My recent consultations in Seoul and surgical experiences

[shinyglittery]

K Couture said: ↑

Hi, its called Kenacort. Ask your surgeon or dermatologist about it

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thank you I will~!!

 

[chonny]

Thank you so much. I learn a lot from your post. You're so knowledgable about all these stuffs. Since you've had 2 chin implant surgeries, may you share us some of your experience and knowledge about different types of chin augmentaion as well, please? Thank you a lot.

 

[k-couture]

Hi im glad you found my post useful.

I would only recommend 2 materials for chin augmentation. Silicone and hydroxyapatite. Some surgeons have use cartilage, fillers or gortex and from what I've heard they don't work out that well due to higher risk of deviation and irregularity of the shape.

My first implant was done in Thailand at the Yanhee hospital. Do not go there. Dr Prechart was my surgeon and he basically took a block of raw silicone, cut out the shape and shoved it into my chin. I found this out later after it was causing me pain and i did a facial ct only to learn that the implant was jagged and misplaced. It was performed intraorally. I was actually semi awake during the procedure and i could feel him cutting into me it was quite terrifying. Silicone usually works out well if its a properly manufactured implant and the placement position is correct. I've been told that an external incision from under your chin gives better placement.

After I returned to Australia i got the implant removed and replaced with hydroxyapatite. I would highly recommend using hydroxy granules for a chin augmentation. Great results and no pain, minimal risk of complications. This was done through an incision from underneath my chin and there was no scarring after 3 kenacort injections to dissolve the scar. So how this method works is they use hydroxyapatite granules, which is an extract from corals. The surgeon will then mix the granules with your blood and turn it into a putty form. Then the putty will be moulded onto your bone and it will fuse with it. Using this method your body won't reject the implant and no leathery pocket will be formed around it. Only thing is its hard to find a skilled surgeon who can perform that procedure. The guy who came up with that method is Brian Mendelson. He was also the one who operated on me. If you choose to use this method make sure the surgeon is skilled in it and is using the granule form and not the solid implant. Removing the hydroxy is not easy thats why your surgeon needs to be skilled enough to do it in one go.

Hope that helps

 

[fraulein]

K Couture said: ↑

So in November I was in Seoul for 3 days and all I did there was back to back consultations at 5 different clinics. I figure my experience might be of some use to those of you looking to get work done in Seoul. I'll go through what I like and dislike about each clinic, what I noticed, what to look out for and how and why I selected Dream medical as my most likely candidate for revision surgery. Please note that Dream medical may not be suitable for you as it really depends on each individual's needs and expectations.

ALSO IF ANYONE HAS HAD PROCEDURES DONE AT DREAM? Pls let me know as while Im almost certain ill be going there, some feedback and reviews would be good because so far I haven't managed to find any post op info on them.

Before I begin, a little bit about my surgical experience. I've had 2 nose jobs both open and closed rhino(one with silicone and the other with diced ear cartilage and scalp tissue), an alar reduction, a concentric malar lift, 2 buccal fat removals, double eye lid surgery, 2 chin implants (silicone and then replaced with hydroxyapatite), concentric malar lift and hydroxyapatite implant in the mid cheek (subsequently removed the hydroxy due to too much elevation), and a jaw reduction. I am quite lucky after having so much work done I do not look plastic and fake in the very least, but it has been a learning curve and in some ways trial and error for me. All i can say now is that I know how to better select the right surgeons, the right procedures and ask the right questions for myself.

Anyways so before I arrived in Seoul, I had sent off several e-mails to different clinics based on research I had done and recommendations. Most of the e-mail replies you get will be from consultants and not the surgeons so I urge you to interpret them accordingly as whatever information they give you will most likely not be sufficient or 100% accurate for your individual case. Leave your decision making to when you meet the surgeons. For me, I wanted to get a revision rhino, lateral canthoplasty and cheekbone reduction. The clinics i visited were 1) Dream, 2) VIP, 3) BK, 4) OZ clinic and 5) ID clinic. I was going to visit Regen but didn't have the time. Do a ctrl find with the numbers if you just want to read up on these specific hospitals. I apologise in advance as I can seem long winded. I try to be as detailed as possible! Also i had to split the post into 3 parts cos its too long so bear with me lol....

