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K Couture's guide to seoul plastic surgery


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Hi K Couture, i would like some questions answered on your:

Section 6: Price Bargaining

Say i knew which surgeons i want to choose and want to book them in advance. Does that put me at a bargaining disadvantage?

say would it be difficult to bargain during consultation since they knew i already have them booked for surgery?
 
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To actually hold a surgical slot would require a deposit tho. If you are going to place a deposit make sure u know the terms. Example: Is it refundable and how soon if you cancel is the refund applicable?

Second, knowing which surgeon you want doesn't put you at a bargaining disadvantage. Either way, if you pick a more reputable or one of the senior surgeons then it really doesn't matter if you book them in advance. You will not be able to bargain as much as if you get a less reputable surgeon. Contrary to popular belief, surgeons actually do have alot of control over price. A consultant can only shell out prices within a range which the surgeon deems acceptable. I know this because when my uncle was getting his orbital muscle repaired, the consultant received a call from the surgeon who gave her strict instructions that because the surgery is complicated and would take at least 6 hours, the price had to be a minimum of 9.5 million won. Once this happened there was no longer anymore bargaining possible. This only happens for very complicated cases tho but Im just citing it so you understand the control surgeons have with price and why the more reputable ones will not have their skill and expertise undermined.

Also how much you can bargain depends on your knowledge of the clinic's price range, low, mid, upper mid, high, the seniority of the surgeon and the market value for the procedure. Like if you wanna do eyes at teium, sure you can bargain. But if they quoted you something reasonable and according to market value within their clinic range, you will not be able to drop the price down by much. Its the same with April 31. They are one of the most expensive for rhinos starting at about 6ish million won for primary rhino and you will have a tough time trying to drop it below the high 5 millions to the 6 million mark. Surgeons like Kwon and Kim have the mentality that "if you want my surgical expertise, you pay for it. If not go somewhere else."

You will however have a much better chance to get a lower price if you go to Seoul very soon because the market isn't doing well at the moment due to it just coming out of the Mers scare. This means more surgical slots per surgeons are open and this means revenue loss for every slot that is not taken. Once the mainland chinese start coming back to Korea we can all kiss the Mers prices goodbye. Its the same principle as why prices are higher during peak season. Each surgeon can only do so many surgeries a day. If the surgical slots are filled there's no reason, from a business stand point, to be open to lower prices too much.
 
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Should i mention the mers outbreak to try and lower the price? Ive always been a face to face type of person that way both parties can be happy with a price before moving forward.

It just seems backwards to bargain first , book surgery dates, then fly for consultation.

Dont get me wrong i do want the best possible price but also want to have the best doctors aswell.

I was wondering if there was a way to barter the price first book surgery dates, pay deposit, do consultation then re-bargain the final price before i go ahead.
 
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it makes no sense to bargain first. U need to be assessed by the surgeon for them to know how simplistic or complicated your case is. Or what methodology to use even.

U can mention the mers but it won't affect the price since the korean gov officially delcared an end to it. The main thing to remember is the industry is slowly picking up but not back to what it was before mers hit so just take advantage of the price drop now to get your surgery
 
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You didn't respond to my post......jk please take your time busy lady haha.

I read your recent post about hydroapptite implant. Could that be used to fix sagging? With the current technology there must be some way to correct sagging which doesn't involve a face lift don't you think?
 
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lol sorry boo I think I completely missed it.

Uhh about hydroXYAPPATITE, that's how u spell it btw, its gives volume. Doesn't do anything for sagging. Its something like bone cement but much better in terms of molding and shaping capabilities and more accepted by your body since it greatly resembles bone. It also fuses to your bone so it stays in place. But does it fix sagging? Nope. There's no way to alleviate sagging without an actual lift like i told u before. No such technology out there.
 
