Consultation Review for Septal Perforation + Full Removal (Seeking Advice)

I’m posting this in case my write-up helps even a little, and at the same time I’d like to ask for advice too! Is there anyone who had surgery with the same case as mine? First of all, I didn’t know I had a perforation in my septum, and I only found out while going around for consultations this time. Nine years ago I had eye, nose, and paranasal augmentation surgery at a hospital that did both plastic surgery and ENT, and back then I just accepted it and lived thinking, well, the columella looks pulled up, but that’s how it is now. So I’ve only had surgery once. But now, when I take selfies and look at myself, my impression feels too strong, the area between my eyebrows looks high, and I strongly feel that it looks unnatural, so I wanted full removal and to just return my face to how it originally was. I’m also considering medial canthoplasty reversal + double eyelid removal, so if anyone has done that at `ㄹㄹ`, please let me know! Please no brokers. My surgery history is eye epicanthoplasty + incisional double eyelid surgery, and for my nose, when I called the hospital they said the implant was Gore-Tex and the nasal tip used septal cartilage (I don’t know what method was used for the surgery, so I asked again and am waiting for a reply). At that time, I also had septoplasty done together with the surgery, but honestly I didn’t have a crooked nose or nasal congestion, so it was a surgery I didn’t need.. That’s why it’s the part I regret most. Please be really, really careful with septoplasty. I don’t know whether it’s okay if it’s done at a truly excellent hospital, but in my personal opinion, if there isn’t a major problem, I recommend just living with it.. This time I really felt it to my bones that surgery is something you do only when there is a truly serious issue. Anyway, this got long, but when I first went for hospital consultations, I went around asking about full removal without even knowing I had a septal perforation. And I had only brought old face photos of myself, without even checking what implant was in my nose or how the nasal tip had been done! 1. ㄱㅇㅅ: At first, while they were looking at my nose in the consultation room, they said it seemed a bit serious and sent me to the endoscopy room to check. That was when I first learned I had a perforation. (But the monitor wasn’t in front of me, it was off to the side/back? so I couldn’t really see it during the endoscopy, and they only showed me the photos, so honestly I didn’t fully believe it. The next day I went to another nearby ENT clinic and confirmed there really was one.) They said because of the perforation, the columella is being drawn inward and the implant is also moving upward. So if they only remove it without closing the perforation, the columella could get pulled in even more. They said I would need surgery using autologous costal cartilage harvest to close the perforation and lower the columella too, and that the degree of lowering could be done to the extent I wanted. What I felt during this consultation was: I don’t want a knife anywhere near my body, and the director is the type who scolds people, just like in the reviews I’d seen. I was already very flustered because of the perforation, and although it didn’t show much on the outside, I was still upset and couldn’t talk well, but being scolded and getting angry made me feel bad.. It felt a little like I was being treated like an idiot. But honestly, even if he was frustrated from a doctor’s point of view, if he gets angry that easily (as you probably know, not like shouting furiously or anything), I started wondering whether I could trust him enough to have surgery. Still, just in case I might end up having surgery, I forced myself to smile. And the manager told me during the consultation that if costal cartilage is used, the hardness will remain. I already didn’t want anything inserted into my nose or anything hard in there, so I became even less willing to do it. So I put it on hold. Oh, and after the consultation, I thought it might help to know the implant properly for better judgment, so I called the hospital where I had my original surgery and asked, then called ㄱㅇㅅ to tell them. But they said that because my issue was a perforation, that wasn’t important, so I had some doubts. Because I was so busy dealing with the perforation, I couldn’t bring up removing the paranasal implant, so I couldn’t ask about it. Price: 1,320 for closing the perforation and lowering the columella with costal cartilage, and up to 330 for removing the paranasal implant, so 1,650.. 