What Ghost Surgery (Daeri Susu) Actually Means
대리수술 (daeri susu, literally “substitute surgery”) is the practice of having a person other than your booked surgeon — often an unqualified assistant, trainee, or entirely different practitioner — perform all or part of your procedure without your knowledge or consent.¹
The term covers a wide spectrum of substitution. At the least severe end, a senior resident completes a stage of the operation while the named surgeon steps out briefly. At the most severe end, an unlicensed person performs the entire procedure while the named surgeon is operating in another room simultaneously — a practice sometimes called “assembly-line surgery” in Korean media coverage. Both ends of that spectrum are illegal under the Medical Practices Act when performed without informed consent.¹
Ghost surgery is distinct from legitimate surgical assistance. Qualified surgical assistants and scrub nurses working under direct supervision of the named surgeon are standard practice. The defining element of ghost surgery is the absence of patient knowledge and consent: you agreed to a specific, named surgeon, and a different person took the scalpel.¹
Three conditions make ghost surgery financially attractive to unscrupulous clinics. First, high patient volumes in Gangnam-area clinics create pressure to run multiple procedures simultaneously. Second, named surgeons command premium fees, creating margin incentive to substitute cheaper personnel. Third, patients under general anesthesia (전신마취, jeonsin machi — complete sedation) cannot observe or object during the procedure.
The legislative record for the 2021 CCTV amendment explicitly names ghost surgery deterrence as the law’s primary rationale,¹ and K-MEDI formally recognises ghost surgery as grounds for a mediation claim.² Understanding exactly what the practice involves is the first step to recognising the conditions that enable it.
How Often Does It Happen? Prosecution Data
Precise prevalence data is difficult to establish because ghost surgery, by design, is hidden from the patient. Prosecution figures represent confirmed and successfully prosecuted cases — not the full incidence.
The CCTV legislation was enacted specifically because the practice was widespread enough to require a legislative response.¹ High-profile prosecutions in 2016, in which unlicensed or unauthorised persons were found to have performed procedures without patient knowledge, prompted the National Assembly to act.¹ Those cases involved clinics in Seoul’s Gangnam district and received sustained national media coverage, establishing ghost surgery as a recognised patient safety problem rather than an isolated aberration.
Two structural factors limit prosecution data as a true incidence measure. First, patients under general anesthesia cannot directly observe substitution, so discovery depends on post-operative disclosure, whistleblowers, or — since 2021 — CCTV review. Second, many international patients leave Korea before recognising warning signs, and the time and cost of returning for legal proceedings reduces follow-through.
K-MEDI’s formal recognition of ghost surgery as an eligible dispute category² reflects regulatory acknowledgement that the practice extends beyond the cases that reach prosecution. The 30-day CCTV retention window¹ means patients who do not request footage promptly may lose their primary evidentiary resource.
The CCTV Law: What It Requires and What It Covers
Article 38-2 of the Medical Practices Act (의료법, Uiryo-beop) took effect on September 25, 2021. It imposes four concrete obligations on every licensed medical institution in Korea.¹
Installation requirement. All medical institutions must install CCTV cameras in their operating rooms. This applies regardless of clinic size, specialty, or whether the institution primarily treats domestic or international patients.¹
Recording on request. When a patient or their guardian requests that a procedure be recorded, the medical institution cannot refuse.¹ The right to request recording belongs to the patient; the clinic has no discretion to decline. In practice, you should make this request in writing — email is sufficient — before your surgery date, and confirm receipt.
Consent before recording. The institution may not record without patient or guardian consent.¹ This provision protects patient privacy: no clinic can film a procedure and retain footage without your agreement.
Retention and access. Recorded footage must be retained for a minimum of 30 days following the procedure.¹ Within that window, you may submit a written access request; the clinic must provide the footage within 14 days of receiving that request.¹
Penalties for non-compliance. Violations carry fines of up to ₩5 million per incident. Repeat violations may result in licence revocation.¹
Two important limits apply. First, the law requires CCTV installation and obligates recording when requested — but a patient who does not know to request recording before surgery may arrive to find no footage exists of their procedure. Second, the 30-day retention window is a minimum floor, not a guarantee of indefinite preservation. Request footage promptly if you have any concern.
