cersepn

Right off the bat, it's very clear that you don't need zygoma reduction and you don't need v-line. What you need is chin work, either an implant or a sliding genioplasty, to make your face longer. In other words, from a frontal view, that would lengthen the distance from your lower lip to the chin. That will give the v-line look and make your face look slimmer.

I've realized a lot of people don't know what they really need to improve their looks. Your case is a prime example. So sometimes when doctors suggest certain procedures, they immediately think that the doctor is pushing something that they don't need, but in reality they don't know what they truly need. Of course some doctors are blatantly pushing stuff to earn more money, so there needs to be discernment on the patient's part. And there's also the other end, when a patient wants a unnecessary procedure and the doctor gives it to them to earn money, and in the end the patient gets a compromised result. V line surgery is extremely expensive and no doubt a big cash cow for plastic surgeons. I won't be surprised if there are surgeons who will do it for patients who want to pay for it, even if they don't need it. It pays to be an educated consumer.

For jaw/chin/facial shape problems, it's mostly a matter of balance. Whether the chin is balanced with the rest of the face when viewed from the side. Is there enough projection? If there is not enough projection (receding chin), the face will look too top heavy, giving the illusion that the zygoma is too large and should be reduced.

But the zygoma is not the problem. The small chin is. Once the chin is given more projection with an implant/genioplasty, the zygoma will be balanced out and the face looks more harmonious. From what i've observed, receding chins are a lot more common in asians than protruding chins.

The dental bite, how the upper and lower teeth meet, also plays an extremely important role in beauty. That's why braces can change a person's face so much.

I highly recommend reading about facial proportions and beauty. No need to go crazy over measurements down to the millimetre. But general stuff like rule of thirds and fifths in the face.
http://www.cofps.com/facial-proportion-beauty

You will find that a lot of beautiful people's faces have a strong adherence to the 'ideal' proportions, and you can analyze your own face to see how it compares. But of course there are exceptions to the rule

 

I've been through twilight sedation. You basically just feel high and you're conscious but you don't really know what's going on -- it feels euphoric. AFAIK, many patients actually go through twilight sedation but they don't know that they have.

 

john1: Ear cartilage is never, ever used for the bridge; it is only used for tip work. The structure is such that it can't warp - it's kinda like minced meat lol.

"most surgeons these days use an I-shaped implant on the bridge and cartilage on the tip. so the "pole" is cartilage not silicone. silicone is on the bridge where there is not nearly as much pressure" <- Honestly, if you've read medical literature (i had the privilege, courtesy of college's subscription!), most silicon work out there is still L-shaped silicon. And seriously, no. The real world, especially in places like thailand, still uses a lot of implant only, without any added cartilage. Though the better docs like dr lee do use the implant + cartilage approach, it is still not widely adopted.

"silicone is on the bridge where there is not nearly as much pressure so to speak."<- Yea, you're right. I missed out this part. In fact, it's precisely cos the implant is on the bridge that makes things even more dangerous. The bridge CAN be quite mobile. I have friends with silicon noses and it can move. The reason why the silicon implant can stay rather stationary without wobbling about is cos right before the insertion of the implant, the doc is supposed to scrape the inner lining (periosteum of the nose) to remove some tissue, so after the implant is put in, scar tissue will grow back around the area and help to keep the implant in place <- That's the really layman explanation of it; the actual article was a lot more technical and i can't remember the exact words used but the intended meaning is there.

Rib can warp, but the occurence is very low in the hands of a skilled surgeon. Warping happens when the cartilage is trimmed/augmented into an unnatural shape or cut against the natural 'grain' of the cartilage.

I think you missed my point about caucasians + foreign implants. What i was trying to put across is that the same foreign implant in an asian can hold up relatively well compared to caucasians -only- because of the nasal skin type. I really wish i could put up some of the rhino medical articles here but i can't; my college has some way of preventing the articles from being saved. Doctors have in time past tried to use silicon for rebuilding caucasian noses in time past and the results were terrible, with extrusion occuring very soon post-surgery. For the rare caucasian without a tall and strong nose, why would he/she have septal cartilage to work with when they don't even have good nose bridge/definition. Obviously they won't. Again, i'm only talking about caucasians without a caucasian nose.