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Ok all those procedures you mentioned. THEY ARE ALL GIMMICKS! I wrote a post about why zygoma reduction causes inevitable sagging, especially where the arch is manipulated because of how it affects the muscle in that region. That's why you have to be very careful with facial bone contouring. If you are not a candidate, do not do it. I understand it can be hard tho because I am aware that I am not a candidate too but I'm always hoping there's some new innovative methodology which can produce the results I want.

Anyways lemme explain to you why they are all gimmicks. First, What is a Gimmick when it comes to plastic surgery? Its a means to promoting a technique in one way or another whereby the effect DOES NOT WORK or is MISLEADING. I'll go through them one by one.

Weekend lift:
The name suggests to people its a less invasive lift and faster lift. Much shorter operation time. For a lift to be effective, the SMAS tissues must be addressed. You cannot place a time frame on a lift because every patient has different regions of sagging. To add, just because a lift is done quickly doesn't mean its better either. It takes time to properly address the smas tissues. That is why face lifting is one of the longest procedures in terms of operation duration. The names of the lift is not important. Its about addressing and correction of the deep underlaying tissues which are causing one's sagging.

V Lift:
Whatever the hell this rubbish is. Its as gimmicky as Power V surgery. Again, like Power V, the name suggests that a lift can give you a V line. It can't! Not unless you have a naturally V shaped bone structure or you got V line facial contouring surgery. Ask yourself, how many asians do you know who are born with natural V shaped faces? Im sure there are a few but I have yet to see any. I mean, if your bone structure isn't too strong the V shape can be achieved, depending on the individual, with botox and chin implant. But that name in itself is a gimmick. Imagine someone getting an actual lift when they don't have any sagging just to get a V shape only to find out it was ineffective to achieve the results they want. Lifts are invasive procedures after all.

Power V:
Like what I said to wajajaja. This is pretty much a form of facial lipolysis. It is another gimmick and it won't give you a V shape like the name suggests if you don't already have it. And most people don't have a natural V shape. It just removes facial fat that's all. Whatever it can achieve, acculift can do too in a less invasive manner because acculift doesn't rupture as many tissues. It does NO TIGHTENING. The tightening effect it claims to produce is false. It claims to address the Smas tissues but that is also false. The only way to address the Smas tissues is through an actual lift where the deep layers are corrected accordingly. This procedure will not be recommended to older patients because it will just cause more sagging. Even when facial fat is removed from young people, a surgeon has to be careful because when too much is removed, sagging occurs. This is especially more evident in older patients.

Acculift:
While I do love this method, the tightening effect it claims to give is also a LOAD OF BS. Again, even tho it is very non invasive and great for facial fat reduction with excellent targeting capabilities, it does not address the SMAS. Therefore, like Power V, any tightening is superficial and reverts back once residual swelling is gone. Similarly, you gotta ask yourself, why when an older patient goes in asking for acculift to tighten their loose skin, a surgeon would not recommend it. Cos it doesn't tighten! Its superb as a non invasive facial volume/fat reduction but thats all it is.

Other procedures to look for are thread lifts, ulthera, thermage. These procedures again, don't last long because they do not address the SMAS. Just remember when it comes to a lift with long lasting results, do not think what the name suggests. Think of the medical science behind it. What part of the facial anatomy is truly required to be addressed in order to achieve what you want? Same goes for other procedures, not just lifting. There's so many BS gimmicks out there its not even funny. Don't get excited when you see photos, be they by the clinics or from blogs or what not. Alot out there is photoshopped. And you should be more concerned with your own pre-existing facial structure and not someone else's.

I've been loaned a medical journal from the ISAPS regarding lifting and facial bone surgery. Its an actual medical journal and not the rubbish that is available out there. If you want, kakao me and i'll send snap shots of the pages which would be beneficial for you to have a read.
 
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thanks for such a detailed response. I never thought of it like that but it really is very logical to look at it like that.

Could I do acculift at the side of my cheekbones only to reduce the fat there. I feel some fat next to the side cheekbone part. If taking that fat out maybe my face cheekbones will look smaller?


