K Couture's guide to seoul plastic surgery

[K Couture]

Hi guys so despite the abundance of information we have on the forum I understand it may be a bit difficult for new members and first time surgical patients to get the information they need. It can also be annoying for members to repeat answers they have already responded to in older posts so I'm compiling this guide to aide new and old forumers. When it comes to surgical procedures I will be as objective as possible. While when it comes to the actual process, from shortlisting - navigating yourself around seoul - hotel booking - surgery day - recovery period I will explain how I personally went about it and the logic involved. When I was younger I was very clueless and ignorant when it came to plastic surgery and hence made many bad decisions. I hope what I share can deter people from making the same mistakes.

My Kakao id is: Kcouture if u guys have any other questions that ARE NOT ANSWERED IN THIS GUIDE.

*You can also ctrl find from the table of contents to skip to the section you require information from.

Procedures I have done and will be covering:

Soft Silicone Rhinoplasty (primary)

Diced Cartilage with Fascia and septum via Open Rhinoplasty (1st Revision)

Ultra Soft Silicone, irradiated strut + tip + dermis via Closed Rhinoplasty (Final revision Sucesss!)

Alar Reduction

Acculift

Forehead Fatgraft

Mandible Reduction

Concentric Malar Lift with Hydroxyappatite

Jaw line contouring with Hydroxyappatite

Chin Implant with silicone (primary in thailand FAIL!)

Chin Implant with Hydroxyappatite granules (Sucessful Revision)

Buccal fat removal

Incisional double eyelid

Epicanthoplasty

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Table of Contents:

Section 1: Research and Shortlist your clinics

Section 2: Selecting the right procedure for yourself

Section 3: Securing your consultations appointment and accommodation

Section 4: Navigation and Communication in Seoul

Section 5: Consultation and selecting your surgeon

Section 6: Price Bargaining

Section 7: Night before and Day of surgery

Section 8: Post Op Recovery

Section 9: FAQs (check future posts in this thread as I have not written this one yet)

 

[K Couture]

Section 1: Research and Shortlist your clinics

a) Only select clinics where they specialize in the specific procedure you are wanting to have. Do not go to a clinic where the surgeon(s) are a jack of all trades, master of none. So if you are wanting to do a cheekbone reduction, you would not want to go to a clinic that specializes in nose but just so happen to be able to do a zygoma reduction. For the sake of your face, you want to ensure the operating surgeon is constantly honing his skills and updating his technique when it comes to the specific procedure.

b) DO NOT select a clinic based on before and afters. This is one of the most illogical decision making factors. A clinic will only show you their best work, and you will never have a gauge of their success to botch ratio. Additional, every individual patient's requirements and requests is different. We may look at a before and after and think, oh the surgeon made this patient's nose too low for my liking. When it could also very well be that the patient requested for a subtle change. Finally, some clinics are known to use photoshop so be aware of that too. Before and Afters from the clinic's sources are therefore marketing and do not accurately reflect skill.

c) A common misconception is for people to select a clinic based on "style" that a surgeon uses. I hear alot of people saying for example "I chose a surgeon because of that style of nose". Rather than only performing one type of nose in an aesthetic sense, a truly skilled surgeon is able to do the procedure according to the request of the patient as close TO THE DEGREE TO WHICH THEIR ORIGINAL NOSE STRUCTURE ALLOWS. For example, when I had my most recent rhinoplasty, Dr Park asked me "do you prefer a curved or a straight nose and how sharp do you want it?" My response was "I would like a straight nose and I want maximum tip projection TO THE DEGREE TO WHICH MY EXISTING TISSUES WILL ALLOW." This is an important statement to make as while I wanted maximum tip projection, I would also like my surgery to be performed conservatively so as not to risk and thinning of the tissue or worse, extrusion. Basically, maximise projection in a healthy manner for my nose tissues.

d) Research on the reputation of the clinic, and more importantly the surgeons. Note that just because a clinic is famous (ie: ID Grand BK) does not mean that they are reputable. There's a clear difference between a highly skilled clinic/surgeons and highly marketed ones. A highly skilled surgeon is respected amongst their peers. For example Bryan Mendelson of Australia, who was selected to be the president of the ISAPS back in 2008 by his peers. So one way of learning of a surgeon's reputation is to check if they have been invited to panel any medical conferences or seminars. These events are usually not open to the general public but only centric to the medical community. Hence reputation within the medical industry comes into play here.

e) Know what procedures are most suitable for you. Before you shortlist your clinic, research on the different methodologies available. You should then compile a list of clinics who perform these different methodologies. In this format, while you go for your consultations and obtain varying opinions from the different surgeons, you will be able to make a more informed decision on what method is most suited to your case, to your requirements. It sounds tedious but it is YOUR FACE. I've had to go through enough revisions to wish that I would have been armed with the knowledge I now have back before I had my first ever surgery. For me, plastic surgery has been a learning process through trial and error and I do not wish that upon anyone.

f) Know which surgeons have what specialities at your shortlisted clinics. Know which surgeons are the most senior and most experienced. You do not want a fresh grad operating on you. Likewise, you do not want a rhinoplasty specialist performing your v-line surgery.

