My Plastic Surgery Experience with April 31

[queenofblades]

Hi Everyone, I arrived at Seoul 2 weeks ago to consult several clinics for my rhinoplasty revision. One year ago, I did a pprimary rhinoplasty with Dr Suh. My concerns were bulbous nose, upturned nose, flat nose bridge. Due to limitations from my own tissus, I couldn't achieve the amount of projection that I wanted. In fact, many people around me did not notice at first that I had a nose job. Hence, I'm back one year later, hoping to improve the following areas : 1) nose still too upturned from my point of view 2) improve nose projection 3) improve starting point of radix 4) possible narrowing of alar base.

The clinics I consulted with were MVP, JK, JW , Pitangui, April 31 and Girin.

 

[queenofblades]

Clinic Consultationns - MVP:

The first clinic I visited was MVP. I had read Smitten Kitten's Blog and her results were AMAAAZING. I really liked her nose very much, such a refined and elegant tip. So I booked a consultation with Dr Seo. We had Ellen on hand as a translator and she was great, very honest and forth coming. However, after palpating my nose, Dr Seo said my tissues were still tight. The most he could give me was 1-2mm, and lower the tip slightly. He felt alarplasty would be too much, and I did not really understand what he meant by this. Dr Seo said that the difference will be minimal, if I decide to go through the surgery. Maybe it will be no point doing it. I took note of his opinions and went away slightly disappointed. I did hope that he could help me achieve Smitten Kitten's result.

 

[queenofblades]

Clinic Consultation - JK

The clinic looked grand and posh.

Dr Kim Sung Sik appeared very serious and looked a little bit tired. He did spend some time touching my nose tissues, and then with the help of the English translator made the following recommendations :

1)My implant was placed too high, so he wanted to lower it to a more aesthetic level.

2) Reduce Tip Bulbosity

3) increase tip projection

I then asked him about alarplasty, and whether increasing tip projection will help draw the alars in, hence avoiding alarplasty. Dr Kim said the drawing-in effect will be negligible. If I wanted to narrow my nose visibly, I will have to do alarplasty.

With that, the consultation ended and I was given a price quote and I went on to my next appointment.

 

[queenofblades]

Clinic Consultationn - Pitangui

The decor of the clinic was amazing, very posh and luxurious. Even though I was a walk in customer, I was lucky enough to consult with a medical director, Dr Yoon, almost straight away. He palpated my nose and made the following recommendations:

1) nose implant too high - to lower it

2) nose bridge too broad - he wants to break the nasal bones to make it narrower

3) perform tip refinement and extension. When I told him my primary rhinoplasty doctor told me my skin couldn't stretch and my cartilages were too soft to use, he scoffed. Through the translator, he said he doesn't know what kind of clinic will tell me this kind of wrong information.

4) Alars too wide - perform alar incision but not cutting outside wall tissue but from inside.

Overall, I felt this doctor was confident in his manner, and could give drastic results if one desired the narrow kind of nose. The quote was also surprisingly reasonable despite the posh decor. I duly noted down all his opinions before I went on to my next appointment.

 

[queenofblades]

Clinic Consultation - April 31

I had made a prior appointment to consult Dr Kim Jae Hoon, as I knew he was one of the top few rhinoplasty surgeons in Korea. He had also published articles on rhinoplasty, and I felt more confident of a doctor who has both practical experience and respected by his peers academia wise.

I was warmly welcomed by the translator Brian who spoke excellent English. He recommended that I do a CT scan for a small fee, which would be deducted off my surgery fees should I decide to get it done there. i had a mini consultation with a Ms Pyo before I got to see the doctor. She had such a pretty and defined nose, but it looked so natural too! I kept looking at her nose throughout our consultation. I would have been happy with such a nose. Later on, Brian told me the nose was done by Dr Kim.

Anyway, Ms Pyo drew my nose outline, and then sketched in an improved outline, all the while jotting notes down and speaking to Brian who duly translated.

After that, we were informed that Dr Kim was ready to see us, so I went with Brian to the consultation room.

To my pleasant surprise, Dr Kim spoke very good and clear English!. I was thus confident that I could communicate what I wanted, without fearing something will be lost in translation, although Brian was also present throughout.

I emphasised i wanted to correct my upturned nose and reduce nostril show. I also wanted to increase tip projection and definition.

