Breast Surgery in Japan: Types of Clinics and Surgeon Training

In Japan, only licensed physicians may perform breast surgery. Every doctor who treats patients completes at least two years of clinical training; however, a clinic’s sign does not always indicate the operating surgeon’s specific qualifications.

Understanding the different categories of clinics in Japan, along with specialty names and the regulations regarding anesthesia and counseling, can help you ask more informed questions before surgery.

Who can perform breast surgery in Japan?

In Japan, only a physician who holds a Japanese medical license is authorized to perform medical procedures. To enter clinical practice, a physician must complete at least two years of clinical training at designated hospitals.

Additionally, every clinic or hospital must be managed by a physician who has completed this training.

Checking a physician’s license

The Ministry of Health, Labour and Welfare publishes a national search page for physician licenses. The search is in Japanese and requires the person’s name and sex. Travelers may want help entering the details.

If a name doesn’t appear, the physician may not have filed the required periodic report; a missing name doesn’t by itself mean there is no license.

Clinics and hospitals

Japanese law classifies a place where doctors provide medical care as either a clinic or a hospital. A clinic has 19 or fewer inpatient beds, including none, while a hospital has 20 or more inpatient beds.

Some cosmetic surgery clinics have no inpatient beds, while others have a small number. When a physician who has completed training opens a clinic, the opening must be reported to the prefecture within 10 days. Opening a hospital, or opening a clinic as a non-physician, requires approval.

The facility category is an administrative label, not a safety score. For a traveling patient, the procedure plan matters more than the sign on the building.

Combining breast surgery with a tummy tuck (abdominoplasty) can raise the chance of major complications. Ask the surgeon whether added procedures are worth doing in the same surgery.

Specialty names on clinic signs

In Japan, the terminology used on signs can be confusing for English-speaking patients. The fields of plastic surgery and cosmetic surgery offer cosmetic breast surgery. However, the similar Japanese term “seikei-geka” refers to orthopedics, which deals with bones, joints, muscles, and nerves.

• Plastic surgery: the field that covers surgery on the body’s surface, including many cosmetic breast procedures.
• Cosmetic surgery: a specialty name that combines “surgery” and “cosmetic,” used for procedures that change appearance.
• Seikei-geka: orthopedics, not cosmetic breast surgery.

The Japanese Orthopaedic Association warns that some cosmetic clinics use the term “seikei-geka,” which may mislead patients. If you encounter this term, confirm the clinic’s actual specialty rather than assuming it indicates cosmetic surgery.

Specialist certification

Japan’s regulations regarding specialty names do not mandate board certification for clinics offering cosmetic surgery. While plastic surgery is recognized as one of the 19 primary specialty fields in Japan’s specialist system, cosmetic surgery is not included among these basic specialties.

Plastic surgery training

A plastic surgeon completes two years of clinical training, followed by at least four additional years of specialized plastic surgery training and passes a certification examination. This is the foundational qualification for the field.

Two cosmetic surgery societies

Two separate societies, known as JSAPS and JSAS, certify cosmetic surgery specialists. JSAPS certification comes after a doctor becomes a plastic surgery specialist. JSAS certification requires at least five years of cosmetic surgery experience after clinical training, plus written and oral examinations.

Credential	Who issues it	What it means
Medical license	Ministry of Health, Labour and Welfare	The holder is licensed to practice medicine.
Plastic surgery specialist	Japan’s specialist board system	Completed specialty training and passed the examination.
JSAPS specialist	JSAPS	A plastic surgery specialist with further cosmetic surgery certification.
JSAS specialist	JSAS	A separate society certification for cosmetic surgery.
Anesthesia permit	Ministry of Health, Labour and Welfare	The physician may advertise anesthesiology as a specialty.

Advertising rules for credentials

Japan’s medical advertising regulations require clinics to indicate clearly who issued their specialist certification. While plastic surgery can be advertised as a national specialty, cosmetic surgery is not on the list.

A phrase that says a doctor is certified by the Ministry of Health, Labour and Welfare would be treated as false advertising, because specialist certification comes from the specialty board and medical societies, not the ministry.

One U.S. study of 298 physicians showed why the issuing body matters: 69.5% described themselves as plastic surgeons on a social media business page, even though their certificate came from a separate group.¹ The authors stated that the way certification is described can be confusing for people.

Japanese advertising rules ban claims of superiority between facilities. Treatment result photos must include clear details about the treatment, cost, risks, and side effects. Always check a clinic’s website for this information.

Who provides anesthesia during surgery?

A clinic may advertise anesthesiology services only if the responsible physician holds an anesthesia permit from the ministry. This permit requires either two years of supervised training after medical licensure or two years of experience with at least 300 cases of general anesthesia.

The Japanese Society of Anesthesiologists’ monitoring guideline states that the physician responsible for anesthesia must stay in the room and continuously monitor the patient during general anesthesia.

The patient also needs pulse oximetry and, for general anesthesia, a device that monitors exhaled carbon dioxide. Ask before surgery which physician will provide anesthesia and whether that physician will remain present throughout the operation.

An anesthesiology specialist and a physician with the ministry’s anesthesia permit are different types of qualification. Clarify which one the clinic uses. The type of anesthesia, the length of surgery, and your overall health all affect risk.

Who recommends the surgical plan?

Non-physician staff can provide information about general fees, schedules, and required documents, but a licensed physician must make the surgical recommendation. In Japan, the Ministry of Health, Labour and Welfare considers the selection of a treatment that aligns with a patient’s goals as a medical judgment.

A clerk or counselor can be helpful when you’re comparing dates and prices. Before you agree to surgery, the licensed physician who would operate should examine you, explain the method and risks, and answer your questions in person.

A 2024 expert panel reported that specialist certification is not always a required career step in cosmetic medicine. It also described cases in which treatment chosen with only a non-physician counselor was performed, or in which the treating facility did not handle complications.

If you’re coming from abroad, ask where an infection, a wound that reopens, or unexpected bleeding would be treated and which doctor to contact after hours. You can ask this before surgery, while the clinic is arranging your consultation and travel dates.

At our clinic in Tokyo, Japan, the doctor who sees you at the consultation also performs the surgery. You can discuss the method, risks, and your questions with our doctor before you decide.

Frequently asked questions

Can I trust a cosmetic surgery title by itself?

No. Japan’s rules don’t require board certification for a clinic to list cosmetic surgery as its specialty. The title alone doesn’t tell you how the surgeon trained.

Ask which organization issued the certification and whether it is a basic plastic surgery certification or a separate society certification.

What is the difference between plastic surgery and seikei-geka?

Seikei-geka means orthopedics, which treats bones, joints, muscles, and nerves. Plastic surgery is the field that includes cosmetic breast procedures. A similar word on a sign should not be read as proof of breast surgery experience.

How can I confirm a physician’s license?

Japan’s Ministry of Health, Labour and Welfare has an online license search. It’s in Japanese and asks for the physician’s name and sex. A missing name may simply mean a required report wasn’t filed.

Who should recommend the actual operation?

The physician should recommend the operation after examining you and reviewing your medical history. Staff who are not physicians may help with scheduling and payment, but they cannot make the medical decision for you.