2. ㅅㅅㅇ: When I made the phone reservation, I asked whether they would operate even if there was a perforation, and they said they’d have to see me for a consultation first. (At this point, I had already been turned down by phone at ㅊㅁ and ㅅㅇ, so I called again to check here too because I thought they might reject the reservation I’d already made.) They said the perforation doesn’t affect nose shape (I think they said that as long as it isn’t at the front). They looked inside the nose with their eyes and said the perforation was not in the front. They said perforation surgery is not easy and that they had seen people who still couldn’t be fixed even after multiple operations. When I asked whether it would get bigger if left alone, they said it probably wouldn’t and that it would be better not to touch it. (I think that’s because mine isn’t in the front and is somewhat healed. That’s just my own judgment.) Since the columella is pulled in, rather than full removal they said they would reuse the front septum of the nose and, if needed, harvest ear cartilage too. So, as in other people’s consultation reviews, I thought they were leaning toward leaving something rather than doing full removal. And because my implant was Gore-Tex, they said if it’s removed, the bridge of the nose would become square and would need to be shaved and refined a bit. They also showed me a photo of the squared bridge after Gore-Tex had been removed during surgery. They said after refining it, the bridge of the nose might become lower than my original nose. (I had also seen from other consultation reviews that refining can make it lower.) They said they wouldn’t know how much of my original nose could return after surgery. They said you have to open everything up to know. This time we also talked about removing the paranasal implant, but during the consultation they didn’t really bring up removing it and only talked about the nose. I don’t remember the exact price because I wasn’t really in the mood to decide, but maybe around 450 to 500? 3. ㅊㅁ: I made a consultation reservation by phone, but they called back and said they couldn’t do it because I had a perforation, so they refused. 4. ㅅㅇ: They refused when I made the consultation reservation by phone because they said they couldn’t handle perforations. 5. ㅇㄱㅈ ㅇㅇㅂ: When I asked during the phone reservation whether they operated even if there was a perforation, they said I’d have to come in and get a consultation first, so I was half-relieved after being turned down. Maybe because I had seen a few reviews here about full nasal removal on this community, I went to the consultation already feeling like I might end up doing it here. Based on the reviews, I printed out photos of my nose before surgery, photos right after surgery, and then a dated timeline from right after surgery onward, and brought them with me. (I regretted a little not doing this at other hospitals too, but since it seemed there wouldn’t be much difference because the reviews from other people were the same, I felt I probably wouldn’t need to go to another consultation.) They also said here that the perforation doesn’t affect nose shape. They said it doesn’t interfere with daily life, so perforation surgery isn’t absolutely necessary. They said perforation surgery is difficult. When I said I was told it would be done using costal cartilage, they said they didn’t understand. It seemed like they knew the method of drawing mucosa over for surgery, but the director said he wasn’t confident. (I forgot to ask whether it wouldn’t get bigger even if left alone. If I go again, I plan to ask. But I’m guessing they probably aren’t a perforation specialist, so maybe they didn’t know exactly, or since it doesn’t get bigger, they wouldn’t have recommended surgery.) They said the nose seemed more pulled in than when it had been operated on in a contracted state. (But I think it already looked a bit pulled in even after surgery. Since I was looking at printed photos rather than on a phone, maybe I just couldn’t see it as clearly.) They said they weren’t sure whether there was inflammation. Even when they open it during surgery, if there is no pus or discharge, they can’t tell whether inflammation is present. They told me the name of that type of inflammation, but I can’t remember it.. And they said they didn’t know whether it was due to inflammation or because Gore-Tex had shrunk. At this hospital I also learned that Gore-Tex is an implant that shouldn’t be used.. They said because of Gore-Tex’s properties, it shrinks, so it isn’t used much. They seemed surprised and said they probably didn’t even use it much 9 years ago. They showed me the implants removed from other people. Like in other removal reviews, it didn’t seem like they do capsular removal or shave and refine the