The man accused of the murder of Lindsay Hawker, the British woman who was strangled and buried in a bath tub in a Tokyo apartment, underwent a string of cosmetic operations in what appears to have been a carefully planned effort to hide his identity.

Tatsuya Ichihashi went to at least two cities to have his face altered and was reported to police by suspicious clinic staff, according to police leaks reported in Tokyo newspapers yesterday. But he gave false names and never returned for follow-up appointments, where police would have been waiting for him.

Yesterday, the family of Ms Hawker expressed their dismay at the latest development in the two-and-a-half-year manhunt for Mr Ichihashi. They also demanded answers from the police, who allowed Mr Ichihashi to slip between their fingers after Ms Hawker’s murder in February 2007.

“We have received no official confirmation of any of the reports despite attempts to do so,” Ms Hawker’s family said in a joint statement yesterday. “We would like to know who the surgeons were, where Ichihashi, the only suspect, obtained the money for the operations, and who is hiding him. Which hospitals or clinics carried out the work and why would they operate on a man who is allegedly the most wanted man in Japan?

“It is two years now since Lindsay was murdered and we have never given up hope that he will be caught. We … would like the police … to contact us and explain the situation properly, so that we know the facts, not just rumours.”

The police in Chiba prefecture, where Ms Hawker died, have made contradictory statements, with separate officers confirming or refusing to comment on the latest reports to The Times. But information leaked to Japanese journalists suggests a fugitive who hatched a careful plan to change his face as it appears on tens of thousands of wanted posters across Japan.

According to the Yomiuri newspaper, Mr Ichihashi visited a cosmetic clinic in the southern city of Fukuoka in mid-October where he underwent epicanthoplasty, the operation which converts the “single fold” eyelid of an Asian to the “double fold” of an Caucasian.

On October 24 he had an operation on his nose in the city of Nagoya in central Japan. Staff at the clinic contacted the police three days later because they thought that their male patient, who stood out among the overwhelmingly female clientele, resembled the man in the wanted posters. Examination of the photographs taken by the clinic suggested that it was Mr Ichihashi, but revealed the traces of extensive work on his face.

As well as the double fold on his eyelid, his lower lip was thinner. He had also had two moles removed from his left cheek – distinguishing marks that are highlighted on the wanted posters. His height and build matched those of Mr Ichihashi.

The man was due to return to the clinic on October 31 to have stitches removed, but he never appeared and the name and address which he gave in Osaka were false.

Ms Hawker was 22 when she went missing after giving Mr Ichihashi an English conversation lesson in the town of Gyotoku. When her friends found his telephone number on a piece of paper in Ms Hawker’s room, nine police officers visited Mr Ichihashi’s apartment. He ran away in his bare feet.

Afterwards, they found her naked body in the bath on the balcony. Her hands and ankles had been tied with plastic cord used to bind plants, and she was buried in horticultural soil. The post-mortem examination showed that she had been brutally beaten.

Since then there have been many reports from members of the public who believe that they have seen Mr Ichihashi, none of which have led to his arrest. Police have made extensive enquiries in Gyotoku, as well as in an area of gay bars in Tokyo where, according to the Japanese media, he was a regular customer.

Japanese detectives even mobilised detectives in the Philippines after a report that Mr Ichihashi had been seen in the resort town of Cebu, but this turned out to be a different person of the same name.

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