Please help me...suicidal :(

[heylo]

@caliRoll If you look at her early question on Realself here, she was initially quite on the fence about getting a rhinoplasty. Whatever she may have done afterward is something we’ll sadly never know. Yes, some other doctor may have operated on her, but that doesn’t excuse or relate to the fact that one did, IMO. It's the surgeon’s call as to whether they set the revision hamster wheel in motion for those who really don’t need aesthetic help and whose body image won't remotely benefit from "fixing" what's unbroken.

In my experience, certain PSs have a seriously cross-wired interpretation of the Hippocratic/Hypocritical Oath, among many other things. BDD is essentially a slur that’s used as a get out clause to discredit patients that have difficult starting points or who have genuinely been harmed by previous doctors, as @NadineP mentions. It’s almost never applied to cases that actually merit it, because the diagnosis is essentially based on the self-interest of the psych (money) or the doctor (avoidance). Mariana had issues with self-loathing that pervaded into several areas of her life, so I think the surgery was kind of part and parcel of Mariana's overall dislike of herself rather than any notion of BDD per se.

Hmm... I’m not surprised that Ion copped out of revision surgery once he’d done enough straightforward ones to build his popularity to a fever pitch on Realself.

About April 31 @NadineP I’m so sorry to read that, have you questioned the clinic as to why the promised outcome didn’t materialise or tried to negotiate any kind of revision?

 

[NadineP]

Hi Heylo. I did send pictures . They told me to send clearer pictures. Hmmm. They improved my skin and that is it!. They did not offer a revision and I would be afraid to ask what they would do and it would be absolutely necessary to use rib to try to lenghthen my nose (the decided not to when I was under last time a big mistake imo) and it is very hard to talk to doctors because of the respect issue. I dont even know what to do anymore. I have very few options.
Hypocritcal oath haha. That about sums it up. I feel sorry for ALL the patients that have been harmed by these doctors and yes they use this word BDD as a weapon against these vulnerable patients. tThese kinds of surgeries are almost ALWAYS unecessary and when it is necessary it is usually directly because of these doctors. They should practice another profession so they don't have to deal with all these deranged patients instead of making their living off them and taking tens of thousands of dollars from them and yes, even playing a part in destroying and ending lives. But they don't because they want to bask in their success and deflect their incomptences to their patient (while taking their money). Now a woman is dead. I don't know whose fault it is but I know she is not the first and she will not be the last. Once you get stuck in this loop it is so terrible...I hope she has some peace now.

 

[caliRoll]

But that's the thing though. In a perfect world all doctors are ethical and all patients have a realistic view of themselves. But we don't operate in such a world. It's a sad, tragic situation brought on by a perfect storm of a doctor too quick to say yes, and a patient who can't take no for an answer. Her story really is a cautionary tale for anyone seeking plastic surgery, especially anything on the face. Unfortunately, a lot of us know exactly what it is like to be stuck in revision hell. You are constantly wrestling with the question of "would one more surgery correct my issues" or "am I setting myself up for a complete disaster." I agree that BDD is a very convenient excuse for doctors to smear a patient's name and absolve them of responsibility. That said, in her writings you can sense the desperation and hallmarks of someone with BDD.

I can honestly say now that rhinoplasty is only for people who truly have a nose that is a mismatch with their face. Anyone seeking to tweak here and there or finesse, should think long and hard about it.

 

[MissOrange]

@NadineP I am so sorry to hear this. Have a look at Hong at GNG and the ps at JJ Hong in Apgujeong. A lady from LA got a brilliant revision with Hong but she had silicone and a guy chose his umpteenth revision rib rhino at a very fair price with JJ Hong and he is now happy. I tried to warn people about rhino at April31 after I met a young girl in Seoul last year. Personally I would be terrified of a doctor swap and would not wish to risk not getting the chief ps. If my rib graft gets any shorter, I will have to bite the bullet and choose a rhino doc in SK. @NadineP you could consider fillers until you find a top revision rhino doc. Alternatively if we won the lotto and could afford $30,000 then Dr Dubrow in LA is a 100% guarantee as he uses diced cartilage from both ears and rib wrapped in temporal fascia to extend a short nose.

 

[heylo]

@NadineP If costs permit, could you follow up in person? I tend to find messages are easy to ignore whereas it's hard to wriggle out of face-to-face questions. If rib grafting was discussed, it should surely be brought up again. I do know what the stress of running out of options is like, and sympathise. I procrastinate on contacting doctors for that reason.

@caliRoll I hear you. But as we're not in that world as you say, the financial beneficiary should assume the burden of responsibility IMO. Add that to the "duty of care” and the onus should be on the doctor to select the right patient for that treatment, just as they do in other specialities. That didn’t happen in this case.

We hear of OR deaths, for which the doctor is blamed and sometimes sued - even in cases involving pre-existing medical conditions. Yet suicides are always chalked up to a "problem with the patient", even if surgery made their pre-identified mental health problems worse and may have even created them. Since we define mental health as a medical issue, the actions and motivations of doctors who exacerbate or create suicidal tendencies that lead to a patient's death (Mariana's in this instance) should be thoroughly scrutinised, as much as they would be if the patient's heart had stopped in the middle of the operation or they’d died at some point during their recovery.

