I decided to get a revision surgery after 2 years, following my first surgery in 2021. I saw a post saying that even if you visit 9-10 places, it can be even harder to decide. But I also didn't want to end up regretting it like I did the first time after only visiting one place, so I still knew I had to do some legwork. I narrowed it down through online research and ended up visiting only 4 places. I'll write out the list and my impressions, so could you look it over? I'm really torn, so please help me decide ㅠㅠ
# My current nose condition Used septal cartilage + silicone in the first surgery Silicone on the bridge is lifted > swelling and redness, no pain Slight hump, nose has gotten longer and the tip has dropped, straight line (like a masculine nose) Nostrils are triangular(?) - not completely a bulbous nose, but somewhat similar
# The nose I want The bridge doesn't need to be too high, but I want the tip to be sharp and upturned A soft half-curved line Feminine The tip not too pointy, but slightly rounded (not blunt either) Slight correction of the nostrils Prefer to use as little implant material / as much autologous tissue as possible
<Common points among the 4 places> * Private clinics (I had my first surgery at a large hospital, basically a factory-type clinic, so this time I only looked into private clinics) * No consultation fee and no CT fee (I already had the CT scan done) * Consultation time within 1 hour * Consultation order: manager - doctor - manager * CCTV viewing possible (not live) * Sedation + local anesthesia * Post-op schedule: day 2 removal of nasal packing - day 7 removal of splint + stitches (whether they monitor progress on day 14, at 1 month, and at 3 months varies by clinic. For most, it's optional) * I asked about my first surgery clinic/doctor/materials used, and showed the photos I wanted.
1. A < the only ENT clinic among the 4 • Cost: in the 8 million KRW range - VAT discount if you provide a review/photo - Insurance reimbursement possible (functionally covered by about 2 million KRW, so the actual surgery cost is in the 6 million KRW range) • Consultation details: - After looking at the CT, they said it seemed like materials other than septal cartilage were also used in the first surgery, but it can't be identified precisely from CT alone. - Silicone removal is urgent and necessary > they said to take the antibiotics prescribed before surgery. (There is a large empty space because the silicone is lifted away from the bone, increasing the risk of inflammation.) - They said the bridge doesn't need to be high, and in fact should be lowered to create a better line with the tip. - They recommended a sand plant technique (a method of finely crushing autologous costal cartilage, shaping it, and using it on the bridge) + autologous costal cartilage. - They said an implant-free approach wouldn't achieve the shape I want and is not recommended because of step-offs. - For nostril correction, they said it would probably need ear cartilage + skin grafting. • Explanation style: Mostly explained using the CT images, and showed a lot of other patients' before-and-after photos. They also touched my nose several times. • Aftercare: swelling laser, oxygen therapy(?) - unlimited sessions. Possible whenever I visit. • Additional impressions: - The consultation manager was really kind. (Maybe because it was my first consultation, or because they were so empathetic, I teared up a little ㅠ) - The sand plant method was unfamiliar, so I'm torn. - The price is high, but part of it may be reimbursed through insurance.
2. B • Cost: - Silicone + autologous costal cartilage + ear cartilage: in the 8 million KRW range - Implant-free + septal cartilage + ear cartilage: in the 5 million KRW range - No insurance coverage • Consultation details: - They said the risk of side effects is similar for silicone and autologous tissue. People who will have problems will have them, and people who won't, won't. First remove the existing silicone. - They said the septal cartilage felt firm rather than soft when touching it, so it seems reusable. - If you want a natural look > implant-free + septal cartilage + ear cartilage If you want to go all out > silicone + autologous costal cartilage + ear cartilage recommended. (Donor rib cartilage not recommended) - They said improving the nostril shape could improve it by about 30% if the tip is lifted. - Because my original facial features are large (eyes, mouth), they thought a more glamorous nose would also suit me. • Explanation style: - The only place that took photos from different angles in addition to the CT scan (using a regular camera with a headband) and explained things while looking at those photos on a tablet. They also alternated with the CT images. - The doctor stood very close and kept touching my nose. They even showed me the doctor's own nose (?) • Aftercare: swelling laser, 1-year AS/warranty period • Additional impressions: - The consultation manager said they had also had surgery by this doctor, then lowered their mask to show me their nose and also showed me before-and-after photos. - The doctor seemed to be saying that in the end, it's my choice.