I understand that you came from having a silicon rhino done so maybe that's why you feel more compelled to 'speak up' for that method. I'm not saying -everyone- who has silicon/gortex done is definitely gonna get complications, but the risks are real.

Yes, it's sad that not many doctors in the west are not well-versed with rib/autologous rhino; but in korea/taiwan, the trend is increasingly towards rib/autologous. Which i think, is a good thing.

 

I haven't posted here in a long time but felt the need to seeing the amount of potentially false info spread, not by posters here but gasp, doctors.

First and foremost, you have to realize that doctors will always say things to support what they've been consistently doing for a looong time. Not only that, it makes _alot_ more sense to use a rhinoplasty method that is cost-effective and easy (both for the surgeon and patient). What am i driving at? Simply put, silicon/gortex may not always be the best material for rhinoplasty.

But obviously, your doctor who's been handling foreign implants his entire medical career isn't going to tell you that. And because potential problems that might occur with rhinoplasty usually tend to surface only after a couple of years, it is much more difficult for the patient to go back to the doc and complain about it - after all, people expect a nose job to last a long time.

They might even think it's just their luck that the implant deviated/extruded on its own, since the doc, who is usually the only source of info, told them right from the start that silicon is 100% safe with very low complications.

I might come off sounding totally anti-foreign implant, and i don't deny that. Yea, this is the asian nose job thread, but ever wonder why silicon/gortex is almost never used in caucasians (not that the majority of them needs a higher nose bridge, but for certain odd cases with no bridge) yet used in asians with moderate success? It is cos asians have much thicker nose skin. Think about that further -- the silicon bridge is exerting a tent pole effect (your nasal skin being the tent; implant being the pole). And the only reason why asians tolerate implants better is cos the skin is thicker so as to withstand that pressure. Isn't that scary?

This is the exact reason why almost all good doctors still using silicon as their primary material use septal/ear cartilage together with the implant, to not only add definition to the tip, but prevent that tent-pole effect.

The problems with using silicon are intrinsic to the material itself - there is no way around it by superior rhinoplasty skill. Just do a search on "silicon calcification" and you'll find plenty of supporting evidence. The implant does not, and will never, integrate itself as part of your body; it is always a foreign part.

I have a lot more to say but am quite tired now. Hope you guys understand where i'm coming from. I just hope that for everyone contemplating a rhino, your first rhinoplasty will be your last

 

You're entitled to your opinions, and the thing about asians desiring bigger eyes MIGHT be true, but the double eyelids that asians crave for are usually in MOST cases, NOT the same as caucasians (deep set with an extremely high crease). The typical beautiful asian double eyelid does NOT look anything like the type caucasians have. I'm at work now so i can't dig out the pics for proof but yea. And you must really have been seeing the wrong before and after plastic surgery pics. I think i've explored asian plastic surgery enough to know that alot of top quality plastic surgery work does not make a person's face look westernized. But i guess by YOUR definition, as long as the nose is high/sharp, i guess that makes it western eh?

About the nose, just because you haven't seen asians with naturally high noses doesn't mean there aren't any. In the northen part of China, there are loads of chinese naturally born with extremely high and sharp noses. But to say that desiring a higher/sharper nose just because someone wants to look western can't be further from the truth. Many indians have really high and sharp noses, so going by your logic, i should be able to say asians want to look like indians too?

There are honestly plenty of beautiful asian celebrities who don't look the least bit caucasian even with big eyes and high/sharp nose. By that i mean, people don't go, "Hey that dude looks like he's a caucasian-asian mix". All they see is an attractive asian face. I'll probably update this post with some pics to show what i mean.

Just don't be so stereotypical. I don't deny that there's plenty of people who want to look western-ized, but to say that everyone who wants a high/sharp nose with bigger eyes has intent to look westernized is.. just a flat out fallacy

 

That is such a zzz job
The dorsum is way too thick for the girl's face - there's nobody with a bridge that has the width even from the top to the bottom. The alars are still so fat and the tip looks odd from certain angles. The angle of the nose is also totally off and doesn't look good on her face. I think her before nose looks even better. Sigh

Its sad to see that people are getting butchered for exhorbitant prices.