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Hi K Couture
Thanks for posting your experiences. I'm heading to Seoul in late January for revision rhinoplasty. I've consulted with Drs. Toriumi, Frankel and Thomas Le and all recommend rib grafting. I had a bone graft (which is an out of date procedure) and the graft has resorbed over time. My friend had her surgery with Dr. Paik Moo Hyun from http://www.ps101.co.kr/language/index1.jsp#M5 who is evidently well known among Koreans. He did a stunning job on her nose but it was a primary for her. He recommended a dermal graft from the sacral area and septal cartilage. My concern is that dermal grafts have a high resorption rate - but they look and feel quite natural. It seems all the American doctors are all for rib grafts and the one's in Korea are not - do you happen to know why?
The other questions I have is that I'm also doing fat grafting to forehead and cheeks and under eye area. Do you think a 3D scan would be necessary for something like this? Thank you in advance.

 

[chonny]

K Couture said: ↑

Hi im glad you found my post useful.

I would only recommend 2 materials for chin augmentation. Silicone and hydroxyapatite. Some surgeons have use cartilage, fillers or gortex and from what I've heard they don't work out that well due to higher risk of deviation and irregularity of the shape.

My first implant was done in Thailand at the Yanhee hospital. Do not go there. Dr Prechart was my surgeon and he basically took a block of raw silicone, cut out the shape and shoved it into my chin. I found this out later after it was causing me pain and i did a facial ct only to learn that the implant was jagged and misplaced. It was performed intraorally. I was actually semi awake during the procedure and i could feel him cutting into me it was quite terrifying. Silicone usually works out well if its a properly manufactured implant and the placement position is correct. I've been told that an external incision from under your chin gives better placement.

After I returned to Australia i got the implant removed and replaced with hydroxyapatite. I would highly recommend using hydroxy granules for a chin augmentation. Great results and no pain, minimal risk of complications. This was done through an incision from underneath my chin and there was no scarring after 3 kenacort injections to dissolve the scar. So how this method works is they use hydroxyapatite granules, which is an extract from corals. The surgeon will then mix the granules with your blood and turn it into a putty form. Then the putty will be moulded onto your bone and it will fuse with it. Using this method your body won't reject the implant and no leathery pocket will be formed around it. Only thing is its hard to find a skilled surgeon who can perform that procedure. The guy who came up with that method is Brian Mendelson. He was also the one who operated on me. If you choose to use this method make sure the surgeon is skilled in it and is using the granule form and not the solid implant. Removing the hydroxy is not easy thats why your surgeon needs to be skilled enough to do it in one go.

Hope that helps

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Wow once again your post is so detail and informative. It does help a lot. Thank you so much. I'll spend more time to do research on this, it seems I don't know anything about chin augmentation beside silicon implant and injection (not sure what it is). I appreciate your post a lot cuz I can't find many posts that share experiences on chin augmentation here.
May I ask you 1 more question if you don't mind. I know you're Australian but what is your ethnicity? Because you said there is no scar on your chin, that's really awesome. I'm Asian and I'm worried a lot about those scarrings and pigtails tend to appear more obvious on Asian skin.

 

[k-couture]

Chonny said: ↑

Wow once again your post is so detail and informative. It does help a lot. Thank you so much. I'll spend more time to do research on this, it seems I don't know anything about chin augmentation beside silicon implant and injection (not sure what it is). I appreciate your post a lot cuz I can't find many posts that share experiences on chin augmentation here.
May I ask you 1 more question if you don't mind. I know you're Australian but what is your ethnicity? Because you said there is no scar on your chin, that's really awesome. I'm Asian and I'm worried a lot about those scarrings and pigtails tend to appear more obvious on Asian skin.

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Hi Chonny, I'm 1/4 british and the rest Singaporean Chinese. My skin type, despite being paler lol is more asian. Don't need to worry about scarring. With the kenacort it won't leave a scar. Also the skin on your face and the skin on your body is veryyyy different. You tend to scar alot more easily on your body than your face. Also very rare to get keloid scarring on the face but is common on the body for asians.

