Five things to check before a lifting treatment

“Checklist” articles written by clinics tend to run in one direction. They list the items to check, they leave the impression that there are places which do not meet them, and at the end they say that this clinic does.

We do not intend to write that way. There are two reasons.

One is the law. Article 56(2) of the Medical Service Act prohibits advertising that compares a clinic with other medical institutions (subparagraph 4) and advertising that disparages other medical institutions (subparagraph 5). A sentence like “there are clinics like this, so be careful” can be read as either of those two, even without naming anyone.

The other is fact. In preparing this article we traced the sources of the claims that are commonly made, one by one, and the gap between what could be verified and what could not was large. If you write down what cannot be verified as though it were fact, everything else you verified is doubted along with it.

So this article contains no sentence saying “some clinics do this”. Instead it contains only “here is how you can check this”. The judgement is properly yours to make.

You have probably seen a number printed on the material describing a lifting device. What is not widely known is that there are two kinds of number.

To put it plainly: an advertising review number is not proof that the device has been approved. It is the number given to a review of the advertising copy. When the two numbers appear side by side they are hard to tell apart, and when only one appears it is hard to know which it is.

Using an unapproved device is something the law prohibits directly.

Article 26(1) of the Medical Devices Act — “No one may repair, sell, lease, give or use a medical device that has not been approved or certified, or that has not been notified …”

What matters here is that the word “use” is in the provision. It applies not only to those who distribute the device but to those who use it.

How to check

Since 8 January 2024 the Ministry of Food and Drug Safety (MFDS) has run a public medical device information service. It offers searches by business type — manufacture, import, sale — and a search of the medical devices held by each clinic. The address is emedi.mfds.go.kr.

The simplest method is to ask at your consultation: “Could I have the MFDS approval number for this device?” An approval number is not information anyone has reason to conceal.

One thing to add: with medical devices, the approved name and the trade name used in the market are often different. A different name coming up in a search is not in itself a problem.

This item is the clearest, because there is both a statute and a set of judgements.

Article 27(1) of the Medical Service Act — no one who is not a medical practitioner may perform a medical act, and a medical practitioner may not perform a medical act outside the scope of their licence.

On whether aesthetic procedures fall within this, there is a Supreme Court ruling. Supreme Court, 28 June 2007, 2005Do8317 held that cosmetic surgery is also a medical act. On a nursing assistant inserting hair follicles with an implanter down to the dermis, the court held that even with relevant knowledge, so long as the person had not received a doctor’s systematic medical education and a doctor was not substantively involved, the act fell outside the scope of assisting in medical treatment.

There is also a judgement on lifting devices.

For balance, however, there is another judgement we should mention. Jeju District Court, 2 May 2019, 2018No334 acquitted a doctor who had instructed a nursing assistant to remove molluscum contagiosum, holding that if the act was assistance in medical treatment carried out under the doctor’s proper direction and supervision, its unlawfulness could be negated.

In other words the issue is not only “whose hands did it” but “did it go beyond the scope of assisting in treatment, and was the doctor substantively involved”. Leaving that distinction out and writing “it is always illegal if a nursing assistant does it” would not be accurate either.

How to check

At your consultation, simply ask “who will be performing today’s treatment?” And on the day, look at whether the person who actually comes in is the person you were told about. Those two things are all there is to it.

The cartridge of an ultrasound lifting device has a set number of shots it can deliver. On the question of reusing this consumable, an explanation is widely circulated online that it is “a breach of the ban on reusing single-use medical devices under the Medical Service Act”.

As far as we have verified, that explanation is not accurate.

It is true that Article 4(6) of the Medical Service Act prohibits the reuse of single-use medical devices. But which devices those are is set by the Enforcement Rule and by Ministry of Health and Welfare Public Notice No. 2022-404 (23 May 2022), and the list is this — catheters inserted into sterile tissue, intravascular catheters, drainage catheters and containers, implantable medical devices, devices related to Creutzfeldt-Jakob disease, and devices suspected of being an epidemiological factor in an outbreak of infection.

Ultrasound lifting cartridges are not on that list. So the phrase “a breach of the ban on single-use reuse under the Medical Service Act” is legally incorrect.

That does not mean there is no rule at all. The provision that actually applies is elsewhere.

