Eye, Brow & Forehead
Q: What causes the eyelid crease to disappear after the Upper Blepharoplasty? Can it be fixed?
A: If the eyelid were not stitched deep enough before, there is a chance that later it will become loose and undo the change made by the initial operation. A fix would require that the surgeon reopens the wound to perform the stitch again.
Q: Which is better -- large or small eyelid crease?
A: It is recommended that the size of the eyelid crease is proportional to the overall facial appearance. Overly large eyelids crease will make the face appear sleepy and tired, while very small eyelids may not appear to be much different from before undergoing the operation. It is recommended that the individual consult with the surgeon on the desired outcome.
Q: Which is better -- parallel or taper medial crease?
A: This will depend case by case. The medial crease can be fixed to a certain extent, but it is recommended to keep the original shape to maintain the most natural appearance.
Q: After the operation, when can the patient start applying makeups?
A: The suture will be removed on Day 7, after which the patient can apply makeups.
Q: What is the recommended wait time to have a nose surgery after a recent eye surgery?
A: Before performing a nose surgery, the surgeon must assess the nose bridge and the elasticity of the nose skin, both of which will be difficult to assess due to the swelling caused by the eye surgery.
Therefore it is recommended that the patient wait 2-3 months for the swelling to stop. On the other hand, it is possible to perform both the nose and eye surgeries simultaneously, because the swelling would not have been much yet.
Q: Is it recommended to remove eye fat?
A: This will depend on the individual. Patients with sunken eyes should not be removing their eye fat, but may consider relocating or adding instead. Patients with bulging eyes already have an abundant amount of eye fat, and should consider removing some of it.
Q: How do I get rid of the dark under-eye bag?
A: There are several studies confirming that injecting lipofilling to the under-eye bag can help improve the appearance. The fats are taken from the tummy or thigh fat, processed and then injected to the intended area. However, the results may vary across individuals, and it is very difficult to accurately predict the outcome.
Q: In Lower Blepharoplasty, what is the difference between Subciliary and Transconjunctiva?
A: The subciliary approach is often performed on patients with excess and sagging eyelid skin, and are required to remove excess skin. Transconjunctival approach is recommended for patients without excess eyelid and sagging skins, and only need to address the excess eye fat.
Q: Are there any implants for nose surgery that can be twisted?
A: The implant (silicone) used for nose surgery can be categorized into mainly the rigid type vs flexible type. The flexible type will pose a lower risk from implant protrusion, and will allow for more minor movement to be made if necessary.
However, it is not recommended to twist or move the implant unnecessarily because it will enlarge the implant’s capsule, risking it shifting out of position.
Q: How long after the nose surgery can I start exercising?
A: After the surgery, the body will produce a thin layer to encapsulate the implant, which will typically harden after 4-6 weeks, and be fixed in place after 3 months.
It is recommended that the individual performs light exercising such as walking, jogging, and aerobic about 4-6 weeks after the surgery, and resume regular exercising 3 months after the surgery.
Q: How long before I can undergo ulthera/thermage or facial treatment after a recent nose surgery?
A: For areas other than the nose or surrounding, the patient can receive the treatment after 1 week. For areas on the nose or nearby, it is recommended to wait at least 4-6 weeks. For areas where there is still swelling, it is recommended to wait until the swelling stops before taking the treatment.
Q: What is the chance of the scar from a nose surgery turning into keloid?
A: Typically, keloid will appear only at certain areas, including ear, breast, back, and shoulder. It is rare for a nose scar to turn into keloid, yet it is still recommended to closely monitor the wound to prevent it from getting infected, which can lead to keloid.
Q: Is it possible to remove previously injected fillers?
A: It is possible to remove dissolvable fillers. However, for non-dissolvable filler types such as liquid silicone or permanent filler, it will merge with the patient's tissue, preventing the surgeon from removing it.
The solution is to perform an operation to remove the merged filler, and even then it may not be possible to completely remove them.
Q: For individuals with thin nose tissue, how prominent can the nose surgery achieve?
A: The result will vary depending on the approach. Close Rhinoplasty will achieve a less prominent result than Open Rhinoplasty because there will be less nose skin to be stretched in the Close approach relative to the cartilage used in the Open approach.