 

[k-couture]

Fraulein said: ↑

Hi K Couture
Thanks for posting your experiences. I'm heading to Seoul in late January for revision rhinoplasty. I've consulted with Drs. Toriumi, Frankel and Thomas Le and all recommend rib grafting. I had a bone graft (which is an out of date procedure) and the graft has resorbed over time. My friend had her surgery with Dr. Paik Moo Hyun from http://www.ps101.co.kr/language/index1.jsp#M5 who is evidently well known among Koreans. He did a stunning job on her nose but it was a primary for her. He recommended a dermal graft from the sacral area and septal cartilage. My concern is that dermal grafts have a high resorption rate - but they look and feel quite natural. It seems all the American doctors are all for rib grafts and the one's in Korea are not - do you happen to know why?
The other questions I have is that I'm also doing fat grafting to forehead and cheeks and under eye area. Do you think a 3D scan would be necessary for something like this? Thank you in advance.

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Hi Fraulein,
i am not too familiar with dermal grafts but i was recommended it by Dr Park Yang Soo of Dream cosmetic as an alternative to the ultra soft silicone implant he offered. He said if my skin is too thin to take the silicone he will use Dermal graft. The name of the product he said he would use is called Auto Dermal??? i think??? And its a lab manufactured dermal with strong shape and been treated to minimize reabsorption. It seems that dermal implants that can taken from your own tissue has a high rate of reabsorption but not the lab manufactured ones.

About the American doctors prefering to use rib versus the Korean surgeons, you are absolutely right that is the case. I actually a pointless argument with someone on this forum a while back who kept refuting this fact because he enjoyed arguing pointlessly lol. Anyways there are 2 reasons. Firstly Caucasian surgery tends to dominate the western market. And caucasians more often get reduction rhino rather than augmentations. When a caucasian patient does require an augmentation, their skin is not as suitable to the hard silicone implant as asians because caucasians have much thinner skin. This increases risks of complications for them. So rib grafts are more ideal. Over time this has become a cultural belief amongst the surgical practitioners.

You won't need a 3d facial scan for a fat graft. 3d facial shows bone structure and not the soft tissue. So I can't imagine it would make any difference unless you are planning to get v line or jaw/cheeck reduction surgeries.

thanks for the link ill definitely look into it!

 

[neverperfect]

4. OZ clinic

He said most likely he will remove the cartilage but leave the goretex. Issue with that I had is I knew the goretex would not give me sufficient elevation. He said most of my elevation came from the goretex but I can actually feel the cartilage in my nose and I know from both having it implanted inside me and reading the medical report that majority of elevation I had was from the cartilage and not the goretex.

.[/QUOTE]




Hi K Couture,
You mean he will remove the cartilage and replace with goretex? what you have right now is diced ear cartilage and scalp skin, correct?
I am actually interested in diced cartilage for nose augmentation. Although you're not satisfied with your second rhino, does it has more to do with the doctor's skills or the material is just not enough to give you the desire height that you're looking for?
Thank you again for being so informative.

 

[k-couture]

no what i mean is he wanted to remove the diced cartilage and KEEP the goretex. My nose is currently botched because the surgeon Charles Lee from Beverly Hills decided to use goretex, and then placed diced cartilage on top of the goretex to build the bridge. This ended up with some protrusion and the top of my nose is permanently red. Its really something you should not do according to every other surgeon i have spoken to. So what I have now is goretex and diced ear cartilage with scap tissue above the goretex. Both implants are in the nose bridge area.

Its both the doctor's skill and the material. First, he should not have mixed both implants together. Second, you should bear in mind that alot of surgeons who advise against the diced cartilage method do so knowing that protrusion and irregularity tends to be more common with this sort of implant. In terms of height it depends on your nose and how much cartilage you have to harvest. If you do not have enough to harvest on one ear your surgeon may also take it from the other ear.

I honestly would not recommend the diced method tho. For me, I personally believe that a dermal implant or silicone gives better results.