Dr Kim was warm and fatherly in manner and took time to palpate my nose and face, and refer to my CT scan. In all the appointments and subsequent ones with other clinics , I found that this particular Dr gave me the longest time and discussed the most details for my consultation. He did not give me a sense that he had to rush off for the next appointment. I was grateful for his patience.

The following recommendations were made:

1) Nose implant was placed too high, and it drew attention to the bridge between my eyes, instead of overall face, giving an 'off' look. He will lower it slightly to a more natural position.

2) He will perform tip plasty to lengthen and refine the tip. He agreed that the skin stretchability may have issues, but if I agreed to lower the bridge placement, I will be able to have excess skin to spare for the tip.

3) He agreed that the upturned nose was still present and will correct it.

4) regarding alarplasty, he did not recommend it. He said actually my alar base was in correct proportion to the rest of my nose and face. However, he recognised that I did want a narrower nose and he showed me a photo of one of his patients, who after tip extension, had a 'tenting' effect which actually drew the alars in. The result looked like about 1mm each side and I think I would have been happy with that. Another reason for not recommending alarplasty was that he said i may have trouble breathing. He noticed that I seem to have a blocked nose and checked the insides of my nose. He was thus worried that smaller nostrils may make the breathing more laboured.

After nose consultation, Dr Kim made a suggestion that he wanted to make my face look more feminine. I was afraid he wanted to shave
of my zygoma, and I told him I actually liked, and wanted forward facing cheekbones. He said yes, he knew what I meant, that I wanted a more 3D face. He suggested fat grafting to achieve this effect and also to make me look younger.

I duly noted all his recommendations, then got a price quote from Brian, then went on to my next appointment at JW.

 

[queenofblades]

Clinic Consultation - JW

Dr Suh, the doctor who performed my primary rhinoplasty last year, looked the same as always, professional, cool, calm and confident. He said that one year has passed, and that the skin has stretched enough to give me a little more extension at the tip, which he will extend using my ear cartilage. I did not remind him that he told me last year my cartilage was too soft to use. Dr Suh also did not feel that my implant was placed too high . He felt that the starting point should be at top row of eyelash level, which was where he placed it. He also did not recommend alarplasty.

He felt that using my ear cartilage, and just closed rhinoplasty this time, no need for open rhinplasty, he could achieve tip extension. I duly noted his recommendations , then went on to get a price quote from Jay the translator, and it was extremely reasonable.

 

[queenofblades]

Clinic Consultation - Girin

The translator Kyu mi was really lovely and pretty and I liked her a lot. She also had the most amazing skin, which she attributed to 4 fat grafts. I began to seriously consider fat grafting at this point...

Girin did a CT scan for me which was good, I feel. Then before I met Dr Lee, I was given a mini consultation with a medical consultant who also suggested breaking my nasal bone to make bridge narrower.. However, Dr Lee subsequently checked my CT and said my broad nose bridge was due to soft tissue, not bone, so it wouldn't help. Dr Lee also palpated my nose and recommended:

1) lowering the implant which he felt was placed too high

2) tip extension with ear or donor rib cartilage. He felt that he may not be able to give me tip definition though.

3) no need for alarplasty due to 'tenting'effect of tip extension.

After that he had to rush off for surgery, so I got the price from Kyu mi and went on my way to ponder over these few clinics.

Price wise, in order of most expensive to least expensive, the clinics were: Apr 31, JK, Girin, Pitangui, JW. MVP did not give me a quote as they felt there was no point performing surgery for what they felt to be a very minimal difference.

 

[queenofblades]

In the end, I decided on April 31 as I had the most confidence in Dr Kim Jae Hoon's ability, and I also felt that he sincerely wanted to make my nose better. I also decided to do fat grafting after seeing Kyu mi's amazing skin. Dr Kim was actually not available for surgery for 1 week, but last minute a patient cancelled an operation on Fri the 13th, so I took that slot instead. Brian explained that they do not want to stress the doctors out so they only allow them to perform 2-3 ops a day.

 

[queenofblades]

On surgery day, in the theatre, Dr Kim came in and we went through one last time, in detail, what we wanted to achieve. I also had some last minute questions, like whether fat grafting would cause facial sagging, and Brian assured me that it wouldn't.