However, it is not possible to 100% determine the result prior to the operation -- the surgeon can determine how much nose skin can be stretched only AFTER the implant has been inserted in a Close approach or the new cartilage framework has been created in an Open approach.
Q: I have previously had an Open Rhinoplasty operation. If I want to have another nose surgery, does it have to be Open Rhinoplasty again?
A: Yes. Typically an Open Rhinoplasty operation will involve modifying the nose cartilage. If followed by a Close approach, one may risk damaging the skin, tissue, and cartilage.
Lip, Cheek & Chin
Q: Can Buccal Fat Removal surgery help create a slimmer facial appearance?
A: For patients with abundant buccal fat, it is possible that the operation will help lead to a slimmer face. It is different from jowl, subcutaneous fat and malar fat, hence it is recommended that the individual consult with the surgeon to discuss the best approach.
Q: If I am wearing braces, can I undergo a lip reduction surgery?
A: It is recommended to do lip reduction surgery after you have removed the braces, or close to removing. This will guarantee that the end result will be more inline with the initial plan. Wearing braces will affect the shape of the lip -- the less protruding the front teeth are, the thinner the lip will appear and the gum more visible
Q: How long do I have to wait before I can have dental care after a recent lip reduction surgery?
A: This will depend on case by case, but typically after 4-6 weeks so that the wounds are in place.
Q: What should I do if the scar becomes hardened after a lip reduction surgery?
A: At the moment there is no definite cure, but it is recommended that you massage the scar regularly for 3 months, which is a simple method to help soften the wound.
Q: Is it possible to remove a previously injected chin filler, and undergo a Chin Augmentation surgery?
A: Similar to the nose filler case, it is possible to remove a dissolvable filler, otherwise the surgeon must remove the merged filler tissue. In some cases, the tissue will swell after the removal, thus prohibiting the surgery. The surgeon will have to close the wound and revisit again after 6 months (or until the swelling stops completely).
Q: In Chin Augmentation, what is the difference between creating an internal cut in the mouth and cutting open the skin under the chin?
A: The method of cutting open the skin under the chin is recommended for lengthening the chin, because the cut will be positioned close to the implant. The risk of infection is also lower because it is easier to clean.
However, one drawback includes having a faint scar mark under the chin. The internal cut method is recommended for individuals with retrude chins and/or those who do not want any visible scar. It is, however, more prone to infection and having the implant sliding upward.
Q: Which is better for me -- narrow vs wide base implant?
A: This depends on the nature of the chin base width. Narrow implants are usually recommended for individuals with smaller chins, and vice versa. Using long-legged silicone implants in individuals with small chins may result in the implant edge being visible from the outside.
Face & Neck
Q: How useful is anti-scarring cream?
A: There is no clear evidence that anti-scarring creams are effective. The marks from a plastic surgery will naturally heal anyway. These creams do not have any side-effects, so if you are comfortable paying for them then you can choose to use them.
Q: How long after the surgery can I resume taking supplementary vitamins?
A: Vitamin C and collagens can lead to excessive bleeding during and after the operation, thus it is recommended to avoid taking them at least 1 month before and after the operation.
Q: If I have previously had fillers or threadings, can I still undergo a Face Lift operation?
A: Yes you can. However, the fillers and threadings will create scar under the skin, limiting the skin’s flexibility and the degree of modification that the surgeon can achieve. In summary, the scar will make the operation more challenging, more time-consuming, and will take longer for the swelling to stop.
Q: Why should the individual stop smoking before undergoing an operation?
A: Smoking will deteriorate arteries and veins under the skin, and wil risk having dead skin, splitted wound, and infection. Therefore it is recommended that the individual stops smoking 3 months before the operation.
Q: What is the length of a Face Lift cut?
A: The cut runs from the temporal hairline to the earlobe. In the case of doing Neck Lift with Face Lift, the cut will extend from the earlobe to the backside hairline, and sometimes with a 2-3cm cut under the chin.
Q: Is it possible to remove the jowl by liposuction only without undergoing a surgery?
A: Only liposuction is needed for young individuals whose skins have not sagged. For others, it may be recommended to undergo a neck lift surgery to remove excess skin at the same time as having liposuction.