*In the next section I will go through some medical procedures which I am familiar with, especially the ones which I have experienced as part of the surgical procedures.

 

[K Couture]

Section 2: Selecting the right procedure for yourself

Rhinoplasty:

a) Open vs Closed rhino

There's 2 different Incisional Methods. Open rhinoplasty and Closed rhinoplasty. Open is a more invasive technique as it requires an incision at the collumela with the nose being completely opened. The advantage to this technique is that the surgeon has better navigation in the implant site. Majority of surgeons (except for cases requiring ONLY an augmentation of the bridge) uses this method. The down side is that as it is more invasive, recovery takes longer and is alot more uncomfortable on the patient. For me personally, recovering from open rhino was as bad as my jaw reduction. One of the worst parts of recovery is the packing, which goes partially down to your throat. You can forget about breathing through your nostrils while the packing is still in there. Packing is usually removed within 1-3 days. Mine was removed the day after surgery when I had open rhino. But many people have had to withstand it for up to 3 days. Another limitation is your collumela shortens after open rhino. This isn't much of an issue for those who do not have short collumelas and have a successful primary rhinoplasty.

Closed rhinoplasty in contrast requires alot more surgical skill. Hence why most surgeons would recommend open, not because they cannot perform the surgery by closed, but because they do not have the skill level using this technique to make it their FIRST recomendation. Its one thing for a surgeon to say "I can perform it by closed if you want" and another for a surgeon to suggest the closed method right off the bat. Closed rhino is significantly easier on recovery as it is done through a small incision in the nostril. The nostril will depend if the surgeon is right or left handed. No risk of collumela shortening too. These are the reasons why I decided on closed rhino for my most recent and only successful rhinoplasty. I had sustained extrusion from my 1st revision and required reconstructive rhinoplasty. My collumela would also lose elasticity from another open rhinoplasty. Hence it was most logical for me to have my surgery performed through the closed method. The problem for most surgeons doing the surgery through closed is that for the tip area especially, it requires a high level of skill to maximise tip projection. This is as Bryan Mendelson, 2008's president of the ISAPS explained to me: Tip projection is very much possible through the closed method, but navigation is difficult so only a surgeon who specializes in the closed method should perform the surgery in this manner. What I mentioned earlier regarding specialization applies in this case. For tip work especially through the closed method, you must find a surgeon who specializes in this method, who constantly hones and improves their technique with this methodology.

Implant types:

b) Goretex - considered by many within the medical community to be an obselete implant type. Goretex has the advantage of being porous, but that is also its disadvantage. Removal requires excision of the tissues which have grown into the implant and thus thins out your skin. When your skin is thinner you become more susceptable to extrusion. Surgeons who suggest goretex are likely to have a surplus of this form of implant in their inventory.

c) Hard silicones - there's different types of hard silicones. Avoid all these like the plague. Good surgeons no longer use hard silicones as it puts too much pressure on the skin and thins out yur tissues. This is the reason behind the high rate of extrusion and complications from silicone implants. Regardless of whether it is an I shape or L shape implant, both are horrendous. Tho the L shape implants have an even higher infection rate because the collumela is more prone to complications than the bridge. We should always avoid artificial implants FOR THE TIP AREA.

d) soft silicone - this is a softer version of the hard silicone. I had this form of silicone during my primary rhinoplasty 8 years ago. Its density and texture is very similar to rubber.There are now upgraded forms known as ultra soft silicone.

e) Ultra soft silicone - this is the form of silicone which is mostly used in Seoul at the moment. It is very soft and doesn't place pressure on your tissues. I used this in my most recent revisional rhinoplasty. There are different heights and widths available so it is advisble for the patient to select the heights and widths of their choice. Usually for a conservative improvement 2.5mm is ideal. 3.5-4mm is for those who want a more significant augmentation. However, this all depends on your skin tissue. I have thinner skin now having sustained damage from my previous rhino. Therefore my elevation is a 2.5mm ultra soft silicone plus 0.5mm donor fascia to protect my tissues. So I now have a 3mm implant and a defined and sharp nose. This is in part because my skin is thinner. This form of implant provides aesthetically superior results in terms of shape and structure as they are pre shaped and available in different sizes to fit the needs of the patient.