 

[NadineP]

Hi Heylo and Miss Orange. I am afraid of going to Korea because when the Doctor says no, he says no. I would go if Dr. Lee at VIP would see me but he will not. He already said no. I wish I did have 30k . I will check out JJ Hong and GNG. Thank you Miss Orange. Diced rib cartilage in fascia is the best. It looks the most naturat. Stupid Burget threw mine out when he botched my nose in 2011. Does anyone have anyone have any thoughts on Constantian in New Hampshire. Personally, I think Dr. Lee at VIP is amazing at lengthening noses. I saw a guy that had a nose exactly like mine that was fixed by him last year.

I agree with you Heylo these doctor's need to be scrutinized especially when a patient commits suicide. What a horrible, horribly tragedy. I know a couple of Jack Gunter's patients committed suicide before he retired.(they got necrosis from him and one was a very young girl)

It doesn't see that April 31st is good at lengthening noses and I think they are very overpriced. Why? Because Dr. Kim works on celebrities and he is an academic. Who knows I could have been switched out. He came to see my right after but that good looking doctor saw me for my first follow up (Dr. Park?) who knows but my result is not good.

 

[heylo]

@NadineP How many docs did you see in Korea? If you only tried VIP and April31, then the good news is that you have SO many more clinics to approach. Cast your net as wide as you can. From my very limited knowledge, VIP is - on the whole - one of those "foreigner clinics" that does many primaries and moderately difficult revisions, forgoing the toughest cases. One place I have seen more difficult revisions from is MVP, although there are 1000s more that we don't know about, being so far away.

Another strategy for if you go back to Korea, which would admittedly take some gumption, is to visit VIP with your somewhat improved nose and they may not remember you. We're all probably quite unremarkable due to the mass of enquiries that they receive from around the world, even from Westerners. Personally, I'd avoid any US doctor, I have never really seen any revision to write home about from them.

I once came across the male Gunter patient who had necrosis - simply awful what he went through. And utterly horrendous that a girl ended her life as a result of his negligence, who I presume he didn't support either. Unlike the guy, she probably had no money for the 6 figure reconstructions. From what I understand, Gunter had not long retired just before he passed away himself, which means he was too old to be active in the field at that point. But yes, negligence also encompasses an agreement to operate on an imagined defect and IMO that's the gist of what happened to Mariana at the hands of Lucian Ion. It's so terrible to realise she really won't be coming back.

 

[NadineP]

HI Heylo. I only went to those two clinics, yes. I am sure i made a big mistake but it is very hard when you don't know the good places Oh my what if they recognize me at VIP? They are going to boot me out the door and I will be so embarassed. I agree about the US doctors. Yes, that patient was called Michael Funk and he has a facebook page that I looked at. He, of course, looks a million times better but those flap surgeries leave devastating scars that you cant really see in posed pictures. I saw the scarring outline on his tip in his non posed photos on facebook. Also, the nose is no longer aesthetic. I know he is grateful that he was restored to normal though and thankfully he was. Yes, we dont hear a lot about these suicide cases because the doctor wants them to go away and keep them quiet. I only knew about the girl because another doctor told a patient because she had consulted with him before she committed suicide.I am sure she did not have the money. How heartbreakingly sad. Yes some of these doctors are ancient and they should not be practicing! That is just a fact.

I will check out MVP online and also GNG and JJ Hong. I think Korea is the best at lenghtening noses. I just happened to pick the wrong clinic :/

 

[heylo]

@NadineP I would contact as many clinics as possible to increase the probability of finding a doctor, and out of those who respond positively, I'd do further in-depth research on before visiting in person again. There are Kakao groups of patients and if you can find them, that'll give you more leads. In the past, I've researched using Facebook, Instagram and even Google+, which one or two clinics used in place of websites. I also pasted Korean hashtags into a translator, searching using the most popular and relevant ones. Some of these clinics don't have English websites at all - others are in Chinese. Definitely, start with MissOrange's suggestions and MVP - I hope either will accept you.

Another option is Iran, "nose job capital" (allegedly). I used Arabic hashtags to search for Iranian nose surgeons and built a list that I started putting into a spreadsheet, although I kind of abandoned this because Iran seems like more of a minefield and you can't really gauge anything from some of their websites. Don't blame yourself for going to April 31, think of it like "my skin has improved, one problem down". I agree that the Koreans are the best at nose lengthening, so it's wise to focus your research here.

I think men can get away with looking a bit beaten up and scarred, or even look handsome with a nose that is far from great. For women this almost never applies - that's just the way of the world. Hence, none of us should be forced to live with evident botches. It's a matter of survival, IMO.

 

[K Couture]

@KCouture, here is the realself link to her before any surgery nose and her postop rhino. https://www.realself.com/question/woldert-08-the-narrowness-my-nose-before-reversed. In my opinion, her 14 months post rhino posted on real self looks worse than her original perfect nose she has posted in comparison, and she had waited 14 months to allow for any rhino swelling to abate fully. I am sure she appreciated your support and friendship through her nose ordeal but I can see what she could see..the bridge was narrowed but the tip appears wide and short and there is a bigger gap between her nose and upper lip.

