amyknows Posted August 23, 2018 Share Posted August 23, 2018 Literally last Monday 18th August I had my revision rhinoplasty with Dr Jin Hong Ryul at the Dr Jin’s premium nose clinic. IT was a crazy 2 weeks but things actually went alot smoother than I thought. First of all, travelling to a foreign country was confronting enough, but having to trust the doctors there to have surgery on my face, that we all know will have life changing effect, took my worries to a whole another level. Yes, I was worried but I did what a responsible medical tourist would do and that was to do LOTS of research from checking the doctors background, educating myself about the types of materials in rhinoplasty and methods, reading medical journals/books, speaking to real patients and of course, cross-checking with Korean medical authorities and bodies (eg Visit Korea, KHIDI, KSAPS, for each surgeons credentials who I was interested in. It helped that I was given a checklist of things to do before surgery Steps 1-6, from a lovely lady at Visit Medical Korea, who I later visited in person located in Myeong Dong. During those two weeks I met up with another fellow rhino buddy who travelled to Korea, Pulpy, who I met on KakaoTalk. IT was like a plastic surgery getaway both fun and also unnerving because you didn't know the surgical outcome until home time. It's true ps can be a gamble. But you can prepare for it to give yourself the best chance of a good outcome. Over a decade ago, asian rhinoplasty in Australia was unheard of and unfo when I had a nose job in Sydney it was both shocking and the results was not what I expected. No one told me how bad swelling was and above all, how long it would last. Rhinoplasty was a lonely journey in the past and I recall realself.com was the only go-to place for info. I didn't have like-minded friends online, let alone friends I knew personally, to call up and share about our concerns or experience about having a nose job. Despite a decade later, I still don't think Australia is a go-to place for for asian rhino sadly. Link to comment Share on other sites More sharing options...
amyknows Posted August 23, 2018 Author Share Posted August 23, 2018 The Sydney surgeon was obviously not good with asian faces and he built up my bridge with medpor too high for my asian face and used my septal cartilage for my tip. Tip was unprojected as a result. I looked masculine. Overtime, my tip had shifted to the left and my nostrils were crooked/asymmetrical. The alars though were done well. Since then I didn't want to go for revision because I was too scared of further surgery so I never touched it for many years. Fast forward 13 years on, I became a health nut, so last year in 2017 I decided I wanted to remove my medpor shell and remove the tip graft which I thought was causing me a crooked tip. Above all, I no longer wanted to have a foreign implant. I went back to the same surgeon and long story short, he removed the medpor implant and crushed my tip graft hoping it would resorb. This is when things went downhill. My nose retained the implant shape after its removal, and it looked good for the first 12 mo because of the swelling. Then all of a sudden at 13 mo my skin must've shrink wrapped and at this point, my bridge went from plump to flat/wide. My tip felt it went wide, flat and droopy like it did preop over a decade ago. But nostrils more deviated than ever. I could see I went from pretty to fugly. The nose made such a huge difference to my face. I was depressed for about 6-7months. I even developed a habit of looking down alot because I didn't want people to see my face! But instead of willowing in sadness, I was determined to either accept my new botched look and move on OR if that wasn't possible, I would have to consider further surgery but this time with a reputable surgeon who I was confident through and through. I became this picky patient who asked a million questions and made sure I educated myself with most rhino terms/techniques and risks around that, so I could communicate/understand the doctor 100%. I researched almost everyday for about 7mo, even during work breaks. My mind was fixated on my nose. I was determined to find the right doctor for me. I consulted doctors from USA, Korea and Australia. Dr Donald Yoo (USA), Dean Toriumi (USA), Dr Greensmith (AUS), VIP clinic (Korea), Hanabi (Korea), Dr Jin's Premium nose clinic (Korea), View (Korea), Dr Jang from Asan Medical Hospital (Korea), Regen (Korea), Seoulista (Korea), GNG (Korea). In my mind I knew I wanted autologous material either dermis, fascia, ear or rib cartilage. In my earlier consults, I wanted only to do my tip but as my bridge flattened after 1 year, I really I wanted to augment the bridge. I did prefer ear because I felt rib was too invasive and from a few girls I spoke to on Realself and KakaoTalk, it sounded very painful. I originally settled for Dr Yoo in Beverley Hills however after the second skype call, I then received an email from Vivian his receptionist, to say he could not proceed with my surgery. I was shocked and felt low because I lost a lifetime opportunity to change my nose for the better. To aid in my search for the next surgeon, I followed up with a random question to Dr Yoo if he could suggest a doctor based in Korea who could help. He referred me Dr Jin Hong Ryul. Feeling abit low at that point, I did some quick research on him but opted to see local surgeons instead of going abroad. I did consider Dean Toriumi who is highly experienced with rib but his price point was the highest of all surgeons at $25,000USD BUT also had tonne of negative reviews against him so there was no guarantees. His assistant Patricia was also very difficult to communicate with, sometimes I ended up with no reply at all! I consulted with Dr Greensmith in Melbourne, who I booked surgery with but ended up cancelling 2 weeks prior. He was a nice honest guy but I wasn't confident with his suggestion of either a solid ear graft or dermis graft for bridge augmentation (knowing that dermis can resorb unpredictably and ear can weaken/curl up over years) and wanted to use fascia to even out my tip asymmetry. Link to comment Share on other sites More sharing options...