 

[fraulein]

K Couture said: ↑

1) Dream Medical http://en.e-dream.co.kr/

My first stop was DREAM. Upon entering I noticed it looked like a fancy iphone store, very white, very clinical, very minimalist and very corporate looking. It was also filled with mainland chinese in there. They have 2 translators who are available on certain days for english speakers and everyday they have Chinese translators available. I've realized that the protocol in Seoul is that they will first send you to see the consultants, who will recommend you procedures based on what you want to achieve, what they offer and what they think you should get done. After that they will send you to see the surgeons. For me, whatever the consultants say goes in one ear and out the other because I am aware that their job is to sell you procedures and they have little to no medical training. Especially with my case since its rather complicated.

First surgeon I met was Dr Park Yang Soo, who specializes in Rhinoplasty. He is also the director at Dream. Very friendly, down to earth and informational. He may not speak perfect english, but he is fluent enough where we can communicate and understand each other. His solution for my rhinoplasty would be a closed procedure, removing what scar tissue i may have incurred from the previous revision open rhinoplasty and using an Ultra Soft Silicone implant which will then be placed underneath the muscle just above the bone. At this point I was rather surprised that he would do it through closed rhino as every other surgeon I have spoken to said I had to have open rhinoplasty. He explained that as I have already had one open rhino, another would risk causing further scarring to the nose and he had ample experience to perform the surgery.

Next I went to see Dr Kim Young-Joon, facial bone specialist at Dream. He looked at the 3d facial scan and CT they just did for me and immediately said, "you do not have wide protruding cheekbones so a cheekbone reduction is not advised. It will simple make you lose the angles in your face and cause sagging. One cheek bone look slightly bigger than the other because as this 3d scan shows, you have a very slight asymmetry." He told me to fix this asymmetry there was a drastic option which pretty much involves breaking your face is half and reattaching it, but this was only for patients with very severe asymmetry and not for me. The other method would be to use acculift. A minimally invasive laser which will shrink my soft tissue from the inside of my face. He explained it as an "internal shrink wrap" to the face. Now this made sense to me as my asymmetry was only made obvious from all the other crap I had done to my face which I didnt really need. From looking at the 3d scan i could tell it had nothing to do with having one cheekbone that is wider than the other.

Last Surgeon I went to see at Dream was Dr Cho Hye In. She is the eye specialist. A very young doctor, not too chatty, speaks softly and didn't explain much to me. I said I wanted a lateral Canthoplaty to make my eyes look bigger from the bottom edge. She uses a medical object against my lower eye lid, pulled it down slightly and held up a mirror. "You want it to look like this?". I said yes and she said there would be scarring and swelling for a few months but she could do it.

What I liked about Dream?

a) Very professional and customer centric atmosphere.

b) Whilst waiting for the surgeons to meet me I sat next to a couple who was waiting for their post op check up. This 65 year old grand mother who looked like she was in her mid 30s was only a week post op and I couldn't see any scarring and minimal swelling. Very impressed.

c) Park Yang Soo and Kim Young Joon explained the procedures to me in detail, were thorough with communication and patient with my many questions. I also LOVE IT when a surgeon tells you not to get a procedure because they feel it would not be suitable for you. Patient satisfaction and care > Profit.

What did i not like about Dream?

a) Dr Cho Hye In did not make me feel comfortable letting her potentially operate on me. She was not too detailed in her explanations either.

b) Consultant who wasn't very knowledgable...but thats kinda to be expected.

2) Next stop VIP! http://www.beauty-korea.com/

So this clinic is alot smaller and less luxurious than Dream, but it was still aesthetically pleasing. If im correct there is only one surgeon there too, Dr Lee Myung Ju. Which isn't a problem as long as he is skilled in the procedures he offers. His consultant who doubled up as the translator was present during the consultation. She spoke fluent English and my god was she knowledgable. The first consultant I have ever encountered who could explain the procedures involved in such detail. She also wasn't trying to sell me any surgeries at all but rather focusing on the problem at hand.

Dr Lee began by asking me what was in my nose. I told him diced cartilage, scalp tissue and goretex underneath. He was shocked when I told him there was goretex in there too.....but its a very common reaction since Charles Lee of Beverly Hills is an awful surgeon. He then used a camera to look into my nose and told me I had a deviated septum which had to be corrected too by using cartilage to build the shape. He said an open procedure is the only method possible for me using rib cartilage. I asked if I could use donor cartilage and he said the reabsorption rate is too high for that to be feasible. The invasive nature of rib harvesting and knowing the cons of using cartilage left me uncomfortable with having my nose done with him despite reassurance of his skill from both himself and his consultant.