I think the point @heylo is making is how can we prevent this tragedy from happening again as we all agree she had a perfect nose that did not require rhinoplasty. Before a patient signs a surgical consent form, the plastic surgeon has to deem she is competent to make an informed decision. When surgical results after operating on a perfect nose lead a patient to eventually end her life, surely there is some culpability in a surgeon who touches a perfect nose and then continues to operate repeatedly on the nose? Surely a surgeon would say no you don't need rhino as the realself plastic surgeons suggested in their comments to her in 2012, you are not a candidate because of x, or may I suggest you get a second opinion. We don't have a profile photo of her original nose but from the front view it looked perfect.

I think what is so tragic and unsettling over this is why did a beautiful lady feel she needed rhino on a perfect nose and why would a renowned UK plastic surgeon agree to operate and reoperate and reoperate?

Yeah those were pretty much the same pics she showed me, not exactly those ones but similar. Honestly, I still think she looks beautiful either way and that's what I kept telling her. To me the difference wasn't major nor was it a botch job. Thats why when she showed me her pics my reaction was "wait what? You are depressed over THAT? Girl you are effing beautiful!" I actually told her not to touch it as the difference is so mild and she still looks very beautiful either way. I think I even recall telling her to use bronzer to contour her nose and that there are so many girls with huge bulbous noses who would be ecstatic to have hers

 

[heylo]

Yeah those were pretty much the same pics she showed me, not exactly those ones but similar. Honestly, I still think she looks beautiful either way and that's what I kept telling her. To me the difference wasn't major nor was it a botch job. Thats why when she showed me her pics my reaction was "wait what? You are depressed over THAT? Girl you are effing beautiful!" I actually told her not to touch it as the difference is so mild and she still looks very beautiful either way. I think I even recall telling her to use bronzer to contour her nose and that there are so many girls with huge bulbous noses who would be ecstatic to have hers

I think we have to get into the mindset of someone who was advised to have a near perfect nose worked on and paid money to be ultimately left looking worse (however much so is open for debate). Personally, I see a notable difference in the overall look, width and length. In some respects, it resembles an African American nose more than a Caucasian/Eastern European nose. Think it was all too stressful for her, given she was a bad candidate for reasons relating to her objectively beautiful nose (and face) as well as her poor mental health, which the doctor was briefed on in advance.

 

[K Couture]

I think we have to get into the mindset of someone who was advised to have a near perfect nose worked on and paid money to be ultimately left looking worse (however much so is open for debate). Personally, I see a notable difference in the overall look, width and length. In some respects, it resembles an African American nose more than a Caucasian/Eastern European nose. Think it was all too stressful for her, given she was a bad candidate for reasons relating to her objectively beautiful nose (and face) as well as her poor mental health, which the doctor was briefed on in advance.

wait hold up, the doctor was aware of her mental health even before he operated on her?

 

[heylo]

wait hold up, the doctor was aware of her mental health even before he operated on her?

Yes, her mother wrote to him before her first op, saying that she'd been diagnosed with a mental health condition and asking him to reconsider, or something to that effect. I know this because Mariana stated this on LYB UK, actually bemoaning the fact he "ignored" it and put her in a situation where she disliked her nose more, and I read it. I must try to find the exact post she made - it must've been at least 4 years ago when the forum was active. At that time, it actually struck me as very significant, for her mother to do this. Perhaps because it was quite unusual. Having not seen pictures of her at that point in time, I chalked it up to a meddling mother who couldn't let go of her adult daughter, but all the evidence points to the fact that there was indeed a more serious cause for concern.

 

[K Couture]

Yes, her mother wrote to him before her first op, saying that she'd been diagnosed with a mental health condition and asking him to reconsider, or something to that effect. I know this because Mariana stated this on LYB UK, actually bemoaning the fact he "ignored" it and put her in a situation where she disliked her nose more, and I read it. I must try to find the exact post she made - it must've been at least 4 years ago when the forum was active. At that time, it actually struck me as very significant, for her mother to do this. Perhaps because it was quite unusual. Having not seen pictures of her at that point in time, I chalked it up to a meddling mother who couldn't let go of her adult daughter, but all the evidence points to the fact that there was indeed a more serious cause for concern.

ah ok i see your point now about responsibility of the surgeon. At first I was wondering how on earth would he know she was unstable but if her mother notified him then well...

 

[NadineP]

I think we have to get into the mindset of someone who was advised to have a near perfect nose worked on and paid money to be ultimately left looking worse (however much so is open for debate). Personally, I see a notable difference in the overall look, width and length. In some respects, it resembles an African American nose more than a Caucasian/Eastern European nose. Think it was all too stressful for her, given she was a bad candidate for reasons relating to her objectively beautiful nose (and face) as well as her poor mental health, which the doctor was briefed on in advance.

HI Heylo. This just makes me mad. I agree with you on the aesthetic and I was right in thinking when he started getting popular(Ion): ANOTHER FLAVOR OF THE MONTH