amyknows Posted August 23, 2018 Author Share Posted August 23, 2018 Then I turned to Korea. I consulted with Dr Jin via email several times over a couple of months leading up to August after Dr Yoo's suggestion. I had one Skype call about rib rhinoplasty. I was adament to have rib cartilage for rhinoplasty in general, knowing it carried the risk of warping or calcification. For months I thought about the risks and read up on many medical journals I could get a hold of from my local library. I realised quickly after researching, the risks can be minimised by the techniques employed (eg diced cartilage in fascia, stacking rib strips, solid piece of rib etc) and of course the doctor's experience. Also, everyone has a different warping rate because of the condition, size and shape of the rib is very personal. I tried consulting online via email with Dr Chang from Hanabi and Dr Lee VIP however it was difficult to get a hold of them. It was better f2f. It also helped that I spoke to some girls who had good results with rib rhino in Korea so that gave me confidence. By August, I had shortlisted several S.Korean clinics and knew I wanted rib cartilage as the material. My septum was depleted and ear is too weak for both tip and bridge in my case. Rib rhinoplasty is very advanced so not all doctors are comfortable with this especially when augmenting the bridge. My consultation started with VIP. Dr Lee's aesthetic was a sharper nose. Greeted at the waiting room there were pictures of Audrey Hepburn, famous for her long pointed feminine nose. Consult went smoothly but when I asked the manager the bold question, about rumours of shadow doctors, she told me that another doctor harvests the rib but Lee would do the rhinoplasty himself. I wasn't too keen on K-wire to prevent rib from warping either although I believe this is only used for severe cases only because its a foreign object inside the nose which is why I removed my medpor in the first place! He had a consultant to help translate. Hanabi was good also. Dr Chang was a soft-spoken but you could tell he was a skilled surgeon in both artificial and autologous material. I went to do a CT-scan prior to consult. He examined both inside and outside my nose. He spoke English well. But he explained he didn't do diced cartilage in fascia because there can be some resorption. Dr Jin was very different from the others. First, the clinic didn't have consultants but rather nurses at the reception. I meet Dr Yi in the consult room. He was a very skilled surgeon based on my research and overall the consult went nicely. There was some inspection inside my nose and palpating from outside. I liked how he could do solid rib but if he could not control the warping of my rib graft after carving or laminating (which was my biggest fear) the backup plan was to dice the cartilage and wrap it in fascia. Not alot of surgeons do DCF in Korea successfully but I had confidence Dr Jin could from my research. Shortly after I did an X-ray series of my ribs to see if they were usable and not fully calcified, which was a separate fee. I was guided by one of the nurses to go upstairs in the same building for my scans. Dr Jin spoke English very well. I showed how I wanted my nose augmentated based on his patient photos. His results were like Hanabi very natural but there was still a nice change. Dr Jang from Asan Medical Centre was ok. I visited the hospital and when I met the doctor I was also greeted with 5 other fellow/student doctors in the consult room. There was abit of language barrier getting to the consult with admins/receptionist but he spoke English well and slowly. If I wanted surgery with him, he said it would be months so I booked it tentatively. He suggested diced rib cartilage in fascia and showed me a few patient before and afters. Dr Yoo from View was ok. I was accompanied by several consultants and then finally during the consult he suggested dermis graft and rib cartilage for my tip area. I thought why not use all rib? But I quickly realised he may not have been confident with controlling rib warping on the dorsum. After