I also asked him about a cheekbone reduction and lateral canthoplasty. You see one thing I always do is try to compare the answers different surgeons will give you regarding a procedure and method in order to make an informed decision. He said he could do cheekbone reduction on me but not during the same time as the cartilage rib rhino for safety reasons. He admitted there is always some form of sagging during a cheekbone reduction and explained it like this. "your cheek bones are like the structures of a tent, only they are holding up facial fat, soft tissue and skin. When you reduce them naturally there will be some sagging. The degree depends on the method and skill of the surgeon." What he said is very true as I've had several top surgeons advise me against cheekbone reduction for that very reason.

Lastly we discussed a lateral canthoplasty. He told me that procedure has a high failure rate with the current methods used and causes visible scarring. He also said long term effects are not promising as when we age our eyes naturally start to sag. He further articulated that he has seen many patients who have botched lateral cathos and end up getting revision surgeries over and over again with little success. This made me think twice about the lateral canthoplasty.

What I liked about VIP?

a) very thorough and knowledgable english speaking consultant. Not to mention fluent in English

b) detailed explanations from the surgeon. Tho he had to leave early because of a scheduled surgery, his consultant was sufficient in aiding me with whatever further questions i may have had.

c) Advised me against potentially unsuitable procedures. Always good to learn of different opinions and the logics behind it.

What I did not like about VIP?
a) not really their fault but i do wish there were alternatives to the rib rhino in my case.

b) Dr Lee said a 3d scan when unnecessary when i asked him about cheekbone reductions. After that insightful consultation at Dream, i would say a 3d facial scan is a MUST.

c) Dr Lee wanted to correct my deviated septum and said my nose will always be lopsided because of it. However, I actually asked other surgeons during my consultations in seoul and even went back to Dream once more the day before I left Seoul and spoke to Dr Park about this. They all said that you only need to correct a deviated septum if you have breathing problems. Its unnecessary to correct it otherwise as there are people with perfectly straight noses with deviated septums. Its very common. I also recalled reading of him saying the same thing to other people on this forum who also felt they didnt need to correct their septum.

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was just quoted $18,000 US for revision rhinoplasty at VIP clinic - (using rib graft). seriously?

 

[k-couture]

/chokes on coffee....are you serious? That's even more expensive than getting it done in the US. Are you sure you got the conversation right? When VIP quoted me it was 6000 for rib rhino. My quote was revision rib rhino too.

 

[soong-sister]

VIP is the most expensive one

 

[neverperfect]

K Couture said: ↑

no what i mean is he wanted to remove the diced cartilage and KEEP the goretex. My nose is currently botched because the surgeon Charles Lee from Beverly Hills decided to use goretex, and then placed diced cartilage on top of the goretex to build the bridge. This ended up with some protrusion and the top of my nose is permanently red. Its really something you should not do according to every other surgeon i have spoken to. So what I have now is goretex and diced ear cartilage with scap tissue above the goretex. Both implants are in the nose bridge area.

Its both the doctor's skill and the material. First, he should not have mixed both implants together. Second, you should bear in mind that alot of surgeons who advise against the diced cartilage method do so knowing that protrusion and irregularity tends to be more common with this sort of implant. In terms of height it depends on your nose and how much cartilage you have to harvest. If you do not have enough to harvest on one ear your surgeon may also take it from the other ear.

I honestly would not recommend the diced method tho. For me, I personally believe that a dermal implant or silicone gives better results.

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Wow! such a combination of materials. I have tried to search for any type of reviews for dermal implant but haven't found one. When you were at Dream, did you get to see any before and after photo for such?

 

[k-couture]

no i unfortunately did not. I have a habit of spending all my time interrogating the surgeons i consult with rather than ask for before and afters lol

 

[jhkim]

Where did you stay in Seoul?
Also it would be helpful to leave some information about nice hotels or hostels.