bridge. I didn’t ask about capsular removal, so I don’t know, but when I said that if I remove Gore-Tex my bridge would become square and would need shaving, their stance was that the body always tends to return to its original state, so that kind of thing isn’t necessary. But they said if shaving is needed, they’ll shave. I already liked that part after reading other people’s reviews. And unlike other hospitals that said they would insert something to reinforce it or whatever, here they talked about full removal just like in the reviews, which I liked. They also said that even after full removal, it didn’t seem like my nose would become even more elevated than it is now or that the columella would get pulled in further. However, whether it would come down more is unknown. I also consulted about removing the paranasal implant, and they said because the paranasal implant is currently placed under the nasal alar area, the alae may have dropped downward, making the columella appear relatively more pulled in. That made a lot of sense to me too. They said paranasal implant surgery is dangerous if done through the mouth, so they remove it from inside the nose. I heard there are people who had problems even though they only had one intraoral incision, so I felt lucky. Other hospitals didn’t mention paranasal implants, so because they brought this up too, I felt some trust. And maybe because they value patient privacy, they didn’t show review photos. I wished they had just shown me before-and-after photos with only the nose cut out, so that was a little disappointing. Oh, but they did show photos taken during surgery. While I was waiting for my consultation, a person who had recently had nose removal happened to come in for a checkup/treatment. And this may be a sensitive point, but there was someone who had removal surgery here after having gone to one of the hospitals I visited for consultation. 6. ㄷㅌㅈ: This place seems to specialize in nasal perforations, so I already made a consultation reservation, but the earliest opening is in March, so I’m just waiting for now.. If anyone here has had perforation surgery together with full removal, or had surgery to close a perforation, please share your review.. No brokers in the comments. Consultation fee: maybe 30,000 won? 20,000 won? (I’ll check later and edit it.) And if an endoscopy/video is taken, if insurance applies it seems like 30,000 or 40,000 won? and if not, around 130,000 won~ (I’ll confirm this amount later too and edit it.) 7. ㅋㅂㅈ: I made a reservation because of my nasal perforation, but the reviews are bad, so I’m thinking about canceling. Consultation fee is 10,000 won. 8. ㅈㅇㅈ: I didn’t make a reservation because there were quite a lot of bad reviews. 9. ㅅㅁㅇ: Was this originally ㅍㅅㅋ Clinic..? I looked at the site for ㅅㅁㅇ Hospital, and since it didn’t mention the drawbacks of implants, I thought maybe they’re only saying that because surgery brings in money, so I didn’t trust it and skipped it. 10. ㅇㅊㅂ: I’ve seen people mention this place a few times, so I checked the website. This may sound a bit harsh, but the style of cosmetic work looked unnatural and not very good, so I skipped it. So that’s the consultations I’ve had for now.. The one I’m leaning toward is ㅇㄱㅈ ㅇㅇㅂ, but the only thing that worries me is the perforation.. If I really don’t close the perforation, will there be no problem? I’m worried it might get bigger. I do feel a little uneasy, but I don’t have any symptoms. The only thing is that once, long ago, I had a nosebleed for the first time in my life, but other than that I have no symptoms at all. If anyone has had perforation surgery, please share your review or advice..!!!! The perforation size is 16 mm. + I’d also really appreciate honest reviews from anyone who had double eyelid removal and medial canthoplasty reversal at `ㄹㄹ`. And what I’ve felt while going around for hospital consultations is that, just like other people’s reviews say, not all of the so-called top three removal hospitals are necessarily good.. I’ve never had surgery there, but you can still get a sense of things while going around for consultations, right? Personally, that’s how it felt to me. Everyone wants different things, so the right surgical method also differs, but now I don’t want anything inserted into my face anymore and I want to return to my original face. And I’m saying this really sincerely: don’t get cosmetic surgery. What I’ve felt in my life is that your original face without surgery is simply the best fit for you, the most distinctive, and the prettiest. Greed really does invite trouble. This got way too long.. Thank you for reading all the way to the end of this long post. Please please leave a review!!!