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Scared Kramer patient

Cosmetic surgery clinics must also deal with aggressive and persistent complaints from unreasonable complainers.A claimer may initially intend to receive a free beauty treatment and file a complaint after the treatment, or he may change his mind midway through and make unreasonable demands to the medical institution and demand a refund of the treatment costs.In any case, it seems that these types of complainers often request returns and refunds for products that have been extensively used, even at stores other than medical institutions.Both hotels and department stores have complaint countermeasure manuals.This is a case where even the slightest mistake is blamed on the victim and the accommodation fee is waived or compensation is requested.Unfortunately, in a private clinic like ours, it is absolutely impossible for a patient to be treated as a complainer from the beginning, so we have not taken sufficient measures and have fallen prey to complainers. .There are actually complaints that specifically target people in the medical field.Since the stain cannot be completely removed by treatment, please refund the treatment fee in full.There was a patient who made this persistent request.As for the treatment cost, even though he received the treatment at a discounted campaign price, did he make a planned complaint asking for a refund after the treatment?Makes me suspect. They say something outrageous: ``Even though I received counseling that said the stains would be completely removed, the stains still aren't coming off!''First of all, as a doctor, I cannot guarantee that the stain will be completely removed.This is because there are some stains like melasma that are extremely difficult to eliminate and can only be controlled.In addition, there are many cases where just thinning the area is enough to be effective.There are regular complainers who make aggressive complaints about even the slightest remaining stains.They unilaterally insist on things that are convenient for them, such as the staff's poor response, lack of explanation, too high costs, or the fact that what they are saying is wrong.Some patients even make threatening complaints.Up until now, I had thought that I would have to accept a refund due to the risk of having to spend time with such unreasonable patients, but as a medical institution, I would like to provide a thorough explanation and provide materials. Therefore, we will never succumb to unreasonable complaints as long as we provide treatments that are currently considered effective by medical science and there are no problems.When we talk about medical troubles, we often talk about mistakes and negligence on the part of medical institutions and doctors, but it is also true that there are patients known as complainers who have an abnormally sticky temperament.There was a case in the past where a doctor I knew had forged a medical certificate and asked for a refund.When we informed the clinic's lawyer that we would be filing criminal charges against the doctor who submitted the fake medical certificate, the clinic's attitude completely changed and the unreasonable demands were no longer made.First of all, we will treat the complainer with hospitality and explain re-treatment options that are acceptable to them and give them priority, but if they repeatedly make unreasonable demands or act in a way that could be considered threatening, we regret that they will not be able to comply legally. We must take appropriate action.Doctors have a duty to guarantee and protect the health and safety of their patients, but I have learned from actual cases that they also have to protect themselves from the fear of complaints.It is unfortunate that medical institutions need to deal with complaints so that they do not spend so much time dealing with such complaints that they neglect the medical care of other patients.

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Devil cosmetics

There are cosmetic manufacturers that combine all the trendy ingredients into their products.Among them, be careful about cosmetics containing hydroquinone.At the clinic's affiliated companies, patients sometimes wonder why they don't add hydroquinone, which is highly effective against age spots.Doctor's cosmeticsFrequently asked questions by users.The reason is simple.Hydroquinone should be treated as a pharmaceutical product, as it is easily oxidized and the safety of its inclusion in cosmetics has not been reliably confirmed.Hydroquinone is XNUMX times more effective than arbutin (in vitro), and I think there are some people who use it without paying attention to its safety, because the topic is all about its effectiveness.In the past, its use in cosmetics was prohibited in Japan, so it was only used sparingly by some dermatologists to treat age spots.It is a very unstable substance, and if it is simply dissolved in water, it will quickly oxidize and turn brown.When added to cream, it turns pink, so it is a raw material that requires difficulty in ensuring its stability.The reason it was originally banned in Japan was because none of the manufacturers submitted safety data to the Ministry of Health and Welfare.However, after the relaxation of cosmetic regulations in XNUMX, it became possible for companies to use products other than pharmaceutical ingredients and some prohibited ingredients even without safety data, and this led to the emergence of hydroquinone cosmetics.However, this does not mean that cosmetic manufacturers have confirmed their safety.Naturally, it is highly toxic, so many countries have regulations against hydroquinone, and in the United States, it is written on cosmetics that you should stop using it if it does not work after XNUMX months.In Europe, where cosmetics regulations are progressing as well as in Japan, hydroquinone has been designated as a prohibited ingredient and its import from overseas is blocked.In Japan, the situation is very ambiguous, and there are no warnings about hydroquinone in cosmetics, nor is it prohibited, so it is left unchecked.If hydroquinone is used under the supervision of a specialist, the specialist will make an objective judgment and advise you to stop using it, but when it is added to cosmetics, there are no warnings like in American cosmetics. Isn't it true that we keep using it forever?In other words, there is definitely a problem with using oxidized hydroquinone in cosmetics.This is the reason why major cosmetic manufacturers are refraining from adding ingredients.Hydroquinone becomes highly toxic when oxidized, so it can only be used as a product from a company that places great emphasis on stability when creating cosmetics.Rather, hydroquinone should be treated as a medicine to be used under the prescription of a doctor.By the way, the whitening effect of hydroquinone is achieved by suppressing the action of tyrosinase and preventing small melanins from sticking together and forming large melanins (preventing melanin polymerization).Unfortunately, there is a difference between the amount of hydroquinone that is effective (whitening) and the amount that causes side effects (irritation), so although it is certainly powerful, it is also a burden on cells and is not included in general cosmetics. there is no.Is it no surprise that it is banned in Europe?It appears that stricter regulations are being considered in the United States as well.I want all women to acquire solid knowledge about cosmetics so that they don't fall prey to companies that chase trends that prioritize profit and ignore safety.