 

You're not supposed to smoke -_-
It will make you much more prone to infections and increase the chances of complications by alot

 

Haha, therein lies the irony. Even though asian rhino isn't as common in the US than it is in korea, most caucasians aren't going to think there's something fake about you, since they've been seeing tons of high, prominent noses their entire life. Unless they're ignorant enough to believe every single asian has no bridge, which is absolute rubbish. On the other hand, i don't wanna live in korea cos even if i was blessed with a naturally good nose, people are gonna think it was 'made'.

 

Let me put it this way. If your natural nose was going to bump into something really hard, the bones are going to break anyway. So it wouldn't matter if you had an implant or not. It's really harder than most people think to get your nose hit directly

 

Wow, is korean or english your first language? You speak very good english if english's not your first language. The most important thing you have to remember is.. if you don't feel comfortable with your doctor for whatever reason, DON'T go to him. Trust in your doctor's probably one of the most important things any prospective patient must have.

What are the popular clinics that you know about? By any chance, do they have websites? I've been dying to get some info on korean clinics, but i don't know the language, and google translator ain't good enough to translate out some search terms for me.

Your aunt knows what she's talking about. The tip is really what separates a good nose job from a bad one. I'm personally against foreign implants, despite their frequent use in asian rhinoplasty. Korea might be the land of nose jobs in asia, but there's still something really quite unethical about many of the doctors there, who claim that silicon noses willl last forever. Sure the implant itself would, but it doesn't last forever under your skin. Sooo many people have problems after 5-10 years and of course by then the patient can't go back and demand for a refund, plus she wasn't guaranteed of a permanent result.

 

Lol, if you say so. Like i said, THAT is the asian standard of beauty. If you don't agree, you can believe what you want. But one thing is certain; lucy liu is not a conventional asian beauty. Stop being so emo about this whole thing. We were just talking about what's attractive in asian culture and the west, and how it's different. Honestly, who gives a damn if she's rich and famous lolol.

asin: That's probably cos KTH's one of korea's first few beauties; maybe it explains why so many other girls want to look like that too. Anyway han ga in doesn't really resemble her, it's just that particular photo that bears a very slight resemblance. The miss korea? omg.. dun get me started. She's an insult to kth

 

Are you saying that just because nini said lucy liu's ugly? So she has to post up her own picture to 'prove' she's better looking than lucy?

lol, that's like saying simon cowell can't **** on people in american idol just cos he doesn't sing as well/bad as them.

lucy liu is definitely NOT the asian type of pretty. All my friends don't think she is good looking; that's a poor representation, i know. But the features that most asians find universally attractive - big eyes with double eyelids, small face, are not found in lucy liu. I'm also not saying that the presence of those features alone make a women beautiful, but it will be hard to find an asian female celebrity who's pretty without those features.

This is what i'm talking about
http://www.youtube.com/watch?v=u0uTUaPxDq8

 

Yea looks like i'm not the only one who went WTF when reading all those american tabloids about how hot lucy liu is -_-

Haha, the other korean actress in Lost, i forgot her name already, she was in the first and second season. She's pretty to asians too, or at least to me doh.

 

Just make sure that if you see something amiss with your nose, like skin discoloration, pus or some weird skin pigmentation on the tip/bridge, DON'T hesitate to go down immediately. No hate, and i hope your nose lasts 10 years.. but we'll see

 

Hard to say, it could very well be the skills.. or an inherent problem with foreign implants. It's also quite likely those woman had their noses done when the surgeons haven't had refinements in technique.. the way they do now. Take for instance Korea, most of their PS clinic websites i've seen, utilise this approach now - silicon bridge with tip graft.

Those implants all look like L to me. There are some I in that bunch.. but rather few. Alot of them have had their collumelar strut, which is the _ part in the L trimmed, which is why it looks short and almost like an I.

I'm pretty sure that most of the good clinics that aren't on the web (Why should they be? They've got all the business they need) should be using these techniques and more. It wasn't the case last time, when they just used the implant without tip grafting, leading to the common extrusion and complications etc.

