Ex-gangsters go straight... to surgeon who can hand them a new life

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What happens when mobsters want to abandon their criminal ways and go straight? For American wiseguys, the options are limited: run and hope for the best, or inform on your mates and live in FBI-sponsored witness protection, always remembering to check under the car hood every morning.

In Japan, which has an estimated 80,000 full-time gangsters, there is no police help and leaving often requires an offering to appease the offended honour of an oyabun (boss) - one's little finger.

Of course, this being the criminal underworld, cash will do just fine, but few junior hoods have much money, so the options are to sleep with the fishes or say goodbye to your golf-grip. The preferred tools are a very sharp knife, a spotless white handkerchief and a manly grimace as you amputate your pinkie at the joint - an honour sacrifice known as yubizume . A colleague provides a piece of string to stem the blood and the hood is off to his new life, via the hospital.

But then the problems start because nobody wants to hire, marry or even sit next to a former gangster with a missing pinkie. That's where Yukako Fukushima comes in.

A sort of hi-tech Florence Nightingale of the underworld, Ms Fukushima is one of the world's leading makers of hand-made prosthetics and she has used them to help more than 500 gangsters, or yakuza, go straight, often for little or no profit. Sitting in her small office in Osaka - the yakuza capital of Japan - surrounded by body parts so real looking they could have fallen off her, she explains the trials and tribulations of your average reformed hood and why she helps them.

"Many former yakuza want to go back to work but without their pinkies nobody will take them on," she says. "They're often not bad people at all, although they can get very angry and scary sometimes. Some of them can't bring their kids to the swimming pool or be seen with their children in public at all because the other kids will bully them and say, 'your father is a gangster'. So I help them out." Like its corporate counterpart, the yakuza world has been hit by lay-offs, suicides and the unwelcome attention of the authorities. The 1992 Anti-Organised Crime Law kicked off a recession-hit decade for the underworld, which has consolidated and downsized like the rest of Japan Inc. While the top criminal organisations have flourished, smaller gangs have gone to the wall and thousands of employees have tried to go straight.

Many former hard men come to Ms Fukushima broke, desperate and fingerless, meaning the 32-year-old former industrial arts student has had to develop counselling skills to go with her technical talents to deal with blubbery ex-hard men: "People don't think about this but many yakuza have killed themselves; the statistics are really high. They come in here with no money, job or little finger and sometimes they just burst into tears and blurt it all out," she says.

Although she has been fiddled out of money many times, she still offers fingers made to order that should cost about 150,000 yen (about £750) for 50,000 yen. "It's often all they can afford."

As in most Japanese companies, the customer is king and every effort is made to meet every client's needs. Ms Fukushima spends hours making her silicone creations as realistic as possible: blue veins for older feet and hands, and matching finger sets for former hoods who like to go out in the sun - darker for summer and paler for winter.

So seriously does she take her work that she has had three trips to the hospital for overwork and stress, not helped by police who come and lean on her for information about her unusual clientele. "I don't have client privilege like doctors or lawyers unfortunately," she says.

The obvious question is, after years of dealing with untrustworthy men nursing violent tempers and mutilated mitts, why does she still do it? Ms Fukushima, who got into the prosthetic business after taking pity on someone with a missing ear, says she's not clear herself. "Part of it is for my own enjoyment. I enjoy helping people. I can help people out with this skill I have and they come back and tell me I've helped them get their lives back.

"I am also really angry with the government, smashing up gangs but not providing any help. When people say, why do you do this, I say I didn't have a choice. I felt I had to. I want them to have happy lives, to make families and get jobs. Everybody deserves a second chance."