Okok so if I were to have a lift, I can just tell the surgeon to do my sagging and not mention what type of lift I want. Just to fix the part that is sagging. However, would it be ok for me to tell the surgeon I am not ok being under general anesthesia for too long? I have no health issues I just feel uncomfortable being under operation for a prolonged period of time. I don't have to lift my whole face after all.

Yes I would love to have a read of the medical journal. I feel so uneducated and clueless about all this. You have been teaching me and everyone else so much on here and I really thank you for it. I've sent you a kakao message just then for the journal. Thanks again K!
 
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/FacePalm! Noooo do not tell the surgeon you want to put a time limit on your face lift! You can't rush a lift. Look just to give you an idea. When I had my concentric malar lift, which is not considered a full face lift, I addressed the lower jaw area because my sagging came from oversection of the jaw bone. Botched mandible reduction at the Yanhee Hospital pretty much. So that procedure took 4 hours give or take. My mum's full face lift took about an additional 2 hours.

10 years later after the concentric malar lift done by Brian Mendelson and a mild face liposuction done with a tiny needle through the inner nostril 2012, I have a 5mm sag on the mid face area. He did tell me that there will be some slight sagging should I use lipo on the midface region. But at the time I didn't really care because of my obsession with having more symmetry. Dr Mendelson told me for him to manipulate the SMAS tissues for this degree of sagging would take around 1.5 hours. Under general anesthesia. For some cases deep sedation may be used. It really depends what the surgeon feels is necessary. The only problem with me getting another lift is Dr Mendelson feels its too minimal for the invasiveness of the procedure. Doesn't matter that it would only take 1.5 hours since I only have sagging at one particular region. The fact of the matter is, to get into the area requiring correction is invasive.

So do not put a time limit on your surgeon. If you are going to undergo something invasive, never rush the surgeon. Why would you want to have invasive surgery for crappy results right?

Most people do not have much fat on the side of the cheekbone, I highly doubt acculift will make your face less wide from the lateral cheekbone. What I used acculift for is facial symmetry. I had more fatty deposits in my right side than my left. I also want to have a slimmer face overall. To add, my right cheekbone is more forward than my left, thus the fatty tissue on the right side sits more forward. So this was the treatment plan I requested using acculift for facial symmetry:

1) Reduce less fat on the left mid cheek compared to the right
2) Reduce more fat on the right mid cheek and removing fat ONLY on the right cheek (not the lateral bone area). As in the fatty deposits on the right side of my cheeks.
3) I did not remove any fat on the left cheek because its already very slim

Acculift is great for targetting problem areas because of its precision. But the area must have fault. I have never seen anyone with excess fatty deposits at the lateral cheekbone region because fat just doesn't tend to store there. Its most likely thicker skin and soft tissue as most asians have that. Thus, acculift will not be suitable for you to achieve what you want.

No worries I'll send you snaps of the medical journal. I just gotta look through which pages are applicable to you. Its a thick book i can't snap everything lol.

Also think about this for a moment yeah. For some people, a wide facial appearance is due to a flat mid face. If your midface is flat you can augment it to make your face more dimensional. Doing so will make your face slimmer. Think about these shapes whilst looking directly from above:

A Square - Looks wide doesn't it?
A pyramid, with a square as a base - Doesn't look wide correct?

That's because the Pyramid is projected and dimensional. Its the same principle for mid facial augmentation to create dimensions. Not everyone is suitable for this tho so you best to consult a few surgeons to see if it will work for you.
 
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My face isn't boxy per se, I want it smaller without feminizing my already androgynous face. I could do with a bit more height to my middle cheek bone but then I might look too girly. You see I have to be very careful with what I do because slightest change could unintentionally make me look too fem. Its hard enough as it is being mistaken for a girl everytime I go on the airplane. It is so embarrassing.

