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korea double eyelid revision consultations.

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boii18
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korea double eyelid revision consultations.

Postby boii18 » Sun, 11 Jul 2010 9:01 am

Detailed Consultation Notes

Been taken aback tat most of them are just businessmen just wanting to make a quick buck..similar to chuang wj of wisclinic. sighs.. hence i will not proceed to consult with the rest of the doctors, its such a waste of money, transportation and consultation fees.. sighs.... and I am running short of cash now, too. So just spending the next few days recuperating. Overall they clarified my understandig of eyelid anatomy, with dr choong helping the most. =)

1) chung of eve plastic
- eyelid can be lowered 1- 1.5 mm using fat injection
- risk is lumpiness.. to solve that, inject deeper and serially ( over a series of injections in 3 month window period ). the fat can be stored for 6 months. basically pay 1 000 000 won one-time fee, and inject as many times i want.
- blunt cannula used during injection..centrifuge for 3 minutes.
- not much pictures to show me.. and all of them were of very very sunken eyelids. he says he doesnt have photos of the lowered eyelid ( specifically high eyelid after surgery )
- i didnt ask him about the risks, just specifically targetted lumpiness.
- he said that the wrinkling of the skin , due to reverse epicanthoplasty, will mostly not be permanent.
- problem is he didn't warn me of the wrinkling effect during the consultation.. i didnt expect it either.. i was quite shocked that my eyes were wrinkled but put it to edema.
- his three photos dont have wrinkling, so i hope that it does not happen..

2) teiumps clinic
- i consulted two doctors - one english speaking , one not really. the one who doesnt speak english apparently supposedly to be more experienced one.
- both doctors say that there is only the excisional method that can be done. my case is not the 10% whereby its hollow and they do not use the excisional method
- they say that they have to remove about 3-4 mm of skin above the new lowered incision line, as i wish for a decrease of 1-2 mm.
- this excision of skin will exceed the current scar boundary.
- they will release the adhesion, and reattach it and make it into a dynamic crease
- they say that my diagrams are too simplified and seemed condescending and full of themselves
- they say that fat grafting will never work. as my eyes are not sunken.
- they say that there is never a method to do it without skin excision, or else there will be two lines ( creases? ).
- seem like businessmen, overall aura that they out to cheat my money.
- when i discussed anatomy with them, they seem to cut things short and think i am wrong in my understanding, said i study too much. they said that the scar tissue is too much and that all the anatomy is different now.
-they say that the incision is 10mm.
- total of 3 doctors in that clinic.
- they seem like businessmen.overconfident.



3) dr baek of vip clinic
- baek does not speak english. got a korean girl translate for me
- dr baek says that the fat injection will not work, when i pressed him why he says that the muscular layer is around 1mm only, and if one were to inject fats, the fat will bulge out as lumps due to the thin orbicularis oris layer around 1mm.
- he says that the fat grafting will press down and prevent the levator muscle from working properly.
- he says that my lip lift scar is worse than my eyes.
- he doesnt think my eyes are that bad.
- when i asked him for photos, we showed me a few generic ones, out of a folder of around 10 pictures.
- he had only a few PRIMARY surgery photos.
- his excuse for not having photos : its not with him now. when i asked him can he email me the photos when he has it, he says that it is difficult to get photos, because the photos were always be taken in different angles, and hard to take 2 photos for good comparison. i think thats a pretty lame excuse.
- he says that surgeons do not do injections. when i asked him about filler injection to lower the eyelid e.g. restylane.
- the translator says that she knows of many patients who did with this doctor, and he has many years of experience. seems like a load of bull-mini cooper.
- he says that he will lower the adhesion of the levator aponeurosis to the skin.
- when i asked him what he will do to prevent readhesion, he says there is no such thing. when i asked him if fats can be slided down or grafted inside, he says that why would he want to do that? he says dont have to do that.
- he says that he has done this procedure many times, and dont have to worry.
- he laughs at my lip lift scar-line and say that the incision could be done in a zig-zag manner to have prevented that scar.
- he quotes me 3000 usd ( crazy ) for a simple excision of the scar.
- he quotes me 2400 usd for revision eyelid surgery.
- he is full of himself and overconfident


4) dr choong of cjcosmetic
- probably the most fruitful consultation.
- hes the most helpful, most keen to help and the most sincere, honest. instead of the rest being businessmen.
- the best $12 i paid . discussions are below;

boii18
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Postby boii18 » Sun, 11 Jul 2010 9:02 am

dr choong of cjcosmetic

he says that my incision is 7 mm.

Reverse epicanthoplasty opinions
says that mostly swelling, some of the wrinkliing in the lower eyelid will resolve itself.
he says that in revision one has to trade something good,and in this case what i got was wrinkle ( unnatural wrinkle which does not occur nataurally even in aging ) . and what i gained was the loss of unnatural appearance.
the more u correct, the more the severity of this wrinkle.
the only way to reverse this wrinkle is medial epi
he says that this is the Only to reverse epi, and is his way of doing too.

Regarding the eyelid; I consulted him total of 45 minutes and i really learnt alot from this doctor. he's not out for your money, and wants to explain all the risks carefully, together with the relevant anatomical aspects and relationships.

What chuang could have done to my eyelid

1) He could have made the 7mm cut, and removed tissue and skin below that cut, in effect shifting my aponeurosis to a higher insertion point.

and/or 2) he could have made the 7mm cut removed tissue above the 7mm fold. this could involve going through the orbital septum and removing some orbital fats from there.

or a combination of (1) and (2)

but (1) is the typical and most common. for (2), it is actaully unlikely as it introduces the possibility of complications like multiple folds.

after viewing meronks video : http://www.drmeronk....omcrease_w.html
i start to wonder also, if the sugeon changes the connections below my levator aponeurosis to introduce those finger-like projections holding the tarsus and orbicularis together.