*Note: A common concern are infection rates when it comes to artificial implants are infection rates. The data concerning infection rates for silicone does not differntiate between the older hard silicone types. From my own personal experience, my skin is alot thinner than the average patient due to damage from extrusion. Hence I would have a higher likelihood for infection. However because the ultra soft silicone is not placing pressure on me despite my thinner tissues, I have recovered perfectly fine.

f) Diced Cartilage with Fascia - This is a form of autologous graft. Which means it is harvested from the patient's own body. This method requires harvesting of cartilage from donor sites. Ear is most common but rib can be used too. The cartilage is then diced up, wrapped in fascia. Fascia is harvested from the patient's scalp through an incision at the side of the head. Scar is concealed by hair. You can expect staples to be inserted to hold the wound from the fascia harvest site for the first 5 days or so. Advantage of this method is the lower infection rate. The logic is that as this is harvested from the patient it is better and there would be no risk to infection or extrusion. This is not true as I had this type of implant for my 1st revision rhinoplasty and sustained extrusion from the cartilage. So while extrusion and infection rates are indeed lower, they are still a possibilty. Use of autologous cartilage also poses a higher aesthetic complications for the BRIDGE area. In part because they are not pre shaped unlike the artificial implants. Potential side effects include: assymetry, unevenness, humps and bumps. This analogy offered to me by a surgeon I consulted with should explain the reason behind these side effects. If you get an apple then dice it up finely and wrap it with soft rice paper, you will find that no matter what you do, the implant will still be an irregular shape and texture.

g) Diced Cartilage with Fat Graft - I've only heard and seen this type of implant recently. Instead of using fascia, it utilizes fat graft harvested from the patient and mixes it in with diced ear cartliage. It is then administered through the nostril and moulded into the bridge. The fat grafts acts as a putty to hold the diced cartilage in place instead of using fascia. The logic behind this method is that the diced cartilage is no longer being held in place by a film of fascia but rather thick putty of fat. It is also used as an alternative for those who want more subtle results and are not comfortable with the use of silicone. However, it has the same limitations as any fat graft, that is the resorption rate. This varies according to BOTH surgical technique and the patient's body so in there is an element of unpredictability there. That being said because the nose area has barely any muscle movement unlike other facial implantation sites, the risk of a large percentage of the fat graft dying is minimal.

h) Rib Rhino - this method involves an incision at the rib area and a cartilage being harvest as such. The surgeon then carves the rib into shape and implants it into the patient. Rib rhino is the most invasive form of rhinoplasty. Many surgeons in Seoul use it as a last alternative for revision patients who, for whatever medical reason, cannot use artificial implants. Potential issues to consider, as with any autologous grafts, are absorption rates, assymetry, uneveness and humps. Again like the diced cartilage, because the shape and structure is not comparable to that of the silicones. However, some surgeons do recommend rib rhino for primary patients as that is their speciality. But as Bryan Mendelson explained to me, the reason behind the aesthetic complications is that most surgeons should not be performing this procedure. Because it is at the end of the day an art form with the shaping of the implant, hence it is difficult to get an ideal shape for the patient. I have seen many cases of unsatisfactory autologous grafts from rib and diced ear with fascia including my own, which is why I avoid autologous methods for the bridge like the plague. So while certainly good results are very much possible, there is also a higher margin of error with these procedures.

 

[K Couture]

*Section 2 continued

Double Eyelid Incisional vs Non Incisional

Both methods are considered non invasive procedure. However, commonsense will tell you that the non incisional is the less invasive of the two. Scarring is a concern for those who consider the incisional method. There are things to do to alleviate scar formation. Some options are applying kelocote or using kenacort scar dissolving injections. Anyways here are a few points to take note of:

a) Incisional is more suitable for individuals with excess fatty tissue and thicker skin.

b) Ptosis can also be done with non incisional.

c) For the non incisional method, risk of stitch coming loose is not significant but can happen. However, the dual stitch method greatly reduces the chance for this to occur. This method applies the stitches like that of a net which firmly secures the tissues in place.

Note: regardless of whether it is incisional or non incisional, there will always be natural asymmetry. No one's eyes are perfectly symmetrical.