It's not so much about the amount of money you're paying, it's more of an ethics thing. He didn't do a good job on your nose.. and he's charging you for him to fix his mistake? It doesn't sound right to me. In case you don't already know this, doctors have a good idea of what your nose looks like immediately post-op as the swelling has not set in yet. You might be wondering why a rhinoplasty might take 1-1.5 hours if it's so simple, assuming it's a closed approach. It's because they take out and insert the implant multiple times to make sure it looks good, trimming it in the process etc. In other words, the doctor definitely gets a good look of how the bridge looks like. Sorry, but i really don't see how that was an honest mistake by the doctor.

Oh and regarding that graphic pic? That white part IS the strut. That's precisely what i meant by the strut pressing against the inside of the nose.. and because asians have thicker skin, that pressure exerted by the strut is better tolerated.

 

Just some stuff that i extracted from medical journals.. it's not accessible to the public. I'm abusing my college's system lol.

"A major disadvantage of silicone is its notorious mobility after implantation and its propensity for extrusion if traumatized or exposed. Nevertheless, silicone has been very popular for nasal augmentation in Asian patients. Its success in this population is aided by the relatively thick skin-soft tissue envelope over the implant. Silicone grafts have given good results in primary but not in secondary rhinoplasty, where a 42% failure rate has been reported.Ham and coworkers reviewed 1500 cases of augmentation rhinoplasty with silicone and found an 18% incidence of complications which they attributed to implant design, or unskillful operative technique.

Similar to Ham and coworkers, the tip was the most common site of extrusion. A greater rate of extrusion and infection was associated with larger implants. The shape of the implant is important, with L-shaped implants for dorsal and tip augmentation being the most vulnerable for extrusion (4-fold greater rate of extrusion than with any other implant shape).In summary, the use of silicone seems to result in an unacceptably high complication and dissatisfaction rate based on large retrospective trials.

Nevertheless, it is frequently used in Asia, and McCurdy cites refinements in technique, the design of the implant (softer elastomer), and patient selection that may be responsible for a lower rate of complication than generally reported."

And.. from another article
"Unfortunately, because of their permanent nature, many of these alloplastic materials are fraught with long-term complications, such as infection, migration, extrusion, and palpability."

"prefabricated L-shaped configuration that acts as an onlay graft for both the dorsum and tip. It enhances dorsal height, improves tip definition and projection, counter rotates the tip, and even corrects columellar retraction. The authors of series that have up to 10 years of follow-up in Asia report a very low acceptable rate of implant infection, extrusion (0-7.9%), and malposition (5%). At the host&#8211;implant interface, there exists some micro-motion between the implant and the capsule, increasing the risk of infection compared with porous implants. As a consequence, there is a lack of enthusiasm for this implant in the Western world."

I'll dig out more bits and pieces when i have the time. You'll notice that most of the time, the only reason cited in medical literature as to why asian skin takes foreign implants better.. is that the skin is thicker. That is really quite scary if you think about it. This means that the implant is still poking the skin and wants to 'get out'; only thing stopping the implant from extruding is the skin thickness.

 

Almost all are of those noses are L implants. I implant is usually used only when there's not much nose bridge to raise. Yes.. it's quite hard to put in words, but basically the I tends to be more mobile. It's really quite a gray area, cos many times you don't know whether complications arise due to implant/doctor error or just that the body can't take it. There's alot of factors.

I meant unqualified not in the sense that they're quack doctors practicing without a medical license, but trained, qualified doctors - just trained in the wrong technique.

Did you also have a cartilage graft done for the tip? I assume you're asian? Honestly, i'm more for autologous tissue aka rib/septal/ear than foreign implants. There's really nothing foreign implants offer over autologous tissue except the fact that it's a HELL of a lot easier for the surgeon to do (don't need to carve that much of the implant, shape is pretty much fixed), and much faster for him (1-1.5 hr max surgery time) => which translates into more patients.. and yea you guessed it, more money

I frequently see in dr's websites that they don't do rib cos it's a much more invasive procedure and prone to warping (BTW, warping is really not a big issue in the hands of a skilled surgeon.. again it's all down to skill) That is true, but they leave out the most important thing - it's part of YOUR body.

I wouldn't go back to your doctor if i were you. Think about it, there was NO way he couldn't have known that your bridge wasn't perfectly straight. Yet he chose to go ahead with the rhino fully aware that you would end up with a slanted bridge. Think about it, a plastic surgeon handling sooo many noses couldn't have seen that coming? Sounds pretty unethical. Plus he's gonna charge you 600 to replace the implant.. when the implant costs like what? Less than a 100 bucks? And i'm being very generous with that amount already.