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Nagoya's unscrupulous cosmetic surgeon who was arrested and went bankrupt

Graduated from the former Imperial University School of Medicine. Became a cosmetic surgeon with no experience. Arrested for violating the Medical Practitioners Act, suspended from practicing medicine, filed for bankruptcy. In XNUMX, an unscrupulous cosmetic surgeon was arrested in Nagoya for violating the Medical Practitioners Act, went bankrupt, and disappeared. did.Dr. S, XNUMX years old at the time, graduated from the former Imperial University School of Medicine and was a lecturer in thoracic surgery at a private medical school in Aichi Prefecture.He started a cosmetic surgery clinic without any training or experience because cosmetic surgery is lucrative.As a thoracic surgeon, I became a cosmetic surgeon, so I can perform any surgery easily and successfully!This PR was his selling point.In the waiting room, his medical doctorate certificate and former Imperial University diploma were proudly displayed.At university, I left clinical work and was solely responsible for animal experiments, so I almost never did any clinical work until right before I opened my practice.My pride was extremely high, and since I was a graduate of the former Imperial University and was in charge of cosmetic surgery, he believed that any surgery would be easy for him, so I performed breast augmentation surgery for the first time in my life while referring to a book. .However, the patient started with local anesthesia, but as the patient complained of pain, the amount increased rapidly, and the patient went into shock due to local anesthesia poisoning.He did not recover and was transferred by ambulance to the Japan Red Cross Hospital.He remained unconscious for several days.He barely survived, but the damage to his brain left him with amnesia.Later on, I was able to hear about the terrifying incident in detail from the staff who worked under Dr. S.A doctor with common sense would have gotten discouraged at this point and performed the surgery carefully, but Dr. S, who always begins the surgery under the influence of alcohol, convinces those around him that the reason there was no fatal accident was because of my good skills. His haphazard surgery accelerated even more.All failures and troubles are the patient's fault.Your skin rotted because you moved, and it happened because you weren't resting.It seems that I was a veteran thoracic surgeon and a cosmetic surgeon, so it was impossible for me to make a mistake, so I yelled at the patient in a way that made them fearful, and dismissed the medical mistake.In addition, Dr. S had a friend of his who worked at the real estate company he employed as an office manager act as a fake doctor to perform medical treatment.When he went to Hawaii for fun, he was arrested for causing trouble by causing the office manager to perform a medical procedure, which was widely reported as a front page article in the local newspaper.Surprisingly, even after this, he continued to perform medical procedures and cause more victims.A large number of patients who had been harmed visited my clinic after Dr. S went bankrupt and went missing.A female patient had a mole on her nose gouged out with a scalpel, leaving it in a pitiful, depressed state, and a female patient suffering from condylomata, a sexually transmitted disease, whose genitals were brutally chopped up with an electric scalpel. A young female patient was suffering from armpit surgery, where the skin was scraped too much, resulting in necrosis and keloid-like scars, making it difficult to lift her upper arm.Many young female patients were victims of Dr. S. Dr. S's evil deeds were well known in Nagoya.He had a strong sense of elitism as a doctor of medicine, a graduate of the former Imperial University, a thoracic surgeon, and a university lecturer, and did not seem to want to listen to the opinions of others.It was later revealed that he had resigned from the university due to problems related to his relationship with women and surgery. Needless to say, the incident caused by Dr. S caused great harm to not only the patients but also university officials and doctors working part-time at this clinic.An incident very similar to that of Dr. S, who was arrested in Yokohama last year, had already occurred in Nagoya more than XNUMX years ago.This incident served as a lesson that just because he graduated from a famous university, because he is a doctor of medicine, because he is a confident doctor, he does not necessarily have the qualifications to be a cosmetic surgeon.Now that his suspension from practicing medicine has been lifted, Dr. S may be using his scalpel as a cosmetic surgeon somewhere.

