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Wales second row Cory Hill has been ruled out of the World Cup without playing a game.
The Dragons forward has failed to recover from a stress fracture and will be replaced by Ospreys' Bradley Davies.
Wales had only two fit regular locks - Alun Wyn Jones and Jake Ball - for their 43-14 win against Georgia.
Another lock, Adam Beard, is not fit for Sunday's game against Australia as he recovers from surgery to remove his appendix.
Versatile Scarlets back-row forward Aaron Shingler replaced Ball in their opener against Georgia in Toyota City.
The 27-year-old Hill's fibula fracture means he will return home to recover while Davies, 32, is expected to join the Wales squad in Tokyo on Wednesday.
Backs coach Stephen Jones said Hill "has tried his hardest to get over that injury and he is just unfortunate".
He also cited Davies' "vast experience", including involvement in the 2011 and 2015 World Cups.
Davies' arrival will mean Ospreys supplying three of Wales' four tournament locks as he joins captain Jones and Beard in the squad.
Meanwhile Centre Hadleigh Parkes suffered what Gatland described as a "bit of a bone fracture" in his hand in that six-try win, but said the New Zealander will be "OK to pad that up and it should not be an issue for him for selection next week".
Gatland also revealed fly-half Dan Biggar was okay after receiving a bang on his chin in the warm-up from flanker James Davies.
Biggar was also hit in the same area by team-mate Liam Williams as they celebrated a try against Georgia.
And the Northampton fly-half also dismissed concerns over the heavily-strapped left arm which he wore from the start of the game.
Bigger said: "It's just a little bit of a strain on the elbow, literally nothing to write home about at all, just precautionary rather than anything, so all good."