Jaw/Mandible Reduction

This procedure can be done using different methods, depending on the degree of correction warranted. Note that this procedure only changes SHAPE not width UNLESS the muscle is physically excised out too. Many surgeon would not want to do this as it poses further risk of complications for an already invasive procedure. To add, botox works perfectly well to shrink the muscles by temporarily paralysing them, therefore reducing width of the lower facial region. Things to note about this procedure:

a) You must do an x-ray and ct, preferably a 3d ct scan to determine that you are a candidate for the procedure

b) Sagging is guaranteed. The degree to which sagging occurs depends on whether the patient is a candidate and how much bone has been resected. Remember the way your facial tissues is currently is due to your preexisting structure. Reduce it and sagging is bound to occur. Your concern in this respect should be the visibility of sagging. For example, younger patients will have sagging but less visible than older patients as their muscles are stronger. However, sagging will occur faster with age since the bone structure has been manipulated.

c) Find a conservative surgeon as even the slightest bit that has been over reduced can increase the sagging effect. I was 19 when I first had this procedure done. The surgeon removed too much bone AND I was not a good candidate for the procedure. What occurred was significant sagging and I later had to get a concentric malar lift to the mid face region to shift the sagging tissues in the lower facial region to the mid face region. Essentially it took another invasive procedure to alleviate the problem caused by the first invasive procedure.

d) Be mindful that surrounding the jawbone, are plentiful motor and sensory nerves. There are risks to temporary damage and permanent damage. Permanent damage of motor nerves will leave the patient in a stroke like condition. So again, find a specialized surgeon to perform this procedure and really understand the dynamics of this procedure before going ahead with it.

Zygoma Reduction

This can involve the lateral (side), 45 degree and or the front cheekbone. Can be done by shaving, fracturing or resection depending on the patient's requirements. Refer to the above points I made regarding things to note of for mandible reduction as they all apply to zygoma reduction too. Again, select a conservative surgeon for this procedure and really understand the dynamics of it before going ahead. Your facial bones are like a tent. When the central structure is erected, the tent is held in place. However when the central structure is removed, the tent falls downwards. Same principle with your cheekbones. Some surgeons will also lift the facial muscles at the same time as the reduction but this is not guaranteed to alleviate sagging.

Fat Graft

Fat is taken out from harvest sites, processed and then transplanted into the targetted region. Harvest sites tend to be most commonly from the abdomen and/or thighs. I chose to harvest mine from the abdomen as I experience frequent hyperpigmentation and keloid scar formation. By having the harvest performed at the abodomen, the incision is done through the belly button and hence poses no risk of noticable scarring. Often is the case where after 3 months, whatever remains belong to the patient. I personally retained around 60-70 percent of my fg at the 3 month mark. That is why this procedure is said to be semi permanent. A few things to note about fatgrafts:

a) Individual resorption rates vary from patient to patient. Surgical technique obviously plays a factor too but the unpredictability lies with the patient's body.

b) When areas with frequent muscle movement have been transplanted with the fat graft, there is a risk of the graft being dispersed and dying. Depending on the area, botox helps. I experienced dents on my post op day 3 for my forehead fatgraft. This is due to my habit of frowning and squinting my eyes while i give people the evils lol...Dr Park's solution was to temporarily paralyse the muscle with botox. The result was 2-3 days later the dents were gone.

c) DO NOT SMOKE. Fat graft requires ample circulation for survivability. Smoking will guarantee you to lose significant volume, even after the 3 month mark!
d) *Important: Find a clinic which provides a free or heavily discounted FRESH 2nd top up within at least 8 months. The gimmick for many clinics is that they provide a free top up through COLD STORAGE within the first 3 months. Fat survivability is much lower when taken from cold storage. It is the same principle behind the coolsculpt "fat freezing" weight loss machines. Also, if a patient requires a top up within 3 months then the surgery was not performed properly. A top up should only be required at least 6 months down the road.

Concentric Malair Lift

This is a midface lift performed through either the lower eyelids of intraorally. It grabs the surrounding sagging soft tissues/muscles and secures it to the mid facial region. Individuals with thicker skin should be mindful that it can cause chipmonk cheeks (mariah carey much? ). Healing process is also long. When I had it done, while most superficial swelling dissipated within 3 weeks, the residual swelling took nearly 8 months to fully go down. This recovery period was much like my jaw reduction. Note however can results can be seen after 3 weeks. An issue we should be mindful of with the mid face lift is the slanting effect it can cause on the eyes. So for individuals with thick skin and fatty tissue should find another procedure more suited to them. Just look in the mirror and gently push your midface upwards. You should notice a slight slanting on the eye.

Hydroxyappatite Granules

This type of implant can be used for the chin, jawline and other facial regions for contouring. It is an extract from corals (which is structurally similar to bone), turned into a fine granule form and mixed with the patient's blood into a putty form. The surgeon then moulds the putty into the patient's facial structure. Great thing about this implant is that it can be scuplted by following the patient's facial structure. Limitations is that few surgeons can perform it and thus if for whatever reason removal is warranted, few can remove it too. Anyone considering this method should look to Bryan Mendelson, the surgeon who pioneered the technique. I had it done as a chin revision, jaw line contouring and inconjunture with my mid face lift with excellent results.

