Plastic surgery in Thailand (Bangkok / Hatyai)

[daybreakk]

Hi, Daybreakk is back with good news. I didnt realise that Merdema is the scar removing gel i used during my secondary sch days. It helps in slowly removing the scars of my pimples . But if you all have higher budget, you can try Activa scar removing gel or Vichy Bi-white Advanced Intensive Whitening Corrective Care. For the Vichy essence you can see results in one week cause i always use it for my pigmentation scars for pimples. and i tried it on my chin implant scars really lightened alot alot!

[boii18]

Hey all

I just called Dr Pat and he says its ok to shift the implant. He also says its ok to do walking next week

He ask me if I'm satisfied with the shape of my nose and I said yeah.

Thanks for everyone's concern, and definitely it has been an added plus to receive confirmation from my NUH plastic surgeon as well as several American P.S on makemeheal.com

My hand was itchy today, and I took out the steritapes holding my nose today that the NUH p.S put ( it was getting loose anyway, oh what bullcrap excuse on my part =/ ). anyways, Yup, Its still straight . Wheeeeeeeeeee. I asked my parents to see and yeah they too agreed that its straight.

With regards to my results, I was satisfied even on Day two , because I had so many procedures done to reshape my nose. The alarplasty and rhinoplasty are defnitely very very "improving" procedures and done at one go, they are shocking. On Day two, I definitely did NOT see any tipplasty result going on ( more bulbous than baseline ). However, in the following days, it start to get more refined, and right now it has reached the point of the same amount of refinement before my surgery. I trust that it should get more refined as the de-swelling process improves, as shown by Lazy.

There's a concept in P.S. called Zero Sum. Its a basic rule, but of course, rules are not rules in medicine. Basically, if the surgeon takes a certain amt of tissue off the skin or does a certain surgical maneuvere, it results in " + A " improvement to the "niceness" of the tip. Agree? Well, of course, if you remove more tissue ( i.e. the value of A gets higher ), then definitely you're going to have more inflammation, am I right? ( Thus, it results in a -B worsening )

In the first week, in order for your nose to at least appear as well as it was before, The surgeon must has done A minus B = Zero. This causes the zero swelling effect that I notice. I think Dr Pat didn't do alot alot of work on my tip, because it was already okay to start with.

As time passes, the influence of "B" decreases. Am I right? The value of " A minus B" will increasingly be POSITIVE ( i.e. positive tip refinement )

hope im making sence.

[boii18]

Hi, Daybreakk is back with good news. I didnt realise that Merdema is the scar removing gel i used during my secondary sch days. It helps in slowly removing the scars of my pimples . But if you all have higher budget, you can try Activa scar removing gel or Vichy Bi-white Advanced Intensive Whitening Corrective Care. For the Vichy essence you can see results in one week cause i always use it for my pigmentation scars for pimples. and i tried it on my chin implant scars really lightened alot alot!

Thanks for yr input. I used Mederma gel too in the past on my hand scars, in my secondary school days as well.

I'm not too sure about the other two, but Mederma is prescribed by dermas worldwide, and has many success stories.

Happy incision-healing!

[boii18]

@inferno
what i have stated in my last post was very clear, that expectiations and rate of recovery varies among individuals. while description & perceptions may differ in a wide range, a picture speaks a thousand words.
I know 3 of u went thr tipplasty+/- other procedure, with boii18 having an implant, which is additional trauma to the nose.
i understand that even with a simple rhinoplasty, individuals already reports different rate of recovery. so the more data is collected, the more realistic the info will be.
so, I am not saying that's anything wrong with u or lazy, pls don't take it the wrong way, we are all here in the forum to share info and encourage each other.
All the best for ur recovery anyway...


@other friends in this forum
yes, when a person is +ve, the body does not secret much harmful biochemicals that affect health and/or healing; a healthy mind gives a healthy body.
i am trying to encourage ppl who go for PS to try to remain as +ve as they can during recovery, to look beyond the present image on the mirror, accept oneself during recovery, although one must not overlook objective (as opposed to subjective perception of one's looks) signs of infection or medical neglience.

On stitches and removal
yes, removing the stitches on skin slightly earlier, say at most 2 days do help reducing scars in certain extent- as stitches are foreign bodies to the body, while it holds the surgical edges together, it causes additional inflammation process too, and inflammation is one of the factors that determine the development of scars.
Of course, no untrained ppl should remove the stitch for u, he must know how to assess wound adhesience as the stitches are removed, to stop when he find the it is really not time yet to remove.
and also, since the stitch is removed, something else has to take over the responsibility of holding the wound together, eg a steri-strip-- a small strip that sticks on wound and can stay on skin for a week and is water proof.
The new trend in surgery is that dissolvable is stitched under the skin as close to surface as possible, while steri-strips are applies over wound during surgery, this reduces scarring to a minimal. However, at this point of time, most surgeons i know are not trained to perform stitching in this manner yet. It is also impt to note that this stitching method may not be appropriate for major surgeries where the incisions are large.

