대한민국 안면 필러 시술 의료분쟁 판례 분석(1997∼2023년)

Background: Dermal fillers are widely used in Korean aesthetic clinics. However, serious complications can lead to legal disputes. This study aimed to analyze filler-related lawsuits in South Korea, focusing on injection sites and complication types. Objective: To describe the characteristics of filler-related legal disputes and assess whether specific injection sites or complications are overrepresented relative to public interest. Methods: We reviewed 43 court decisions made between 1997 and 2023. For each case, the clinician’s specialty, filler material, injection site, principal complications, and verdicts were recorded. Among the 39 procedures performed by licensed practitioners, 20 were confirmed as malpractices. Four of the cases involved unlicensed individuals. A one-sided binomial test was used to compare the observed proportion of malpractice-confirmed lawsuits by injection site with the proportions estimated from the Naver search interest data (p＜0.05). Results: The specialties of most defendants were unreported (48.8%), and only 4.7% were dermatologists. The most common complications were skin necrosis/scarring (39.5%) and optic or brain injury (16.3%). Among the 20 malpractice cases, 75.0% involved nose injections, 20.0% involved the nasolabial folds, and 5.0% involved the lips. In nose cases, skin necrosis and optic/brain injury were equally prevalent (46.7% each), mainly due to intra-arterial injections. Although the nose accounted for only 21.3% of the search interest, it comprised 75% of the confirmed malpractice cases, a significant overrepresentation (p=4.4×10−7). Conclusion: Filler injections, particularly in the nose, require precise techniques and thorough anatomical knowledge. Patients should avoid illegal procedures performed by unlicensed providers, and clinicians must take extra precautions to prevent severe vascular complications.