Buccal Fat Removal

This procedure is performed through an incision at the inner cheekwall. The fat pad of a golf ball size is then slowly teased out. It cannot be physically pulled out because the surrounding areas has too much sensory and motor nerves. Doing so may risk rupturing. This procedure can cause premature sagging depending on the condition of the patient. For example, individuals who do not have really fatty faces to begin with, who seek the gaunt haute couture look will find themselves aging faster. Facial fats at the end of the day do help maintain a youthful appearance. Also, those with NOTICABLE assymetry (everyone's face is somewhat assymetry to varying degrees) should avoid this procedure as it can exacerbate the assymetry.

Acculift

Effective procedure for facial fat reduction. Performed through a fine wire and tiny incision made at the nasal labial creases should the procedure be targetting the cheek or lower jowel region. It is minimally invasive and works by melting the fat. While some of the fat is removed through a suction, most of it is melted. What occurs is that your body naturally flushes out the melted fat as excretion within the coming weeks. When I had this procedure done my face began to contour and slim down for the course of the following month. While I am very satisfied with this procedure I must add that those who expect a true lift out of this surgery should look elsewhere. You will find a concensus of its effective as a facial fat reduction method. You will find disagreement, especially that of western surgeons (check realself) and asian surgeons on its effectiveness as a lift procedure. From my experience having done the acculift, the supposed lifting effect or the "shrinking of soft tissue" is merely superficial due to swelling and heat from the laser. Individuals looking for a true lift should look at other procedures.

 

[K Couture]

Section 3: Securing your consultations appointment and accommodation

Making Appointments:

Some people complain about having limited response when e-mailing clinics. Know that clinics will have different e-mail addresses which will be directed to different departments. Should you have difficulty contacting the clinic, simply call them up. This was the case when I attempted to contact Regen for example. The staff who I called provided me with an e-mail that was directed to the consultant and not the general mail system. I then got a prompt response after. You should also call to reconfirm your appointment after making one online.

Finding accomodation:

Ideally you would want to stay in the Gangnam Area. This will greatly reduce your commute time. You should request the clinics for a list of hotels they are affiliated with as when booking through the clinic they can provide you with corporate rates which are up to 50% off. For example, even before I confirmed with Dream Medical that I was having my surgery with them, I asked them to book the hotel for me from the list of hotels they are affiliated with. I ended up staying at a 5 star hotel for around 120-130 USD a night. If I had booked directly myself or through agoda I would have had to pay nearly 300 a night.

*IMPORTANT: if you choose to stay at one of those dorms for financial reasons, DO NOT tell the host/hostess and/or housemothers where you will be consulting. They will very likely suggest you a clinic too. Whatever the case do not disclose any information to them. These individuals are known to have agreements with certain clinics whereby whenever they send one of the tenants for surgery, they take a cut of the commission.

Knowing the pre op requirements and being prepared:

If you know what procedures you want to get, obtain a list of the requirements. This may range from food to eat, medications, supplements etc. Post op medication is always provided by the clinic but some surgeons prefer medication to be taken pre op. For example, when I had my concentric malar lift, Dr Mendelson gave me a script for anti biotics to be taken 5 days before the surgery. He also provided me with a list of food to avoid, supplements to take and pre op prepartion and post op care instructions. If anyone wants this list feel free to kakao me. Also, for the smokers, STOP SMOKING ONE MONTH BEFORE! Do not use Nicotine Patches as you need your blood circulation to be strong. I quit using e-cigarettes with NO NICOTINE in the e-juice.

 

[K Couture]

Section 4: Navigation and Communication in Seoul

When you arrive at Incheon Airport, there is a convenience store on your way out. Obtain a prepaid simcard and activate the data roaming by taking a picture of your passport on your phone and sending it to the e-mail of the telecommunications company provided on the set up instructions booklet.

There are shuttle buses which take you to the major hotels in the Gangnam area. If your hotel is not on the list, you can get a bus that takes you to the closest point such as Sinsadong Station. After that just cab your way to the hotel. Taxi is very cheap and affordable in Seoul. And they are plentiful too.

With regard to taxis, despite some of them having translation services, its a bit of a hassle as the cab driver need to call the operator and then obtain your address. You should print out a copy of your hotel's address and name in English and Korean, or simply get the business card of your hotel and show it to the taxi driver. Once at the hotel, ask the concierge staff to write the address of the clinics you wish to consult with in korean. All the korean taxis have gps so all that is required is for the driver is to input the address and voila. It costs me only around 4-6 USD per cab ride between locations in Gangnam. So its really economical.

As I mentioned, having data roaming is very imporant in Seoul so buy the simcard from the airport. That simcard is not easy to find in Seoul, tho the 5 star hotels will sell it at the front desk. With data roaming, you can access google maps and google translate. WIN!

