A South Korean actress recently returned to the small screen with a new weekend drama after a two-year hiatus. When the first episode aired, discussion immediately erupted online about whether she had plastic surgery.

Her agency denied the accusation and said her face was swollen because of fatigue while filming.

One online user, however, retorted: “She could say she didn’t go under the knife as fillers are not counted as plastic surgery these days.”

It’s not just celebrities. On Mondays, office workers and students often come back from the weekend with subtly changed faces, which naturally sparks suspicion.

Youn Choon-shik, a dermatologist at Yemiwon Aesthetic Clinic in Gangnam, southern Seoul, defines the latest trend in the Korean cosmetic surgery market as a preference for “natural looks.”

“Patients now prefer natural looks rather than noticeable changes,” Youn said. 

In a country where one in five women has undergone cosmetic surgery, according to the International Society of Aesthetic Plastic Surgery, more people are opting for “petit” surgery. It refers to simple nonsurgical procedures using injectable fillers or Botulinum toxin type A, better known as Botox.

In 2011, 145,000 Botulinum toxin procedures were performed, making it the most popular in Korea, according to the ISAPS.

The figure far exceeded the total number of Korea’s three most popular cosmetic operations ― lipoplasty, breast augmentation and rhinoplasty ― conducted in the same year which totaled 117,000 procedures. Hyaluronic acid, the most popular type of dermal filler, ranked second on the list with 90,000 procedures.

These “injectables” have been half-jokingly called the “fountain of youth” for the elderly, but now the range of patients includes the very young as well.

“For younger patients it can improve facial deformities and for the older generation it can offer rejuvenation,” said plastic surgeon Seo Young-tae at ID Hospital.

The facial fillers have strengths that both doctors and patients recognize. They are more affordable than other cosmetic surgeries, and offer instant results and quick recovery.

“I didn’t worry about aftereffects too much because it was just one injection taking only five minutes,” said Min Sung-a, a graduate student who had Botox injected into her jaw muscles to slim down her face, long a concern of hers.

“There wasn’t a huge change in my face shape but some friends told me that I looked like I’d lost weight. It made me feel good.”

Botox is a toxin-based drug that can paralyze the muscle. It is not only used to rejuvenate wrinkled faces but also to reduce the size of the muscles in the calf and jaw.

Fillers, on the other hand, restore volume to hollow areas such as tear trough and smile lines.

Kim Hee-joo, a 31-year-old office worker, received injectable fillers to lift her nose tip and boost her confidence.

“My job requires me to have frequent meetings and negotiations with many people. Confidence in appearance is not all but it certainly helps me to deal with other people,” Kim said.

The hospital where she had her consultation recommended liposuction for her chin and a nose job, which would have cost 3.5 million won ($3,300). Instead, she decided to opt for nose filler for 300,000 won.

“I wanted to see how my nose would look if I got a nose job. So I had the filler injection which seemed a lot safer than real surgery,” Kim said.

Youn emphasized the temporary nature of the fillers: “They are not permanent. It’s like you can control and modify clay, unlike cement, which you have to break when it gets solidified.”

Some fillers can be dissolved with another injection and those made from hyaluronic acid are absorbed into the body over time.

But this also means a greater risk of overdosing and more money spent on revisiting the hospital every six months to a year. The prices for dermal filler treatments vary from 50,000 won to over 500,000 won, based on where they are injected and the dosage.

Both Min and Kim were told by their surgeons to get another injection in a few months to maintain the effect.

Thanks to a boom in non-invasive cosmetic procedures, South Korea’s filler and Botox market, including both imported and domestically produced products, was worth an estimated 104 billion won in 2012, up from 65.9 billion won in 2010, according to the Ministry of Food and Drug Safety.

Domestic firms such as Huons, Daewoong Pharmaceutical Co. and LG Life Sciences developed their own Botox and filler, targeting the growing international demand.

Doctors also have had to keep up with new injection techniques. In September, a seminar hosted by the Korean Society of Surgeons, an association with over 2,000 registered medical professionals, expanded programs related to “petit” surgery.

“We decided to reflect the trend of cosmetic procedures in which surgeons show interest to stay competitive,” said Lee Dong-yoon, head of the association.

Under the current law, Botox and fillers can be injected by any doctor with a medical license.

Not surprisingly, as the market has got bigger, the number of cases of negative side effects reported has surged as well. According to data released by nongovernmental organization Consumer Korea, 233 reports of negative side effects related to Botox were filed in the first half of this year. The majority of reports involved inflammation and skin damage. In one severe case, one patient even reported partial loss of vision.

The side effects often hit patients who receive the treatment at hair salons and skin care clinics with no license to administer such injectables. They also sometimes use unproved products that could pose serious risks.

“The most important thing is that you have to find well-trained specialists. You need to look into the doctor’s specialty and how much experience he has. Price is the next thing to think about,” Youn said.

By Park Han-na (hnpark@heraldcorp.com)