You reckon a zygoma reduction by placing the bone inwards but higher is possible? I hope that will stop any sagging from happening. Perhaps even if sagging does happen like this it would not be as bad? You mentioned ulthera and thermage. Are those gimmicks too? Would they help if sagging is only a little? Do they address the smas? Would it be better to wait after zygoma reduction to do face lift or will the surgeon know if I need it immediatedly after he finishes my zygoma while I am still under operation?

Sorry for bombarding you with so many questions. I cannot seem to find the answer to my questions and you are the only reliable source of information on here.
 
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Grow a beard maybe? lol.....

I actually had someone propose that to me before, shifting the bone inwards but repositioning it higher. So it might be possible. I am only skeptical because it was Charles Lee who suggested it to me and he is a hack surgeon. But best to ask a facial contouring specialist if that is possible. I wouldn't have a clue with regards to that.

I only mentioned ulthera and thermage because the tightening isn't permanent. They are not gimmicks because they do not claim to address the SMAS with permanency. Rather, the patient is told the TRUTH, that it only lasts a certain period of time and repeated treatments is required for maintenance.

Just remember any TRUE tightening and lifting must require manipulation of the SMAS tissues. To do this the tissues must be physically lifted and sutured in place. This is a time consuming process. Procedures like Power V, Acculift/Accusculpt do not address the SMAS. A gimmick will always be a gimmick. I wrote about this a while back: Korean surgeons swear by the tightening effect of such procedures yet never recommend it to older patients. To add, if you go on realself, the consensus amongst Medical Professionals and plastic surgeons in the West is that acculift/accusuplt is great for fat reduction but does no tightening. There gimmicks are designed to lure in people with no medical knowledge, but will never work on another surgeon. Hence why you get the responses you do on realself by surgeons. With this in mind, you know that the lifting and tightening effect is a gimmick. To date there is no such technology which can address the SMAS. Ulthera and thermage unfortunately only offer temporary tightening and are very costly.

Ive done Ulthera before, lasted about 6 months for me and results were not bad but a little too subtle for my liking. Plus it was so expensive! Note that there are different ulthera machines out there with varying results. Anyways, I just came to the conclusion that due to the cost and period of effect, it wasn't worth it. Rather go for a face lift instead where the SMAS can be truly addressed.

I think it might be better to wait after your zygoma reduction to do a lift. I would only suggest otherwise for older patients where it is very evident that the degree of sagging will be far more significant. One lady I know got her zygoma reduction done at Girin and she got a face lift done immediatedly after. She had a fair bit of excess skin excised during the face lift. As an older woman she required this to mitigate the immediate sagging that would occur. For younger people its not that obvious immediatedly.

If you want some very reliable information, you should look to the surgical societies. There are many mediocre ones so only go for the reputable ones like the ISAPS. If you can get a consultation with the surgeons who panel these societies at their seminars that would be very beneficial for your research and learning process. Only the top surgeons who are respected amongst their peers and the medical community are invited to panel these seminars which are held for practicing and training surgeons.
 
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Have you seen her results at Girin? Is that somewhere you would consider?
 
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Yup I have. It was a very nice improvement to her facial structure. Her surgery was done very well. Correction, it was a drastic improvement because she did Zygoma and Mandible together along with a face lift all at once. I don't recommend doing so much at once as it is very stressful on your body. Not to mention the emotional and mental toll while recovering.

I have been to Girin before. The surgeon was reluctant to perform the procedure on me tho because after looking at the CTs he suggested that I wasn't a good candidate. The only issue I had at Girin was with the consultant I was assigned to. She tried to get me to revise my mandible reduction by cutting more bone. But its like........yes I know I had a shotty job in Bangkok but why on earth would I want to excise more bone when already too much was excised? I should be adding not reducing. The surgeon how ever did not recommend any Jaw work on me.

You should definitely consider Girin for facial bone contouring as that's their speciality. Price wise its really reasonable. MaiQ who used to be very active on here had her surgery done at Girin and they did a great job on her. I think she might have posted some pics of her results on her thread I can't remember.
 
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By any chance do you know how much she paid at Girin?
 
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