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Reports of troubles and accidents of successive cosmetic surgery

Complaints and troubles related to cosmetic surgery that were not previously publicized have recently become widely covered in the media.Unlike medical malpractice, there are many problems caused by unfair claims for treatment costs.This is what has been reported recently.There has been a series of troubles involving medical institutions that have entered into unfair credit agreements for hair removal and breast implants.The Installment Sales Act allows customers to default on payments to credit sales companies if there is a defect in the product or service, but this appears to be because it does not apply to medical practices.On the XNUMXth, lawyers will conduct their first dedicated ``XNUMX number for high-cost cosmetic medical treatment''. ``I ordered phimosis surgery because it was advertised as XNUMX yen, but at the time of the surgery I was told that it would cost XNUMX to XNUMX million yen, and a credit contract was already prepared.'' ``I saw the advertisement saying XNUMX yen. When I consulted about double eyelid surgery at a clinic, the patient was persuaded for two hours to sign a contract for XNUMX million yen, and after the surgery, my eyelids were swollen.'' The Daini Tokyo Bar Association's Consumer Consultation Service receives such medical loan consultation calls every month. It takes XNUMX-XNUMX bottles.Similar calls are also being received at medical consultation centers.According to the National Consumer Affairs Center of Japan, there were XNUMX complaints and consultations regarding aesthetic medicine in fiscal XNUMX, an increase of XNUMX times over three years.Contracts and cancellations accounted for nearly XNUMX% of the total.When it comes to beauty salons, profit-oriented salons that deviate from their core business end up damaging the industry's image, and the same goes for cosmetic surgery.It is also necessary to thoroughly drain the pus to cleanse the industry.I would like the government to crack down on it strictly.

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Violation of esthetic doctor law

Lately, I've been seeing reports of managers and staff being arrested for violating the Medical Practitioners Act at beauty salons.In beauty salons, medical-like practices may be carried out openly in a so-called black box.In other words, the closer the practice is to medical-like activities, the higher the profits will be.Since it is not possible to expect a large profit from the original skin care and healing treatments, it is expected that they will violate the Medical Practitioners Act and engage in illegal activities such as photo hair removal, mole removal, and stain removal.People without expertise or qualifications do not understand the risks.They also tend to over-advertise and perform treatments because they have nothing to lose.Unfortunately, there is no national qualification for estheticians, so from today onwards I can start working as an esthetician right away.In the past, hair removal required advanced knowledge and skills, but now, with the advent of optical hair removal equipment, anyone can easily perform the procedure.However, the risk of burns increases, and incorrect settings can cause problems such as burns and pigmentation.There are also patients who come to my clinic for treatment after suffering from severe burns caused by hair removal at beauty salons.I'm not denying esthetic treatments, but society cannot exist without obeying the law.The reality of major beauty salon chains that pursue only profit is also horrifying.Estheticians compete against customers' sales based on bar graphs to raise prices, and forceful solicitations are made through talk that could almost be interpreted as intimidation.Use campaigns and trials to lure customers into signing contracts for expensive courses.This is a special type of business negotiation and technique.The other day, listed beauty salon company La Parle was suspended from business.It appears that this beauty salon was also using highly forceful and fraudulent methods to increase sales.It was an incident and report that further tarnished the image of the industry.What I cannot forgive is an esthetician who takes advantage of the psychology of women who want to improve themselves and uses esthetics as a tool to make money, or who recommends esthetics by lying that there are risks in cosmetic surgery or cosmetic dermatology treatments. There are many.We have also confirmed the existence of manuals that falsely explain to customers that hair removal in cosmetic surgery is painful, cause many troubles, and carry great risks, and try to convince customers to sign a contract by emphasizing the safety and convenience of beauty treatments.This manual contained content that could be considered defamatory of cosmetic surgeons.If cosmetic surgeons across the country saw this manual, I think they would be very angry about aesthetics.There is no pride or elegance as an esthetician, and the reality is that they are using esthetics as a cover to make money.I hope that the authorities will strictly crack down on this and the industry will return to normal.The Medical Practitioners Act prohibits anyone other than a doctor from removing hair by applying powerful light or lasers to the hair roots.