the first day of consults, I decided I would cancel the other appointments so I could rest. The other clinics were there as backup in case I couldn't harvest my rib cartilage and needed alternative options like dermis or ear grafts. Luckily my rib was ok. I spent one day deciding between the shortlisted clinics and eventually settled on Dr Jin. Why? I liked his natural aesthetics and of course, we had a backup plan to deal with rib cartilage if warping could not be controlled. That was my biggest concern. Even though I'm sure the other doctors were skilled I felt I could "verify" his work and experience, because Dr Jin has published quite a few medical journals and books in his medical career, that gave me further confidence. ON top of that, I could communicate with him directly without going through consultants and his response time was excellent. I also read that he has done the Prince of Malaysia's nose and if he was referred to me by a respectable doctor in Beverley Hills, I thought its a good sign. Equally important, when I asked if I could negotiate a contract agreement clause for my protection to say he is the only one doing the surgery and if things go wrong to take it to the Korean medical authority (as listed as ITEM 3 & 6 in the checklist by Visit Medical Korea), he was happy to do so and signed it himself. At this point, I knew he was an ethical and accountable surgeon. My worries went away and I was ready for surgery the following Monday. The days leading up to surgery I enjoyed the food and culture of Seoul. Fast forward to surgery day I arrived 7.30AM. The night before I fasted and felt so thirsty in the morning. We went over the contract agreement again and he gave me time to read and sign the papers in the outpatient room while a nurse administered IV plasma. Then the anaesthetist registered me and got me to read over another contract and sign it. Then once all was good, I went into the operating theatre next door. After the operation I felt uncomfortable because I had stuffings in my nose and a cast. I couldn't drink for at least an hour until the General Anaesthetic left my digestive tract. I was so thirsty at that point. Surprisingly I had no pain in my ribs I was wearing a waist band and I thought maybe the anaesthetic was still coursing through my body. I actually went walking back home that evening which was a few minutes away. Biotene throat spray was my best friend that night. I went back the next day to remove the nasal packs and everything went ok. My ribs felt fine like nothing happened. Dr Jin and the nurse helped me with some nose cleaning and checked the stitching. I returned every second day for cleaning and checkups until the stitch removal the following Monday. Once the cast was removed, I went home immediately and checked it out at every angle. My bridge was swollen and taller than it is but was assured it would get lower as time goes by. I know this is true based on my experience from other surgeries so I wasn't worried. My tip was upturned abit and now I have a better defined columella! I am so happy although I know it will take at least 12 months or longer in my case to see the full results. It turns out my Sydney surgeon actually did more damage to my nose than he revealed.He buckled my septum and it was curved like a C shape! No wonder my tip was always deviated to the left and quite flat. Also my tip cartilages were spread out and needed resuturing and grafting of course. Dr Jin took 5-6 hours to restore and improve my nose. I had alot of scar tissue from my previous rhino causing alot of redness on my bridge but surprisingly it is now gone! OMG. It's still early days but I can tell from the shape, my tip looks better and more projected and my bridge is much slimmer and taller. YES! I didn't even suffer from bruising like the last two surgeries this time round. Also, I still did not at any point, experience ANY pain in my rib area. The only thing I felt was a slight tug if I was to cough. I was SO HAPPY and grateful things went smoothly! Link to comment Share on other sites More sharing options...
