances in implant technology. The scope of clinical discussion will continue to expand, encompassing how implant pockets are created, how existing tissues are managed, and how patients can be supported in selecting surgical approaches that align with their lifestyles.

As these developments continue, the reasons patients choose South Korea for plastic surgery may also evolve.

Rather than being recognized simply as a destination for specific surgical procedures, Korea can develop into a place where patients are able to choose appropriate medical care based on a broad range of treatment options, thorough explanations, and accumulated clinical experience.

The next stage of Korean plastic surgery should move beyond bringing international patients to Korea. It should focus on expanding patient choice and sharing the medical knowledge and clinical experience developed in Korea with the rest of the world.

I believe this kind of qualitative advancement can contribute not only to the future of breast augmentation but also to the continued development of Korean medical tourism.

About the Author

• Ph.D. in Medicine, Seoul National University Graduate School
• Board-Certified Plastic Surgeon, Seoul National University Hospital
• Appointed Adjunct Clinical Professor of Plastic Surgery, Seoul National University Hospital
• Participated in Let Me In Doctors (Seasons 2–5).

• Source: Dailypharm | Opinion & Columns > Special Contribution
• Email: tuai@dailypharm.com