Q: After the surgery, how long before I can wash my face and hair?
A: After the suture has been removed on Day 7, you can wash your face, wash your hair, and apply makeup. At the same time you should wear the elastic face mask for 2 months after the surgery to minimize swelling.
Q: Is it good practice to massage the breast after a Breast Augmentation surgery?
A: Massaging is only recommended if a smooth surface type implant was used, and is believed to help lower the chance of having capsular contracture. However, there is no clear evidence that massaging is effective in lowering the chance of capsular contracture, therefore it will be up to the surgeon to recommend.
Q: Which is better between smooth vs textured surface implant for Breast Augmentation?
A: The benefits of a smooth surface implant is that there is less chance of having a visible/tangible implant edge, but is slightly more prone to having capsular contracture if the implant is done under the breast tissue (subglandular) layer.
Textured surface implant is less prone to having capsular contracture, but risks having a visible/tangible implant edge. Textured surface implant also has a higher risk of Anaplastic Large Cell Lymphoma (ALCL), which is not found in the smooth surface silicone type approach.
The risk level will depend on the surface characteristic of the textured implant -- the coarser the texture, the higher the risk.
Q: Which layer is best for Breast Augmentation?
A: There are 3 possible layers to insert the implant, each with their own pros and cons.
1. Subglandular: This method is less complex and can achieve a natural appearance. The downsides include higher risks of having capsular contracture, and is not recommended for very skinny patients because the implant edge may be visible/tangible.
2. Subfascial: This method is also less complex, allows for a relatively short recovery period, producing natural results, and also has a low risk of capsular contracture. But just like th Subglandular approach, it is also not recommended for very skinny patients because the implant edge may be visible/tangible.
3. Dual Plane: This approach is applicable for patients of all appearances, and poses a low risk of capsular contracture. However, the patient may experience more pain and bleeding than other methods, and it would take longer for the breast to get properly in place.
Q: Is it necessary to have a corrective surgery to remove Capsular contracture?
A: Capsular contracture can be classified into 4 levels of severity:
1. No symptoms
2. Slightly hardened breast tissue
3. Hardened breast tissue, sometimes with accompanying pain and minor disfigurement.
4. Very hard breast tissue, with pain and obvious disfigurement.
In most cases, patients in 3rd and 4th levels are recommended to have the operation to remove the capsular contracture.
Q: Can I breastfeed after a recent Breast Augmentation operation?
A: Yes you can.
Q: Can I take a checkup procedure for breast cancer after a recent Breast Augmentation operation?
A: Yes. You will be able to take both mammography and ultrasound.
Q: I have done a Breast Augmentation operation, and now I am worried about Anaplastic Large Cell Lymphoma (ALCL). What should I do?
A: There are varied risks of developing ALCL after having a Breast Augmentation operation, depends on the brand of implant. As long as there is still no evidence to confirm the causation, the Society of Plastic and Reconstructive Surgeons of Thailand and the international plastic surgeon society would not advise to remove the silicone.
Nevertheless, it is possible to remove the implant or replace the type of implant used, and it is recommended to consult with the surgeon to understand the details and the pros and cons before undergoing the operation.
Q: Can I breastfeed after a recent Breast Reduction or Breast Lift?
A: Those operations should only be done if you do not plan to breastfeed afterwards, because the effect of the operation on the ability to produce breast milk is very unpredictable, from no effects at all to not being able to produce any breast milk entirely.
Q: What are the different types of incisions associated with Breast Lift?
A: There are 3 types:
1. Periareolar: Suitable for individuals with mildly sagging breasts.
2. Vertical/Lollipop: Suitable for individuals with moderately sagging breasts.
3. Inverted T/Anchor: Suitable for individuals with substantially sagging breasts.
Q: Is it possible to perform liposuction at the same area after the previous liposuction operation?
A: Yes it is possible, as long as there is excess fat in that same area.
Q: Is it possible to only perform liposuction without an additional surgery to remove excess tummy fat?
A: For patients with excess tummy fat whose tummy skins have not sagged, it is possible to only undergo liposuction. Patients with sagging tummy skins (in addition to having excess tummy fat) are recommended to have both liposuction and surgery.