 

Actually, i have read in a medical report that I implants, by virtue of their shape, are less stable than the L implants. I think you shouldn't worry so much. From what i've read, all those complications with the L implants are more due to surgical errors; doctors aren't always the best at what they doing, especially when it's rhinoplasty. Didn't you go to dr charles lee? He's supposed to be one of the best in the states for asian rhinoplasty right, so relax. What is it you're not happy about your nose?

 

Great point! The thing is, people don't notice good nose jobs.. only bad ones. I would like to think that there are in fact, many more rhino-ed people than we, or even the general public, believes. Actually i have seen quite a few bad nose jobs on celebrities, korean celebrities. It looks bad to me cos my eye's sorta trained after all this time, but to most people they go 'wow what a beautiful nose'.

The trend in PS has been and probably will continue to change. It used to be that for women in korea, they would have straight, tall bridges with a very pointed tip. But now, their noses are much more delicate, with the very slight slope that is characteristic of a female nose. The tip is also more natural, with more flesh, rather than being very sharp and narrow. With more and more clinics rising up and competition becoming stiff, i think the surgeons there are hard pressed to improve their skills and establish a name for themselves. Afterall, reputation is everything.

With all that said, i'm glad we're borned not in our mother's time - the time when plastic surgery had this huge stigma of it being 'fake' and all, not to say that it's not true now, but because the results are much better and more importantly, natural.. people are opening up to it. Plus the doctors' skills back then were.. questionable.

 

sliverlight: Man.. what is with those pictures?! I'm pretty sure the 'bride' is a transsexual; not that i have anything against them, but 'she' sure ain't a good example of your point.

 

I'm gonna disagree with you big time on that. It's not merely about attracting a partner; looks do matter, whether you wanna admit it or not, in every aspect of a person's life, in the career, the way people treat you.. the list goes on.
No one is saying character's not important, but when people don't look past the surface, and trust me, it is happening more and more in our wretched society, they don't bother to see how gd one's char is, what's the point?
I don't see why you need to tell your boyfriend just before marriage and it's not 'hiding' something. Plus if he liked you only for your looks.. then he's not even fit to be your bf

 

Dr Kao is great, don't worry you will be in good hands. Actually, dr chuang is more well known for his breast implants; Dr Su is THE doctor for eyes.

 

Goodness.. just relax and be PATIENT. I'm sure you will eat your words once 2-3 months have passed. And you definitely do NOT wish you had gone for the 1.5mm.. trust me.

 

The before and afters i've seen aren't like hyori's nose, but pretty good too. With that said, dr chuang is more known for his breast implants than he is for nose.

I do think that there are better rhino surgeons in TW though, but it's quite hard to get information. Dr Kao and Dr Hsu are both quite popular as well, here's their websites
http://tw.myblog.yahoo.com/face-nose and http://www.ychsu.com/
I might add that they almost do only rhinos, nothing else.

As for the implants, the implants themselves should not pose any problems to the body, unlike you're one of the very rare few individuals with an allergic reaction to them. Medpor is better than silicon for chin implants from what i've read.

 

Yea he had a nose job done. You guys are so kind with your words, cos it looks pretty damn badly done. I think he had his eyes cut too. Guys borned with parallel lids don't look like that.. they look more like this
http://www.jpstar.net/wp-content/uploads/2006/10/Ryo%20Nishikido.jpg
http://galacticparadise.net/itsumo_keikok/memories-img/s_potato0801_03.jpg

wow i just saw the pics vanny posted up. I didn't know michelle reis had her nose done. It's kinda fake looking.. and raymond lam did his nose and eyes, 100% on that.

Anyone watches japanese dramas here? Most of their actors/actresses have superb noses, and very bright big eyes.. Lovely. I wonder if it's all natural.. though when my friend was in japan, he said most of the average joes on the street have high bridges naturally, unlike most asians. =|
http://img149.imageshack.us/img149/182/makilookupei5.gif
http://i33.tinypic.com/2vcdtsw.jpg
http://img510.imageshack.us/img510/7251/nudecopygq9.jpg