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Cosmetic surgery treatment by a fake doctor

I recently saw a newspaper article about a Korean woman being arrested for injecting anti-wrinkle medicine without a license, in violation of the Medical Practitioners Act.How did this fake doctor get you cosmetic surgery?There was a patient of mine who had a very difficult time.An acquaintance told me that a famous cosmetic surgeon from South Korea would come to Japan and perform a special nose surgery, so I underwent the rhinoplasty at home without hearing any specific explanations or surgical procedures.Immediately after that, a foreign object was inserted into her nose, which turned red and swollen, leaving her in a miserable condition.Since I was having a medical appointment in Akasaka, I asked a friend of mine, a cosmetic surgeon, to perform the corrective surgery right away.A strange object had been inserted into his nose.A large, off-the-shelf prosthesis had been inserted haphazardly and had become inflamed and infected.Fortunately, we were able to deal with the problem early, and the incident did not go away, but it appears that this was the procedure performed on the arrested Korean woman.It seems that she thought it was dangerous because she was flooded with complaints about cosmetic surgery, so she changed to injections such as Botox and made a lot of money.Below is the article about the arrest. <Article> The Metropolitan Police Department arrested Korean esthetician Choi Bok-rye (XNUMX) on suspicion of violating the Medical Practitioners Act (practicing medicine without a license) for injecting a woman with a drug to remove facial wrinkles without a medical license. I found out that I was doing it.The anti-wrinkle drug used Clostridium botulinum toxin, which has caused deaths due to side effects overseas.Because it has not been approved for cosmetic surgery in Japan, it is difficult for anyone other than a doctor to obtain it, and the Organized Crime Control Division XNUMX is investigating ways to obtain the drug.According to the investigation, from March to October last year, Choi temporarily paralyzed the nerves and relaxed the muscles of five customers, including a Korean woman, at his home in Chiba's Chuo Ward to remove wrinkles from their faces. He is suspected of engaging in medical practice without a license, including injecting drugs containing Clostridium botulinum toxin, which has the effect of causing death.Suspect Choi came to Japan in XNUMX, and from around XNUMX, she had been performing cosmetic surgery on Koreans at her home. "I was taught this," she said in a statement.Last November, she opened a beauty salon in the same city, but it closed after about a month due to lack of customers.Choi was arrested on the XNUMXth of last month on suspicion of violating the Waste Disposal Act for disposing of empty injection drug bottles and other items at a garbage dump, but around XNUMX used hypodermic needles were discovered in the garbage. The department believes there are hundreds of women who practiced medicine without qualifications and are investigating.

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Terror made in China beauty medical material