 

[K Couture]

Section 5: Consultation and Selecting your surgeon

One of the hardest parts for those with no surgical experience is selecting the right surgeon. So how is this done? I believe this is an efficient method of going about it.

a) Understand your conditions and your needs. In my situation, my priority was a reconstructive rhinoplasty. I had previously done open rhinoplasty and my collumela had thus been shortened. I therefore chose to undergo closed rhinoplasty when it was propose to me as this would negate further shortening of the collumela. Only by knowing the options available for the procedure you are seeking and understanding the limitations of your condition are you able to make an informed decision.

b) Be social. Speak to the staff at the clinic and monitor their level of professionalism. Speak to post op patients especially. When I was at Dream I made it a point to chit chat with the post op patients. This affirms a real patient experience for after care and surgical skill. It was comforting that I met a grandmother in her sixities who just had a face lift, who looked like she was in her mid thirties. However, this shows the skill of the surgeon who performed the facelift, who was not my operating surgeon. So say you are looking to get a rhinoplasty, then you would be lucky to speak to a post op patient you meet at the clinic who has surgery with the rhino specialist.

c) Ask trick questions to the surgeons to test their honesty. For example, when I was proposed goretex as an implant for my revision at OZ clinic, I deliberately asked the surgeon about the difficulty in removing goretex. He stated that it was not difficult at all and I would not have to worry about thinning of tissue. This is know to be untrue as it is a widely known fact within the medical community especially, that goretex requires excision of tissue which thus does in fact cause a degree of thinning.

d) Do not show your surgeon pictures of celebrities. This one of the most eye rolling things you can do. Because plastic surgery is about improvements and enhancements ACCORDING TO YOUR PREEXISTING STRUCTURE. You cannot show an image of someone else and say "I want this nose" or "I want these cheekbones". It doesn't work like that and only displays how unrealistic you are. The most objective way to explain to a surgeon what results you want, is to photoshop your own features in a REALISTIC MANNER. This will give the surgeon a clear idea of what you want to achieve. This is especially important as if you are not specific, a surgeon's sense of beauty and what your ideal is may conflict.

e) Do not go on a tight budget. If you have too tight a budget you should save up so you are flexible with your finances. I've seen too many people picking a clinic because it is cheap and end up with unsatisfactory results requiring revision. The wellness of your surgical outcome must always outweigh your budget. Always! I do not mean paying more is always better. Its about making a calculated and informed decision based on surgeon's reputation, procedures required and difficulty of procedure.

f) *Very Important point here: IDENTIFY A GIMMICK PROCEDURE
Many clinics in seoul utilize marketing to charge a premium on certain procedures. Just like how it is important to know the difference between a surgeon's skill and his marketing team's capabilites, it is just as important to know when a procedure is complete and utter BS. Some clinics will claim to pioneer certain procedures such as the Power V lift. In this case, the "V" tag is added on to a generic form of facial lipo sculpture to attract people lacking in research and surgical knowledge. The procedure is then presented to the patient in a remarkable technical manner which leads the individual to believe its a medical innovation. A much for realistic and more affordable option would be the acculift as you are not paying a premium for rubbish. Same goes for the nose method that allows you to do a piggy nose. You are literally paying a premium of LV level prices in order for you to push your nose upwards to look like a pig. Think about that for a second before you get in awe by this method lol..... Another gimmick I will identify is the LAMs treatment at 365mc. The gimmick here is that you can see the fat removed as they do it, whole 100cc of it, which is nothing. They also charge through the roof for it. After the 100cc of nothing is removed, a fat dissolving liquid is then injected. Now for the truth. This procedure is lipodissolve rebranded as a lipo technique. Lipodissolve is a dangerous liquid which dissolves fats. Problem is it does not differentiate between fat, skin and flesh. Hence the reason why many clinics and some countries have banned the use of this liquid is because it can cause internal and external burning. The swelling period is also very broad and unpredictable. Can range from 5 days to 6 months depending on how the patient's body reacts. This is what the reputable Dr Martin Braun told me when I inquired about lipodissolve. That's not to say all clinics who employ these marketing tactics are bad. 365mc is by no means made up of an incompetant medical team. What I am suggesting is however, that one needs to differentiate between what's a medically efficient procedure and what is merely a gimmick aimed at charging patients a premium.

 

[K Couture]

Section 6: Price Bargaining

So this is where it gets trickey. First I will explain the protocol at majority of the clinics in Seoul. You begin by meeting the consultant. They will discuss your requested procedures and perhaps recommend you alternatives. Some may even try to push unnecessary procedures onto you so be mindful of not falling for that. After you meet the consultant you will be back in the waiting room for your consultation with the surgeon(s). Now the thing to remember here is that you should always know who your specialist and most senior surgeons are. As I mentioned in Section 1 part f), do your research. You always want to request your operating surgeon. If not, during peak periods especially, you may get assigned to whoever is available. You must make it a point that you are getting the best of the best for your face.