3. C • Cost: - Silicone + autologous costal cartilage + columella lifting + hump shaving: 7.5 million KRW - Silicone + donor rib cartilage + columella lifting + hump shaving: 6.5 million KRW - No insurance coverage @ Paid a 300,000 KRW reservation deposit on the consultation day (they said if I wanted a specific date, I had to pay the deposit. Since they guaranteed a 100% refund if canceled, I paid it for now) • Consultation details: - Since I said I tend to get keloids easily on my ears, they said it's better to avoid using ear cartilage if possible. - After removing the existing silicone, they would use a new silicone implant of about 2-3 mm. - I have a slight hump, so it needs to be shaved down. - After looking at the CT, they said there seems to be material inside the nose besides septal cartilage. - They said the nose has become longer and drooped, so the columella needs to be lifted. • Explanation style: Mostly explained with the CT images. They were the only place that used a 3D simulation(?) to show the expected post-op appearance. • Aftercare: swelling laser, swelling injections, swelling medication, 1-year AS/warranty period • Additional impressions: - Dissolvable sutures are used with autologous costal cartilage. They emphasized that it would be less painful. - The consultation manager asked for the list of clinics I was considering, and when I told them, they reacted negatively to the others. - Looking at other people's before-and-after photos, it seems like they are especially good at more glamorous noses.
4. D • Cost: autologous costal cartilage + autologous costal fascia (bridge) + correction of bulbous nose/crooked nose + columella lifting = 7 million KRW - No insurance coverage • Consultation details: - They said the nose skin is on the firm side, so it won't stretch much, which means it would be hard to make it extremely glamorous or very high. - They said that if the columella is lifted slightly, the nostrils will also improve a little. Since the nose is drooping too much anyway, they said the columella needs to be lifted. (But the manager said lifting the columella could make it look over-lifted, so they did not recommend it.) They said ear cartilage grafting for nostril correction would not be dramatic for my nostrils and would just add unnecessary cost, so they did not recommend it. - If I'm worried about silicone, they said they can harvest fascia near the costal cartilage site as well and use the fascia on the bridge. = implant-free, but if using fascia it may look a bit spread out. - Because there is a slight hump, if there are no functional issues, they said a slight osteotomy would be needed. (Recommended if doing fascia; if using silicone, not really necessary.) - They said there is a slight bulbous tip, and because the silicone seems to have moved, the nose is slightly bent to the left, so it needs correction. They also said the nostrils are asymmetric left to right. - At B, they said the septal cartilage felt strong and okay, but here they said the septal cartilage can't be reused, because the existing one has hardened?? and that the support column has to be built with autologous costal cartilage or donor rib cartilage. - I asked about the rumor that costal cartilage can warp, and they said the chance is almost nonexistent because they have their own method. • Explanation style: Explained while looking at the CT images. They rotated the view from different angles and examined the nose in great detail, touched it a lot, and used a long cotton swab to check various parts of the nose. • Aftercare: unlimited swelling laser for one month after surgery, shampoo service on day 2, one session of nose/sebum skin care when visiting at 1 month, 1-year AS/warranty period • Additional notes: - The consultation manager seemed more professional than the others. - If it's an autologous costal cartilage surgery, the doctor said they only do one case per day. - This was the only place among the 4 that served coffee/tea. - Even though I had booked in advance, there was still a bit of a wait.
If you have any questions in the comments, feel free to ask, and I'd really appreciate it if you could tell me whether the clinics I visited seem okay or not ㅠㅠ