Vietnam’s latest cosmetic procedure trend has people injecting hyaluronic acid fillers into their ear lobes in order to achieve elongated lobes like those of Maitreya, aka Laughing Buddha, considered a good long charm.

Vietnamese media recently featured a beauty salon in Quang Ninh where an increasing number of people have been requesting ear lobe fillers in order to change their fortunes. They believe that by increasing the size of their ear lobes to emulate those of Maitreya, a symbol of wealth and good fortune, they will attract prosperity into their lives. Advertisements for this procedure have reportedly become very popular on social media as well, with many salons promising fast and painless procedures to superstitious customers.

One beauty salon owner referred to only as Mr.T  told Vietnamese journalists that the majority of his customers for this unusual procedure are men over the age of 30 who believe that religion plays a big role in their business success. However, women have begun asking for it as well.

Ear filler procedures reportedly take between 15 and 20 minutes, and are advertised as generally safe, with no long-lasting side-effects. And some even promise to adjust the shape and size of the ear lobe, if the client isn’t satisfied.

Hyaluronic acid is the most used filler for ear lobe enlargement, with the South Korean-sourced acid being the most popular on the market. Although considered generally safe when injected by professionals, amateur procedures and dubious quality fillers can lead to disastrous results.

Vietnamese news site Vietnamnet recently reported the case of a Vietnamese man who allegedly wanted to get large, luck-attracting ear lobes like the Laughing Buddha, but without paying someone to do the procedure. So he asked a friend who works at a spa to get him so hyaluronic acid so he could inject it himself. It didn’t go well…

After noticing his ear lobe change color and becoming deformed, the man went to the hospital, where dermatologists diagnosed him with a necrotic ulcer of the ear lobe. It is unclear whether it was caused by having injected the hyaluronic acid into a blood vessel by accident, or simply by the low quality of the acid.

Physicians at Ho Chi Minh Hospital also reported the case of another man who, “due to the nature of his job,” had to get Buddha ear lobes, and wound up with inflamed granulomatous tissue that had to be removed. Doctors suspected that the man injected silicone instead of hyaluronic acid. His lobes had to be surgically reconstructed.

After the procedure went viral on Vietnamese social media, doctors started issuing warnings that those interested in Buddha ear lobes only carefully inform and educate themselves before getting the procedure. And if you’re this superstitious, having the procedure done at reputable facilities, by experienced professionals is also, obviously, extremely important.