Dr Kim appeared very calm and confident, squeezed my shoulder and said "Trust me". Then he left the room to let the nurse prepare the IV and sedation. Brian stayed by my side and tried to alleviate my anxiety of the needles by cracking small jokes. I remembered the last thing I saw was of the nurse tying back my hair and I remarked how pretty her nose was even from my view down below. Then I was out.

 

[queenofblades]

When I woke up, the operation was over and I was in the recovery room. I told the nurse I felt a little pain in my nose, and she promptly gave a painkiller via IV before removing the needle. As Brian had to go on a business trip, he left me in the care of another male translator, Xiao Cui, who was very kind to run to the pharmacy on my behalf to purchase my meds.

After resting for a while, I felt well enough to leave the clinic. I got changed in the dressing room and couldn't resist a peek in the mirror. To my delight, I saw a nose tip peeking out from under the splint. I also thought I saw a bit more projection from the side, compared to first time round.

 

[queenofblades]

The next few days were uncomfortable due to the nose tubes in my nostrils. I also had a continuous running nose, so I went around with a roll of tissue paper stuffed permanently under my nose. On Day 4, I removed the nose tubes and bloody bandages and it was such.a relief.

On Day 7, I came back to remove the splint. To my delighted surprise, Dr Kim came in to remove my splint himself. He was surprised that I was still so swollen. However, it didn't bother me because I know I'm a slow healer. He also explained what happened during surgery. He said my case was a complicated one. At this point, my heart stopped and I had a flash back of what happened at JW, when Dr Suh said he couldn't do as much as desired.

Dr Kim said he found that the tissue around my implant was infected, so he removed the infected tissue. He also found Medpor in my nose tip, which he removed and replaced it with my ear cartilage. I had to ask Brian one more time, that it was Medpor they found, and not donor rib cartilage which I was told I was given during my primary rhinoplasty. To correct my upturned nose, Dr Kim also fashioned a derotation graft, also using my own cartilage. I was impressed as I had researched on derotation grafts before, and knew they were an effective method to correct short nose deformity without making the nose tip overly rigid.

After the meeting with Dr Kim, the nurse cleaned out my nose really thoroughly, before taping my bridge down once more. I was told this helped with deswelling.

 

[queenofblades]

The following days were uneventful, but I was hit by post surgery blues. I was bothered by the swelling from the fat grafting giving me slight nasolabial grooves, casting a shadow on my face which I thought made me look old. I also had slight jowling. I thought I had reversed the effects of my facelift which I had done a year before and thus bothered me.

As for my nose, I had learned to temper my expectations. The change was not obvious, but I could see that the upturned nose was corrected and now the appropriate amount of nostril show was presented from the front view. There was also a small tip llengthening of about 1-2mm. I was a little disappointed that I could not see a narrowing in my alar base yet. Also, my tip and bridge was still swollen and the deswelling process was slow. However, I'm looking just a little bit better day by day. I also had very minimal bruising. I decided to be patient and will wait 2-3 months for the final result . All in all, I'm quite pleased with the result because it looks very natural and I still came out quite symmetrical, despite my facial bone assymetries. Dr Kim did explain that he tried to make my nose symmetrical despite my deviations.

 

[queenofblades]

11 days post op:

The nasolabial grooves from swelling seemed to have lessened and become more shallow. Otherwise, the fat graft on my upper cheeks and forhead does make me look younger and my side profile more attractive.

The nose tip is also looking more defined. I can't wait to see the final result! Thank you Dr Kim for giving me such a natural and good result, despite my tissue limitations. I will update this thread again in one month's time.

 

[jayks]

Hi QueenofBlades,

Thank you so much for taking the time to share your experiences with us about JW and also April 31.

I know it's early yet, but I'm glad to hear that the signs are looking good in terms of achieving the profile you want. I hope that it turns out to be exactly what you wanted.

I'm also in Seoul atm and by the sounds of it seeking a similar Rhino Journey you are on. It's definitely made me want to visit Dr.Kim but it is still very daunting. I original had MVP, JW, Topclass, Shimmian and VIP on my list but I'm still very unsure

 

[jtmc]

Thanks QueenofBlades for sharing. I will be travelling to Seoul this week to have my revision rhinoplasty. Hopefully all turn well. Speedy recovery soon.