There is a wrinkle treatment drug called BTXA that is made in China and can be called Botox.Because it contains pig collagen (gelatin), allergic reactions are relatively common.Moreover, it is said that Chinese products contain large amounts of impurities due to flaws in production technology.Of course, it has not been approved by the FDA.There are also quality control issues, with units per vial varying by a factor of up to 4 or more.In other words, you may be receiving an injection that is 5 times the prescribed amount without you even realizing it. Due to the nature of BotulinumToxin TypeA, when a large amount of ingredients are injected at one time, antibody production occurs (immunity against the ingredients), and then treatment with BotulinumToxin TypeA becomes ineffective for the rest of your life.It is an inferior product that is repeatedly approached by medical institutions when dealers can purchase it at a low price.It is an inferior product that is sold to cosmetic surgery and cosmetic dermatology clinics by unscrupulous traders because it can be purchased at a price that is XNUMX/XNUMX to XNUMX/XNUMX of Allergan's Botox.Recently, there has been an increase in the number of people complaining that this drug was used at other medical institutions and had no therapeutic effect at all.Many patients at our clinic have been injected with Botox made in China and have come to re-treatment because they can not feel the effect at all.It is naturally used by major cosmetic surgery clinics that perform Botox at a discount.A large amount of Botox due to armpit gait and hyperhidrosis?Always check the name of the drug.This is an act that should not be allowed and degrades the quality of aesthetic medicine.Isn't this problem even more serious than the food problem, just because it's not brought to the surface?In the treatment of wrinkles and hyperhidrosis, there is a possibility that medical materials mixed with impurities made in China may be injected without knowing it, and it may even be life-threatening.It is no exaggeration to say that the safety of these drugs is questionable, or rather that they are inferior drugs made solely for profit.Botox is a simple procedure called an injection, and there are relatively few side effects, so many patients do not pay attention to the drug, but please discuss the drug with your doctor.Money-driven clinics will never spend time discussing specific drugs or treatments.In recent years, beauty medicine has come to require quality.Not only major cosmetic surgery chains, but also dermatologists, internists, and obstetricians with little knowledge of cosmetic medicine are suddenly attracting patients as cosmetic dermatologists using Botox made in China at low prices. There are also cases.I had to protect myself.Discounted, low-quality medical care.I am afraid that it will hinder the development of aesthetic medicine.

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Profitable treatment is done more and more

Recently, many treatment systems, treatment methods, and injection materials have appeared, including laser treatment equipment, and we have entered an era of mixed beauty treatment.When I started working as a cosmetic surgeon, carbon dioxide laser was the only treatment laser irradiation system available. When I first saw a carbon dioxide laser irradiator 18 years ago, I was thrilled.Cuts meat instantly and easily punches holes in business cards.This is amazing.It looked like a laser gun, a cutting-edge weapon from space warfare.It was a thrill to pick up a laser gun, something I had longed for as a child.However, I soon realized that the treatment range was narrow and it was difficult to use.The first carbon dioxide lasers were larger than necessary and required large tanks to be filled with carbon dioxide.The purpose of treatment is only incision and removal of the mole.Even though I was one of the first to install it with high expectations, I was under the impression that it was not usable considering its high price.In fact, I rarely used it for treatment.Around this time, there was a boom in phimosis surgery, and clinics specializing in men were opening one after another.We have increased the number of patients by selling laser surgery.However, in reality, it was a poor idea.Scars are ugly and heal poorly, like burns.This was in contrast to the scalpel incision, which healed with a much cleaner scar.It seems that the name "laser" has given the image of magic to patients.Nowadays, there are very few clinics that use the nonsense method of performing phimosis surgery using a laser.Photo RF, Polaris, Thermage, Fraxel, Smart Lipo, Threadlift... new systems and new treatments are coming out one after another.Doctors who enter private practice immediately after graduating from medical school immediately introduce these systems and treatment methods and begin treatment.Just like a charismatic doctor with the latest equipment.The results are obvious.Long-term prognosis is important for any treatment.Even if the situation is good, the treatment should not cause problems in the future.Acquiring new treatment techniques requires time, knowledge, and experience.From the patient to the doctor, why is ○○ treatment not performed?I am often asked this. Can't you do ○○ too?You may also be asked.Of course, I cannot do it if I have no experience, or if my skills and knowledge are insufficient.Until the treatment is recognized to some extent in Japan and the side effects and prognosis are clear, people will not jump on it right away.If the idea is to prioritize profit in medical care, first come, first served.Are medical institutions and cosmetic surgeons who provide all kinds of treatments superior?Medical services are not discount stores or department stores.Treatment and subsequent care must be tailored to the individual patient.Is there really a doctor who can perform any surgery perfectly?It is questionable how many cosmetic surgeons there are who have the ability to deal with any kind of problem.I hope that there are no doctors who provide medical care to patients with half-baked knowledge and skills.

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An inexperienced doctor suddenly became a cosmetic surgeon.