After asking him for his sincere opinions, he would list my options as follows;-

Eyelid Revision - that is in 1-2 years time

He will make a lower incision than my current 7 mm mark.
1 year PO at least is best time. 2 years is better,but better for surgeon. risks for me is still the same, not less.
he will release my attachment of the levator aponeurosis to a lower position.
In order to prevent re-adhesion he will either use orbital fat slide down method by getting access to the orbital septum by dissecting past the orbital septum = may not be best if one has not enough orbital fats as the superior area will become sunken,
other option is to take the most superior part and bend it upwards, i dont really get what he means in this case...
he says that the above two methods takes place in around 90% of his case, the rest of 10% occurs with a fat grafting from a donor site.
the fat grafting will not have that much risks as the fat injection method, higher survivability, and the structural fat is sutured to the place of the old adhesion to prevent migration.the sutures are dissolvable.
any bleeding can be stopped intraoperatively. the only risk i need to worry about is multiple folds due to re-adhesion.
he says that excision is very risky.

Fat injection / Fillers method - if i cannot wait and want things done now.

Dr choong initially says that chung ( eve plastic ) method of fat grafting is not possible.

injection area is same as discussed with dr chung of eve, the injection area is not past the obital septum which holds in the orbital fat. it is in an anterior position - where the orbicularis oculi is, and where the brow-fat /preseptal fascia is.

After some thought he says it is in theory possible due to the gravity effect , and that he can reduce maybe 0.5 mm, but is only recommended for patients with sunken eyelid. he says he has never used this method for non-sunken eyelid like mine.

he predict around 0.5-1.0 mm lowering of my crease, after pressing him for understanding of why it will not work in my case.

Risk #1 : If the fat injected it too much, then it presses upon the levator aponeurosis, causes ptosis to the eyelid. the crease remains in the same position, but the palepral fissure decreases in height. in essence, the crease height will then increase, and the eye will take on a sleepy appearance. the more the amount of injected the more the risk of pressure on the levator aponeurosis. the same goes for filler injections, but filler will resorb in 6 mths or u can inject hyaluronidase to absorb it.

Risk #2 : There is a risk of the fat injected, then died and not resorbed back into the body. the dead fat cells will calcify into hard palpable lumps in the eyelid. These hard lumps will then press down hard onto the levator aponeurosis, causing you to have ptosis and unable to open eyes properly. the same goes for filler injections, but filler will resorb in 6 mths or u can inject hyaluronidase to absorb it.

Risk #3 : Blindness. If the fat were injected into an artery in the eyelid area, then it can cause retro-grade flow into the artery supplying the eyeball.... the same goes for filler injections.

Risk #4 : according to him little/no risk of puncture eyeballs using either method, sharp needle of hyaluronic acid, and blunt needle of the fat cannula.

Waiting first.

regardless of chuang's operation method, when u have edema, the tarsal area is the one that swells, causing a higher eyelid fold. this is because of gravity. since this is so, then my crease can decrease to aroound 1/3 of its height in the next 5 months.

Botox
Last minute he thought of botox injection 4 unit each side lasting a few months, will droop my eyebrow and my eyelid by abit, around 1mm. maybe can try that out when i go for my jaw botox. seems to me the safer way.

hes a genius. but most importantly he was so candid with me, and clear about what goes on anatomically speaking.

hellofranceska
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Postby hellofranceska » Sat, 17 Jul 2010 6:08 pm

thank you, boil18, for taking the time to type out all this and share.

2 questions, the teuimps doctor that you are talking about, is it dr kwon?

and dr choong, do you have his website? I googled but can't find anything about him.

have you talk to dr yang or artwood clinic? he's in taiwan and he focused a lot on eye. edit to add that I don't have any experience with dr kwon or dr yang. it's just that i've seen their name mentioned a lot. i'm also a double eyelid and epi patient looking for revision.

boii18
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Postby boii18 » Mon, 19 Jul 2010 3:07 pm

yes i believe so.
shd be dr kwon
i have only spoken to chuang of wishclinic ( ruined my eyes ) and dr su ( i think shes honest and reliable, but based on my consultation only ).
dr choong seems patient, reliable, explains all the risks carefully, shows before-after photos, willing to discuss anatomy and helpful. but thats based on my consultation only.
google www.cjcosmetic.com

NeverendingStory
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Postby NeverendingStory » Sun, 07 Nov 2010 1:41 pm

Yes, I've heard CJcosmetics is a honest place(price-wise and result wise :D ) and does great revisional surgery especially for the eyes and the nose. THe Doctor cares about the outcome and with really succesful results. Most important thing is if you feel some doctors are only in for your money and lure you into doing extra things to fill his pocket, Thats dishonest.

victim01
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Postby victim01 » Tue, 16 Nov 2010 10:06 am

boii18 wrote:yes i believe so.
shd be dr kwon
i have only spoken to chuang of wishclinic ( ruined my eyes ) and dr su ( i think shes honest and reliable, but based on my consultation only ).
dr choong seems patient, reliable, explains all the risks carefully, shows before-after photos, willing to discuss anatomy and helpful. but thats based on my consultation only.
google www.cjcosmetic.com


any advice for me to lower my double eyelid ?

http://img703.imageshack.us/img703/2756/victim01.jpg


I am very dissappointed with Dr.Nara


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