Article 26(4) of the Medical Devices Act — “No one, in using a medical device, may … alter or modify it so as to differ from the content that was approved, certified or notified”

If the cartridge’s approved specification sets out a number of uses and single use, then resetting that count or refilling its contents amounts to alteration or modification differing from the approved content — that is the legally accurate account.

What we could not verify — and this part matters

We looked for the following three things, and we could not verify any of them.

• A press release or safety letter in which the MFDS addressed the reuse of lifting cartridges specifically
• Academic literature reporting infection or burns caused by cartridge reuse — there is literature on the reprocessing of single-use medical devices in general, but not on this consumable
• Official statistics giving the scale of non-genuine consumable distribution in Korea

So we cannot write “reuse causes infection”. We could not find the evidence. We open cartridges in the consulting room for a reason unrelated to this dispute — so that the patient can see it for themselves.

How to check

One sentence is enough: “could I watch the cartridge being opened?” Opening it immediately before the treatment is the norm, so there is no reason in the sequence of events for this to be difficult.

This item sits in an unexpected place. Among consumer harm related to aesthetic medicine, the most frequent category was not adverse effects but contracts.

Please read the year along with the figures. This was published in 2021 and covers two years of applications received in 2019–2020. Within the range we checked, we could not find any aesthetic · cosmetic redress statistics updated since then. It is not data that should be called “recent statistics”.

Lifting is often carried out over several sessions or bundled across several areas, which makes prepayment easy to fall into. That is why this item is in practice the one that most often causes trouble.

How to check

• What happens to the remaining sessions if you stop partway — whether a refund is possible, and on what basis deductions are made
• Whether that basis is in writing — terms you were only told verbally cannot be checked later
• Whether you can change the area or the treatment — how the remaining sessions can be used if your condition changes

Here is where we explain why the item “cheap prices are dangerous” is not in this article. We could not find, anywhere in Korea or abroad, a study demonstrating a relationship between the price of aesthetic treatments and the rate of adverse effects. It is a claim without evidence, so we did not write it. What does have evidence is not whether the price is high or low but whether the refund terms are clear.

The safety of the lifting family of treatments is reported as broadly good in a number of studies. Let us say that first, before anything else.

There is, however, a reason these numbers should not be read at face value.

We could not find a paper giving the incidence of burns. The material reporting blistering · erosion · ulceration · atrophy · skin necrosis was a case series of five patients, and the vision-related complication was a case report of one 50-year-old woman. A case report has no denominator. That means you cannot know how many out of how many.

A 2025 literature review (22 papers examined) wrote about this problem directly — that the included studies “did not report exact patient percentages”.

So we do not tell patients flatly that “the rate of adverse effects is such-and-such a percentage”. The numbers in the table above are what each study observed under its own conditions; they are not established incidence figures for this treatment.

There is one item worth watching carefully. In the review of 45 papers fat atrophy was rare, under 1%, but its cause was written down as “inappropriate choice of depth”. In other words this is less a matter of probability than a matter of planning.

How to check

See whether adverse effects come up first in the consultation. And you can ask this — “might this not suit me?” If the answer that comes back is “that will not happen”, it is an answer that matches none of the studies in the table above.

The five items in this article have nothing to do with region. The statutes, the case law and the lookup systems are the same across the country.

There is, though, a point at which region does enter into actually choosing a clinic. Distance. Lifting does not usually end in one visit, there are cases where a check afterwards is needed, and if a reaction is not what was expected you have to be able to come back.

So the advice we give is not “choose somewhere close” but “if it is a distance you would find hard to travel again, decide with that in mind”. Aftercare is part of the same episode of treatment.

Miso Clinic is on the 4th floor of the Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, 322 m from Exit 1 of Kyungpook National University Hospital station. Recording the location is information, not the conclusion of this article.

Reduced further, the five items are five questions.

• Could I have the approval number for this device?
• Who will be performing today’s treatment?
• Could I watch the cartridge being opened?
• If I stop partway, what happens to the remaining sessions?
• Might this not suit me?

None of the five are hard questions to answer. That is why we think they are worth asking.

Written and reviewed by Lee Chi-Hak, MD, medical director of Miso Clinic in Daegu, South Korea. Every study cited above is given together with its design, its size and the limitations the authors themselves recorded, and where we could not find data, we have said that we could not find any.