Anyways after you meet the surgeon, they will place notes on the computer and send the data back to the consultant. According to this data, the consultant will then set their opening price. This is where the bargaining process begins. Things to note of are that depending on who your surgeon is, you may not have that much room to bargain. Furthermore, the consultant may only be able to drop the price as much as the surgeon is willing to. Hence they have to follow the pricing protocol of either the hospital and/or the operating surgeon. So here's how you go about it.

a) Know the market value of the procedure. By this I DO NOT mean comparing rhinoplasty between two clinics per se. Do not bother comparing prices between clinics with more than one level of pricing difference. Pricing level refers to the clinic range. Low, Low-mid, mid, upper mid and high range. It makes no sense to compare the prices of a low-mid to a high range one. We are bargaining now so we have to think in a business sense. There is a reason why clinics with more infrastructure can charge and has to charge more for their services. A mid sized or large hospital will have more of overhead and costs to cover, and they will not drop the price for a primary rhino to be comparable to a low ranged clinic. Low ranged clinics tend to be operated by single surgeons who do not have as much costs to cover. Important to note is that a clinic grows in size by having investors identify the skill and credibility of the surgeon and therefore are willing to pump the finances in to grow the business. This is also a potential reason why many smaller self operated clinics never end up growing. Because if you invest in a clinic you invest in the surgeon and his skill/reputation too.

Apologies if the above is slightly confusing. But I hope you get the point to compare market value/price of procedures between range related clinics

Additionally you must consider whether or not the higher ranged clinics are charging prices which are warranted. To identify this you need to not only be aware of the market value of the procedures according to comparative clinic ranges, but also the reputation, skill and specialization of your operating surgeon.

b) Know the reputation of your surgeon. Don't expect to get prices you would pay for an experienced senior surgeon to that of a junior level surgeon.

c) If you come in with a friend who is also having surgery, your surgery should be charged as a combined rate. But know that however much your discount may be depends on how many TOTAL procedures are being done and what the TOTAL cost is, not how many people are doing surgery with you. So say you and your friend are both getting eyes done. Your bargaining power would still be less than someone who is getting eyes, nose and chin done. Likewise, if you are getting eyes and nose and chin done you have less bargaining power as someone who is getting V-line and zygoma. This is because despite the difference in number of procedures, the total cost of V-line and zygoma is far higher.

d) Understand the complexity for your procedure. Surgery is tailored according to the individual. Just because someone paid 3.5 million for a nose job does not mean you should be getting that price too. Surgery is after all, not standardized as every patient has different needs. Every patient has a different internal and external structure to work with.

e) Try to convince the consultant that you will recommend friends to THEM in particular. The more cases a consultant closes the more they earn. Use this incentive in their pay structure to knock the price down some more. But talk is cheap. Note that you need to display credibility for the consultants to trust this statement of yours as everyone tries to pull this lol. Here is one way for credibility to be asserted. My friend recently had her eyes, eyebags and nose done at the same clinic as me. When bargaining, I told the consultant that she's a successful businesswoman who has 5 profitable restaurants and 2 clothing boutiques. My friend then presented her business cards and showed the consultant the web address of her businesses. This implies she has strong social capital with wealthy networks.

f) If you had a friend or know someone who previouly had surgery at the clinic, drop their name. Especially if they are having the same procedures done, especially if they got a good price. That way the price range would not exceed your friend's price UNJUSTIFIABLY.

So in conclusion, identify the market value of your surgeon and your procedures. Come equipped with this knowledge and cite whatever data you may have at your disposal. Know your competitive advantage and then go all AHJUMMA when bargaining. Most of all, be realistic when bargaining. This is not an outlet in china that sells fake lv bags lol.....

 

[K Couture]

Section 7: Night before and Day of surgery

Sedation:

If you are undergoing sedation, do not eat or drink least 4-5 hours before your surgery. Some surgeons say 3 hours but I've known some people to chuck up by cutting it too close.

General Anesthesia:

If you are undergoing GA do not eat or drink or least 8 hours before surgery. Whenever I underwent general anesthesia I made it a point to refrain from food and water starting 12 midnight.

If for whatever reason you are very very uncontrollably thirsty (its called will power ppl!), you can request a disgusting mixture to drink before your surgery. But seriously....just use your will power.

Be mentally and emotionally prepared!

Make sure to speak to your surgery when you see him in the operating room. Just a final quick run down of what procedures he will be doing and how he would be doing it. For example, when i had acculift, I asked Dr Kim to circle the fatty pockets on my face which i wanted to target specifically.