@boii18
i think, in comparison to some, u r already quite +ve and calm towards the events that followed the PS, i am truly happy for u.
i believe u will recover well w/o much further complications, all the best!!!

While I underwent three procedures " Tipplasty, Alarplasty and Implant" , the effect is definitely more obvious for me even at Day Two due to reduced nostril width and increase of nostril base height, and the sharpening effect of the implant. My tip is not very bulbous to begin with ( though it is ). I definitely swear that Dr has made my tip sharper looking than before, however. If you shift your alar inwards, it makes your tip appear larger definitely. But at this day, at this moment, my tip looks "fitting" with my alar, instead of sticking out like a sore thumb, though I can definitely see room for much improvement.

I trust that Dr done everything he can to ensure atraumatic surgical technique, and so most of us did not suffer much "damage". I read an article and its very important to use atraumatic surgical technique. See that youtube video? Its a great example of violent surgical technique, definitely resulting in more scarring. However, one has to BALANCE the "time" factor and the "trauma" factor. The LONGER a wound is exposed, the GREATER the chance of infection.

My mom says my tip is still swollen but will get better, but my nose is much sharper and higher than before.

Nothing is wrong with Lazy or Inferno? I guess it all boils down to different surgical techniques ( probably Dr pat did a much more "powerful" reduction, thus Lazy or Inferno will have much more defined tip than mine eventually - think that A and B formula ). Also boils down to individual healing rates, and I think that mindset does play a part as well. So I've been trying not to be upset or whatever. I admit when I saw my implant shift, I was depressed and shocked, but then I tried the best I can to remain +ve. I must say that I have zero pain and zero post-op effects. in fact, much to my surprise, my weight remained the same >.<

Well, I'm objective ( Who wants to think positive , really, if your nose is terrible... I dont think anyone can possibly do that ! ) about my results. Anyway, can add me on my MSN. I be glad to show you my current nose now At this moment, I cannot say that Dr Pat is a good surgeon or whatever, but IMO, he has practices good techniques and has moderate to good artistic taste. With regards to the rest, we will have to look at final shape, implant position, alar healing, and columella scar healing. My Alar looks terrible ( it was a wedge and sill excision ) cos of the scabs. But the columella scar looks to be healing Very well.

I'll definitely be following up with Dr Lee from NUH in order to prevent hypertrophic scaring or even prolonged scaring. Thinking of going back to Tokai in Mid-May , the weekend with Monday being Vesak Day. Would wanna do botox there, and follow-up my nose. Hope he can inject kenalog or something to my scar tissue.

On stitches and removal, I think the exact timeframe is impt. However, if it is removed early, it might have a better post-operative outcome. I think the best judge would be a P.S. who sees you in real life, or better still, the original surgeon. Thus its BEST for you guys to stay in BKK for 1 or 2 weeks. After removal of stitch, you can initiate scar therapy.

Yes I trust the NUH p.s. can assess wound adhesiveness. In fact, my wound is no longer an incision mark, but has a scab. You can see the stitch going through the scab. How scary. I hope its ok. Yes , steri-strips can be placed if the stitch is removed a teeny-weeny bit earlier.

With regards to dissolvable stitches, Dr pat uses dissolvable stitches in my nose, however, he says he wish to use non-dissolvable stitches outside. reason being inflammation. dissolvable stitches have been known to cause inflammation, itching or other side effects, so its best to stay to tested and proven nylon ( or other material, though nylon is strongest ) stitches. Yes, I have internal incisions too O.o I was doing some cotton bud work and guess what, some stitch came out from inside my nose O.o

What I hear so far is about stitches being stitched as close as possible, yes, and placing steristrips. But that is limited to the area of body in question. I have read that wedge and sill excisions ( alarplasty ) are best covered with nylon stitches which are deep into the skin. reason being, that is the area where most of our movements are too, and yeah, they are placed near indented pockets of the skin ( the nostril indentations )

[boii18]

Boii,

Did the PS say early removal of stitches will be better for scars? How long did you leave the cast on? 7 days seems to be the normal.

Please rest and be careful to take things slow. Give it 4 weeks to settle. ALways correspond with your Doc if anything is happening.

Are your scars obvious now? Are you using any sar cream like mederma? Ask doc before you use anything (ca ask i there is anyting to make the scars heal faster and nicer).

Yea indeed I heard so from Dr Lee.

