The key to a successful surgery is in the preparation work: before surgery, you should check with the clinic to ensure that the risk of side effects is minimal. There should also be a specialised plastic surgeon, and the results from the clinic are proven to be reliable and effective. To help those thinking of plastic surgery with their preparation work, Eunogo visited 1mm Plastic Surgery clinic, which has received more than 5,000 reviews, and met with Dr. Kim Hyung Suk, to talk about rhinoplasty and revision rhinoplasty. Dr. Kim is not only a medical doctor but also an outpatient professor at a university hospital and a clinical consultant. He is also comes from a diverse background, including being a full-time member of the American Academy of Plastic Surgery.
Dr. Kim Hyung Suk from 1mm Plastic Surgery
Could you tell us about different types of rhinoplasty?
Dr. Kim: Generally, rhinoplasty can be divided into open and non-open types depending on the surgical method. In the case of an open type, the incision is made from within the nostril to the columella, and the inner structure of the nose can be checked accurately as the surgeon can get a good view, so it is carried out when there are many changes to be made to the nose or when the length of the nose is to be altered. As for non-open type, the incision is made only inside the nostril, which has the advantage of having no external scarring and is suitable for a nose that does not have much to correct. Basically, it is often combined with a fusion technique for increasing the height of a low nose bridge or nose tip surgeries that improve the shape of the tip of the nose.
Westerners and Asian men often have nose bridge surgery together with surgery to correct their wide nose bone or crooked noses, whereas some Asian and African customers also have nostril reduction or nose tip correction. Revision surgeries take more time than the first surgery because of the scar tissue produced after the previous surgery.
What's the reason for using different implant materials, such as using cartilage from the ribs versus the nose?
Dr. Kim: The materials used are bound to be different for each person because each surgery is a 1:1 customized design.
For low nose bridges, artificial implants such as silicon and Gore-Tex, or natural implants using cartilage from the patient are usually used to raise the nose bridge. For excessively high nose bridges, the protruding bones on the nose bridge or tip are trimmed without inserting implants.
For nose tip surgery, using a cartilage significantly lowers the probability of nose tip collapsing. After considering the patient's skin thickness and desired shape, soft ear cartilages or the deep skin tissues inside the buttocks are used, because they have a lower rate of inflammation unlike artificial materials. Rib cartilages are used in situations where the nose tip is significantly lower than the much-higher nose bridge, where the nose tip is very short, where the results of the previous surgery is not satisfactory or when you wish to reduce the probability of the nose tip collapsing.
What are the most common reasons for a revision surgery?
Dr. Kim: There are a variety of reasons, such as problems caused by implant material, artificial appearance, and so on. Various ethnic groups have different anatomical structures and distinct characteristics such as skin, tissue, cartilage and bone, which means that you can get very different results even with the same rhinoplasty procedure. If the patient's skin thickness or overall facial balance was not taken into consideration, side effects such as silicon exposure, implant becoming visible, or an excessively high or sharp nose. It can result in an unnatural image.
If the resulting nose does not fit your face, chances are that you'll consider getting another surgery as time passes and trends change. In short, the basic design is wrong. The nose is in the center of our face, so it greatly influences a person's overall image. We have to perform customized surgery considering the patients' facial features such as face length and width, and size of the eyes, even down to slight differences of 1mm, so the patients will be highly satisfied with their results.
How long is the recovery period and how long the patient has to stay at the hospital?
Dr. Kim: Except for special cases in which the nose is too crooked, generally rhinoplasty is carried out with sleep anesthesia. There is no disruption to daily life, you can be discharged on the same day of the surgery, and go for a light walk.
The cotton in the nose is generally removed one day after surgery and a maximum of three days after surgery for more complicated surgeries. Taping or splints on the nose bridge are removed seven days, and stitches are removed thereafter. For those who have to return abroad, you can leave the country after monitoring the progress for three to five days according to their schedule, but you are recommended to stay in Korea for about seven days.
What should you consider when choosing a clinic?
Dr. Kim: You should choose a good clinic right from the start, to ensure that the surgical outcomes are satisfactory. You should check whether the "real name" (where the names of medical staff taking part in the operation are provided to you) and "safe surgery guarantee" systems are in place, and that the clinic's basic safety system is well equipped, the infection control system for maintaining a hygienic environment, and additional follow-up management after the entire process. For revision surgery cases, it is also important to directly consult with a medical team that is flexible, in order to see the improvement you want. It is important to know if the clinic or doctor is well-known in the field of revision rhinoplasty.
It's also important to have a resident interpreter or go through a concierge like Eunogo, for patients who cannot converse in Korean. Patients are more reassured when they can communicate effectively what they want to the doctors, as well as hear accurate explanations about the surgery.
What are some side effects of rhinoplasty?
Dr. Kim: Practically all cosmetic surgeries have side effects such as inflammation, bleeding, swelling and pain. What most people are worried about is inflammation, but some level of inflammation is bound to happy. This is true even if the implant is using the patient's own cartilage and not an artificial material. However, this is an issue that can be managed and reduced greatly, and it is important to select hospitals and medical staff who provide follow-up programs such as injections and laser treatments to help patients recover quickly while checking on the progress with the surgeon to see if the implant is in place and if the wound is healing well.
Is there anything to be careful about after the surgery?
Dr. Kim: Post-operative care is very important for rhinoplasty. In order to achieve satisfactory results after surgery, patients must know of the precautions well and practice them diligently. The swelling is the worst for the first 3-4 days, and then it slowly reduces afterwards. During the initial swelling period, there will be a big difference in swelling depending on whether the internal bleeding is heavy or not. Therefore, it is important to help stop bleeding and relieve swelling by using cold compress for the first 3-4 days. After 3-4 days when the bleeding has more or less stopped, the wound will begin to close up and heal, so hot compress is recommended to enhance blood circulation and allow the invisible impurities around the tissues to dissipate quickly.
In addition, care must be taken to prevent the implant from becoming distorted or deformed as the nose is pressed, such as maintaining a straight posture while sleeping and avoiding eyeglasses for a period of time after surgery, so that implant can be held in place during recovery.
Are there people who are not suitable for rhinoplasty?
Dr. Kim: Although there are no specific targets who are not suitable for rhinoplasty, there are some people who require more attention and care. Anyone who has weaker blood vessels and bleeding tends to be severe, takes aspirin-related medication regularly for chronic conditions and has experienced severe bleeding during past surgeries should inform their doctor of their medical history, to ensure that their rhinoplasty proceeds safely.
Before and After Photos of Rhinoplasty