IV will be inserted either into the arm, the vein on the surface of your wrist (not the underside) or through the vein on the surface of your hand. Some local anesthesia will be injected in the site. That's the part that stings the most. After that you won't feel anything from the needle. I personally prefer having the needle in my wrist area because it feels less restrictive. But it really depends on where your vein is most visible. Most people just do it at the arm.

When you wake up you might be a bit groggy so your clinic should let you rest in the ward for as long as you require. I do know some clinics who just send their patient off right after surgery. This is BAD! Make sure you will be allowed to rest in the ward for as long as you need. Confirm this with the staff during your consultation.

* Note: Don't be scared if you wake up during the operation should you be going under IV sedation. That is perfectly normal. Many of us have even started conversations with the surgeon while they are performing the surgery. I find that comforting personally because I trust my surgeons. I mean once you go into the surgical phase, all you can do is to trust your decision and your surgeon.

 

[K Couture]

Section 8: Post Op Recovery

I've had quite a number of people kakao me while having panic attacks whom I had to calm down. You guys were all too unprepared! Read this and be mentally, physically and emotionally prepared for the recovery process.

Swelling:

You will swell. If you don't, you're an alien. There are two kinds of swelling. Superficial and Residual. Superficial swelling occurs right after surgery. Residual is the last phases of swelling where you reach your final results. I will provide a generalised time frame for swelling period but it also depends on nature of the procedures performed and whether you are secretly wolverine(#davin lol.....) in disguise.

Superficial Swelling:

a) Be prepared to have superficial swellin for up to 3 weeks.

b) You will look normal after superficial swelling is gone. This is around 60-70% of your swelling. But your final results will not be visible yet.

c)Swelling gets worse at Peaks at day 3

d) Swelling moves DOWNWARDS. So if you got a forehead fatgraft for example, your eyes will become swollen too. If you got your nose done, your mid cheeks might get swollen too. This is NORMAL

e) Do not go crazy and say you hate your results only a few days post op. Everyone will think you are a nutcase. You are swollen. Swelling conceals the post op results. What you see initially is never accurate. Know this fact and don't cause a scene at the clinic. The only time when you can tell that your results are satisfactory early on if there has been some complication. So if you end up with a huge oversized woodpecker shaped beak for a nose, yes.....your surgeon botched you up. Something like that is blatantly obvious and not just a matter of swelling.

Residual Swelling:

a) This is the remaining swelling that can take up to 6 months to dissipate.

b) You will notice gradual improvements to your face. For example, my nose only reached its final contour and definition after 4 months or so. It looked good 2 weeks after surgery when superficial swelling went down but it looked great 4 months after when residual swelling was gone.

After care:

* You should see your surgeon for at least 2 check ups. Once soon after post op and once right after you leave. You should also be given emergency contact details of the clinic just in case anything happens. Some clinics have awful after care and the patient only gets to see the nurse after the surgery. Cross these clinics off your list as that is unethical behavior.

Follow after care instructions carefully. Those with stitches should meticulously clean their wounds and apply ointment or whatever medicine has been provided. Ointment helps loosen up stitches so the nurses can remove them with ease. If your stitches are too dry they may not be able to remove the stitches.

Sleep elevated at a 45 degree angle. Keep yourself hydrated and take vitamin C. Redoxon/blackmores is my choice. Do not coop yourself up in your room. Go for short slow walks as it helps with blood circulation. Get a humidifier for your room if the weather is dry.

For those of you who want a list of foods and medication and supplements to use and avoid which Bryan Mendelson provided me with, kakao me. I cannot be bothered typing it out there as I have a snap shot of it on my phone and its way too long to type.

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I will add a frequently asked FAQ Section for section 9 of this thread later on when I have time. Anyways as I mentioned before, pls only kakao me if you have questions which ARE NOT ANSWERED in this thread.

 

[koreasaurus]

Thank you sooo much K, you are without a doubt the greatest contributor around here and your work is greatly appreciated. The time you take to inform/teach/help us on and outside Purse Forums is truly generous and I seriously couldn't thank you more. You are most definitely the Queen of this section lol. I wish this could be a sticky thread as I know it would tremendously help us, and future PS seekers.

 

[hopefulbliss]

Thanks for putting so much time and effort into this post and forum! Everytime I search for something in this forum I will always see your input and your responses are always so helpful

 

[milkychoco]

Thank you for taking the time to share all these information, K Couture!

 

[tuneup]

Swelling moves DOWNWARDS. So if you got a forehead fatgraft for example, your eyes will become swollen too. If you got your nose done, your mid cheeks might get swollen too. This is NORMAL

KCouture, you're amazing for doing this! I should have read this thread before panicking and posting a new thread with my FG questions in.

Feeling a little less bothered by my beady puffy eyes now lol.

 

[prismaticence]

Thanks for writing! This is so useful