Anyways, I checked the internet and yes indeed scars will heal better if stitches are removed earlier.

My scars are bad, sad to say.

Umm. I will use scar cream once the stitch is removed

Will hopefully go back to dr pat in May in order to receive scar treatment, follow-up and to get botox done.

removing earlier will reduce scarring? thats radical new discovery for me!=)

my friend did dermabrasion i thikn 6 months after rhinoplasty and it helped greatly to reduce the scars. but to be honest, even before she did it, no one would noticed unless you really stare.

dont be worried!! eat a lot of fish, collagen and vit c!!

thank you

well, i think that my skin care moisturiser includes salicylic acid and as good as it has been fading my acne scars, it should fade the surgical scars alrite and yeah, I do daily cleansing using a normal cleanser. I sometimes do at-home chemical peels ( neutrogena pore refining peel ). however, will consider dermabrasion as a scar treatment if its bad in future.

[boii18]

@Boi18:
I cannt post my pic for a while..
no.. seriously!! I cannt.
the reason is that i am battling with two issues:

a. I have this swollen nose tip which makes me look really stupid.. i have no shame in accepting it

b. I got skin inflammation due to splint.. Its simply not going.. and i am not putting anything on it either right nw.. as it may aggravate the situation.

I have no problems in making people to freak out after looking at my pics, but at the same time everyone will be really discouraged to go for tiplasty.. May be after few more weeks.. when things will settle down a bit.
Dont worry about about your alar stitches marks, as those will not be visible after some time.. it will become pinkish for a while and later after few months it will be quite unnoticable.. But i ,for sure, need to get some skin rip off procedures to get rid of this pretty nasty scar i have got on my nose (due to skin inflammation).. its almost like as if my skin has really really got burnt there, but it has been healing from some time now.

Also, I am just wondering why Dr. Pat didnt put dissolvable stitches for you in nose. Any particular reason for that? I am surprised by this belief that removing stitches at an early time makes them heal better..
I think its all bullcr*p. The intelligent decision is to get it removed at the day suggested by your doctor. Too early may make you lament, if its not healed yet and a bit late will end up in chances of having infection..

@Shal0m:
I dont know whether being optimistic makes you heal better or not, but for sure I understand this fact that tiplasty differs for each individual.. its more or less about what exactly you wanna do with your nose.. thus, the healing time alters significantly for different individuals.
I am pretty sure that Lazy, I and Boii have gone thru' different kinda stuff. I could not go for L-plant as I already had a really high outward projection and putting an implant would have made me an alter ego of "pinocchio".

Well, i am not expecting myself to get wonderful results within 6 weeks time. Trust me, nobody can heal with in a timeframe of 2 weeks if nose has gone thru' some severe tampering. As i said earlier, if you are considering to go for tipplasty, decide and PLAN about everything including your definition of perfect nose and your downtime period.

I understand how you feel *nods*.

Its not for my sake but for forumers sake that I do not wish to post publicly the gore pictures especially on Day 2. Nonetheless those interested can definitely add me on msn to see the pictures.

reason for my implant being that if my nose bridge is increased, my tip will have to proportiionally increase too, and i didnt like my tip projection before that, even though rotation is ok.

hope a quick recovery to your inflammation to the splint... but i don't see how it can cause scarring? is it that bad, or is it some discoloration?

i take out my cast several times a day to let my skin breathe. laugh.

[boii18]

shal0m thanks for well-wishes

but where did you do your nose and chin?

[Inferno]

@Shal0m:
ha ha ha .. i have no idea how and why we got into this. I really didnt mean to complain, but it all went in a bit oblique way. Apologies for that. I really didnt mean to sound that way.. and you are right, its a matter of perceptions and preferences

Honestly speaking, I was really not that gloomy due to my surgery. Infact, I started roaming around on third day itself after my surgery. I was really not that distressed or discouraged during past few weeks except during these few incidents which took toll on my head:

When my friend told me that i have unequal nostrils. Though, it was due to swelling, but i was really not unexpecting that kinda trouble.

I went to my regular Starbucks and one of my known Barista was astonished to see my nose and asked "What happened to your nose? You had a really nice nose? Whats the problem now?" He he he .. No prizes for guessing, I couldnt enjoy my lunch after that.

So to summarize it well, I think i am a victim of
- this thought whether i have pressed self-screwing button by having this surgery.
- Impatience. As per my friends, I need a high dosage of 100% high quality of "Patience". I wonder whether there is any product like that.

To Shal0m and Boii18:
If you are thinking to go to tokai in coming months, let me know. I have to visit dr. pat atleast once for a regular check-up kinda thing.. He has promised that if something goes wrong, he will fix it. Moreover, I want to enjoy my trip this time instead of going alone and staying at hotel like a dead corpse.