Generally, a minimum of 10 years of clinical experience is required before starting a medical or surgical practice.This is the minimum period necessary to learn case experience and basic techniques as a specialist.However, in the field of cosmetic surgery, there are many cases in which patients suddenly open their practice after only 1-2 years of clinical experience.Many doctors who enter private practice after a short period of clinical experience are those who worked at major cosmetic surgery clinics.Why?This is because most of the major cosmetic surgery clinics do not have a solid training system in place, making it impossible for them to learn surgical techniques, conduct academic research, and gain solid clinical experience.Something like this?It's an easy surgery.Adaptation is fine.Unless the patient makes a complaint, the surgery is considered a success.For now, I'll just have to put him under anesthesia and insert a scalpel.I started cosmetic surgery with an extremely easy-going feeling.Only businesses that prioritize profit rather than medical service to patients stand out.When you can get a surgical fee of 100 million yen for just a few minutes of surgery, your financial sense becomes paralyzed.Once you have acquired the know-how in advertising and counseling, academic considerations, surgical techniques, and troubleshooting become secondary. Within 1-2 years, I was born as a self-proclaimed charismatic cosmetic surgeon.He even appears in the media calling himself a genius cosmetic surgeon.Surprisingly, there are some doctors who proudly post their career history on their homepage with 1-2 years of clinical experience.Cosmetic surgery is not such a low-level academic or medical field that even a genius or skillful doctor can open a cosmetic surgery clinic by himself within 1-2 years of clinical experience.This is a very unfortunate story.In addition, a doctor with only clinical experience in internal medicine incorporates cosmetic surgery when he opens his practice, and performs Botox injections, collagen injections, petit plastic surgery, thread lifts, photo RF, etc. like an experienced doctor, which he has never performed before. There are actually quite a few cases.Treatments and surgeries that may seem simple may have deeper meaning and must be performed carefully.It is absolutely necessary to be able to adapt the treatment and take appropriate measures in the unlikely event that a problem occurs.Of course, this is impossible for a doctor who suddenly became a cosmetic surgeon.Being a prosperous cosmetic surgeon and being an excellent cosmetic surgeon are two completely different things.It is important for cosmetic surgeons to constantly study, strive to improve their skills, and carefully provide medical services to patients to the best of their ability.Please be careful of self-proclaimed cosmetic surgeons.

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Trouble with surgery for hypertension

The current situation is that surgery for armpit bloating and hyperhidrosis is performed on the premise that even if it is not effective or causes trouble, unlike facial surgery, it will just be a tear-jerker.Underarm bloat/hyperhidrosis surgery is covered by insurance, but generally you will be hospitalized after the surgery and receive post-operative care.Why is it necessary to be hospitalized?Underarm surgery itself is simple for specialists.However, post-operative rest and care are more important than any other cosmetic surgery.Once the skin is peeled off, the apocrine glands, which are smell glands, the eccrine glands, which are sweat glands, and the sebaceous glands, which are the cause of yellowing, are removed from the back side, which causes great damage to the skin.Without this care, the surgery cannot be considered a success.In other words, it is necessary to re-attach the removed skin in the same condition as the skin graft.If the patient is not able to rest even a little, the skin will float up, causing internal bleeding, and the overlying skin will become necrotic.If possible, you will need to rest for one week after surgery for armpit bloating and hyperhidrosis.If you move even the slightest bit and cause internal bleeding, it will be serious.Among all cosmetic surgical procedures, it is the one with the highest risk of necrosis.Patients who have developed necrosis will have an ugly scar in the affected area.I have treated many female patients who suffer from these scars.If the patient had known about the scars from underarm/hyperhidrosis surgery, I think he would never have had the surgery.It is medically impossible to perform this high-risk surgery for armpit bloating and hyperhidrosis on a day-trip basis without going to the hospital.There is absolutely no effective armpit surgery that is simple, complete, and allows you to resume your daily life immediately.No matter how skilled a specialist is at performing surgery, it is difficult to eliminate 1% odor.It is our duty to thoroughly explain these risks to patients before surgery.Unfortunately, many cosmetic surgeons only emphasize the benefits of surgery and do not fully explain the risks.With the suction method, you can hardly expect satisfactory results.It is also difficult to reliably treat with ultrasound.Cosmetic surgeons perform ineffective armpit surgery that only causes damage to the patient's body, and demand high surgical fees.I am surprised that there are cosmetic surgeons who take advantage of patients' weaknesses and forcefully recommend surgeries, such as the fact that it is difficult to complain because the area is invisible, or it is difficult to complain because the surgery itself is detailed.Cosmetic surgeons have a duty to ensure not only the results but also the management of scars.There is no effective armpit/hyperhidrosis surgery that leaves no scars.