amyknows Posted August 23, 2018 Author Share Posted August 23, 2018 Overall my nose looks much better. Of course SUPER SWOLLEN. I will have more than normal people because I had medpor removed causing heaps of scar tissue. It's only been 10 days since the operation and the bridge and nose tip are quite high but noticeably slimmer. I know from experience, that over the next couple of months this will drop and start looking more natural up until 12-24 months. I cannot wait. I LOVE my front view - I have a better defined bridge and tip definition. I look more feminine with this slightly upturned tip which is a bonus. In the end, I'm so glad I travelled to Korea for my revision and thank god, that I did not settle for surgery in Melbourne and then deal with being disappointed. My rhino experience was much more positive this time round making some friends along the way and once you are there its actually not that scary. This is my third and hopefully final-ever rhinoplasty. Hoping I will be one of those lucky people who disappear from these forums for good and move on with their lives. But before that I owe it to share my experience for those who are thinking of surgery in Korea who had the same fears and doubts I did before going. I am grateful I had surgery with Dr Jin and his team were very accommodating. He is an expert at what his does and he only does noses. For those who feared having rib harvested like I did, he made it feel virtually pain-free. The incision was small and its healing atm. He is able to create natural looking noses. Although it is still very early days for me and very swollen, I love the shape and definition from my result already. I will post more photos months to come. Communication was excellent plus good response times. I mean think about what happens if things went wrong, you need to be able to speak to your surgeon saving the hassle of going through the consultant. If I was you, I would make sure you include him in your shortlist especially if you want natural autologous material be it septal, ear and especially rib cartilage because he is one of the top surgeons in Korea, if not the world, for rib rhinoplasty. Hope my experience was helpful to you for your rhino journey. Now at home finishing this review after recovering from all that jetlag, I know that the hard part has been done. All I need to do now is to relax and focus on recovery. What a journey it has been for me and I don't regret this decision. Good luck to you! 1 Link to comment Share on other sites More sharing options...
amyknows Posted August 23, 2018 Author Share Posted August 23, 2018 Before.. Link to comment Share on other sites More sharing options...
amyknows Posted August 23, 2018 Author Share Posted August 23, 2018 With cast on... you can see the nostrils have changed shape longer and more oval. Tip is upturned.. Link to comment Share on other sites More sharing options...
amyknows Posted August 23, 2018 Author Share Posted August 23, 2018 7 days after...noticeably higher bridge and upturned tip. Bridge more defined but still very swollen. Link to comment Share on other sites More sharing options...
pannana Posted August 28, 2018 Share Posted August 28, 2018 Would you mind telling me how much it costs? Link to comment Share on other sites More sharing options...
amyknows Posted August 28, 2018 Author Share Posted August 28, 2018 Hi pannana, My quote was specific to my circumstance which costed $12000USD. Your quote will be different depending on your situation and what you need done. Good luck! Link to comment Share on other sites More sharing options...
pannana Posted August 28, 2018 Share Posted August 28, 2018 Thank you for your information ! Link to comment Share on other sites More sharing options...
lana_1028 Posted August 28, 2018 Share Posted August 28, 2018 thanks for the thorough review @amyknows glad you're loving the result so far. your nose is really looking good Link to comment Share on other sites More sharing options...
nikkiay Posted August 30, 2018 Share Posted August 30, 2018 Thank you very much Amy for sharing your thorough experience with us! Congratulation on the result! May I ask the full name of Dr. Jin? i may look more into it. thanks again! Link to comment Share on other sites More sharing options...
amyknows Posted August 31, 2018 Author Share Posted August 31, 2018 Hi nikkiay, full name is Dr Jin Hong Ryul. Wish you the best! Link to comment Share on other sites More sharing options...
nikkiay Posted August 31, 2018 Share Posted August 31, 2018 thankyou! Link to comment Share on other sites More sharing options...
amyknows Posted September 17, 2018 Author Share Posted September 17, 2018 Post-op 1-month update: So it's been about 5 weeks since my surgery and things have healed nicely so far. The bridge has narrowed significantly after week 4 and the height has lowered to become more natural. The swelling still persists however it fluctuates all the time and the level of swelling will vary at different times of the day. I find in the morning the swelling goes down significantly in the bridge but at the tip of course it retains the swelling as it takes the longest to heal. The alars are puffy and hard to touch as the tip and septum area is still swollen and stiff but overall this area has softened up since the beginning of recovery. I do find augmentation seems to have less swelling than removal of a graft or implant which makes sense if your making the nose bigger and the skin is therefore stretched. The columella incision has healed nicely thankfully no keloid and is a slight pink but it will improve some more over time. Rib site incision is also good after religiously using silicon sheet every day. It is now a slight white line. Regardless of how bad the swelling is, the fact is, only I notice it. To strangers they wouldn't have guessed I had a nose job. I can only imagine my nose will continue to refine A friend who hadn't seen since the operation said I look fantastic and very natural. I am happy with my nose at this point and waiting patiently for the nose to refine for the better these following months! Link to comment Share on other sites More sharing options...
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