[tanjhj]

shal0m thanks for well-wishes

but where did you do your nose and chin?

wow u 18 only know so much and did so many procedures. nowadays youngster are knowledge sponge.. scary

[Inferno]

@boii18:

I will show you pix online sometime and for sure you will run away. Even Dr. Pat didnt imagine that a splint can make someone's skin to revolt like that.
I cannt blame anyone except my own skin.. its really really sensitive and ready to dish out troubles at any time - splint was just an excuse.
I am enduring sunburns and frost bites from quite some years, so i am not that worried about it. Its just that i need to think of removing the mark.

I still feel lucky because my skin didnt play games with stitches in my nose and chin. I literally came outta it with no troubles, which is kinda awesome

P.S. If we could get new skin like clothes, i would have thrown this one long time back!!

[tanjhj]

any website abt PS doc in Thailand. hope it helps

http://www.thaivisa.com/forum/lofiversi ... 74121.html

[shal0m]

@inferno

hey no worries, really! we r in the same boat of PS, so somewhat that makes us like a "family" and misunderstanding could happen, esp sometimes we fail to communicate well in written words

i think u r sounding more cheerful now, i am so happy for u.

which starbucks is that? the barista is so rude! write in and complain lah!

@boii18
i had my 2nd nose done at nara, together with chin
1st nose is terrible, done at k*** at JB...waste $$

[boii18]

@Shal0m:
ha ha ha .. i have no idea how and why we got into this. I really didnt mean to complain, but it all went in a bit oblique way. Apologies for that. I really didnt mean to sound that way.. and you are right, its a matter of perceptions and preferences

Honestly speaking, I was really not that gloomy due to my surgery. Infact, I started roaming around on third day itself after my surgery. I was really not that distressed or discouraged during past few weeks except during these few incidents which took toll on my head:

When my friend told me that i have unequal nostrils. Though, it was due to swelling, but i was really not unexpecting that kinda trouble.

I went to my regular Starbucks and one of my known Barista was astonished to see my nose and asked "What happened to your nose? You had a really nice nose? Whats the problem now?" He he he .. No prizes for guessing, I couldnt enjoy my lunch after that.

So to summarize it well, I think i am a victim of
- this thought whether i have pressed self-screwing button by having this surgery.
- Impatience. As per my friends, I need a high dosage of 100% high quality of "Patience". I wonder whether there is any product like that.

To Shal0m and Boii18:
If you are thinking to go to tokai in coming months, let me know. I have to visit dr. pat atleast once for a regular check-up kinda thing.. He has promised that if something goes wrong, he will fix it. Moreover, I want to enjoy my trip this time instead of going alone and staying at hotel like a dead corpse.

I intend to go tokai on May 16 to May 19, because May 19 Monday is vesak day. Yupp. Do let me know if you can make it.

Else, we can always go some other time. Its ideal because of the holiday, plus the fact that my pay day for NS is on the 12th of May. And another thing is that i nid the botox shot asap to my jaw, cause meeting friends in their june holidays =/

cheer up ya!

im sure dr pat will fix yr nose up, else he'll be risking his reputation! and oh, your cost does include the cost of follow-up treatment, so no worries. just relax. it'll turn out better hopefully. Anyway, why didn't you consider doing other stuff besides the tip, such as an implant or alarplasty? I guess those other aspects of yr nose are nice already?

nonetheless, many stuffs in p.s. arent predictable and beyond the horizon of the surgeon's view so ........ well, we have to take it in our stride. wells, im sure it would turn out fine with expert treatment. get him to package in some other work to yr nose if he does revision for you oh, you can ask him for kenalog injections to reduce swelling, if you cant dislike the seemingly perpetual swell. well i do have probs too. i dislike the scabs which formed at my wedge-sill excisions.

[boii18]

@inferno

hey no worries, really! we r in the same boat of PS, so somewhat that makes us like a "family" and misunderstanding could happen, esp sometimes we fail to communicate well in written words

i think u r sounding more cheerful now, i am so happy for u.

which starbucks is that? the barista is so rude! write in and complain lah!

@boii18
i had my 2nd nose done at nara, together with chin
1st nose is terrible, done at k*** at JB...waste $$

shal0m pardon my ignorance, i didnt see any misunderstanding . haha. anyway, happy healing everyones, yeah?

we'll work together towards our common goal of enhancement ^^

after all the pain and suffering, hopefully lets look back and say " oh this is why we did it".

stay +ve!

shal0m did your chin turn out well?

[boii18]

any website abt PS doc in Thailand. hope it helps

http://www.thaivisa.com/forum/lofiversi ... 74121.html

yes heard abt thaivisa before. will be reading it up 2nites!