The legislation does not guarantee that footage will be unambiguous. Camera angle, lighting, and surgical draping can all affect what is visible. However, footage showing a different person than the named surgeon at the operating table has been used as direct evidence in ghost surgery prosecutions.¹
Red Flags Before and During Surgery Day
Ghost surgery risk is not randomly distributed. Specific pre-surgery and day-of-surgery signals correlate with higher substitution risk. Recognising them before anesthesia is administered is the only window where you retain the ability to withdraw consent.
Before surgery — structural risk factors:
Clinics running very high daily patient volumes — sometimes visible from the waiting room volume or discoverable via online reviews — create the scheduling pressure that makes substitution financially tempting. A named surgeon booked for six or more procedures in a single day cannot be physically present for each one in full.
Verify your surgeon’s KSPRS (대한성형외과학회, Daehan Seonghyeong Oegwa Haghoe — the Korean Society of Plastic and Reconstructive Surgeons) board certification before booking. The KSPRS public registry allows direct name-based verification.³ Board certification requires six years of medical school plus a four-year plastic surgery residency and successful board examination.³ Performing plastic surgery without this certification is an illegal medical act in Korea.³
Pre-surgery checklist:
- Surgeon’s full name and KSPRS certification number confirmed via the public registry³
- Written request for OR CCTV recording submitted and acknowledged by the clinic¹
- Consent form identifies your named surgeon by full name — not clinic name only
- You have the clinic’s written confirmation of who will perform the procedure
- You have K-MEDI’s contact number saved: +82-1670-2545²
On surgery day — warning signs before anesthesia:
- A staff member you have not met introduces themselves as “assisting” without naming your booked surgeon
- Your named surgeon does not conduct the pre-operative consultation or mark surgical sites personally
- You are asked to sign a consent form that does not name a specific surgeon
- Staff become evasive or deflect when you ask directly: “Will [surgeon name] be in this operating room for the entirety of my procedure?”
At any point before anesthesia is administered, you retain the unconditional right to withdraw consent and leave.
What to Do If You Suspect Ghost Surgery
Suspicion typically arises post-operatively: the surgeon who visits you in recovery looks or behaves differently than the person you met in consultation, scar placement differs from the planned approach, or a staff member discloses information inconsistently.
Act within the 30-day CCTV retention window.¹ Every step below should begin as soon as suspicion arises.
Step 1 — Request CCTV footage in writing. Submit a written request to the clinic — email creates a timestamped record — citing Article 38-2 of the Medical Practices Act. State your name, procedure date, and the specific footage you are requesting. The clinic must respond within 14 days.¹ Keep a copy of every communication.
Step 2 — Preserve all documentation. Collect every document in your possession: the original consent form, pre-operative photographs, post-operative instructions, receipts, consultation notes, and any written communications with the clinic. Photograph your results and any unexpected scarring.
Step 3 — File with K-MEDI. K-MEDI (한국의료분쟁조정중재원, Hanguk Uiryo Bunjaeng Jojung Jungjaewon — Korea Medical Dispute Mediation and Arbitration Agency) is the government body responsible for mediating medical disputes.² Filing is free for patients.² International patients may file within 3 years of the incident.² K-MEDI can subpoena CCTV footage and, where criminal conduct is established, refer cases to prosecutorial authorities.² Contact: +82-1670-2545 (English-language support available).²
Step 4 — File a police report. A police report at the nearest Korean police station (or via the Health Ministry patient safety hotline) creates an official criminal record of your complaint. This runs parallel to K-MEDI mediation — simultaneous filing across channels is permitted and does not prejudice either process.
Step 5 — Contact KSPRS if a board-certified surgeon is implicated. The KSPRS ethics committee has authority to investigate member surgeons and recommend disciplinary action, including decertification.³ This is not a substitute for legal channels but adds professional accountability pressure.