bad review ?

Today, I'll tell you one sad story that was caused by one bad reviewer in internet.
Last month, one of my former patients visited me and discussed with me about her revision surgery. 
She underwent zygoma and mandible reduction a year ago but she didn't come to ask her revision of her facial bone contouring.
She was satisfied with her facial bone surgery results but she discussed with me about revision of her facelift.
She planned her facelift 6 months after her facial bone contouring because I advised her to undergo facial bone surgery first and facelift later at the first consultation.
Before visiting my clinic once again for her facelift, she changed her plan and went to another clinic.
What happened to her ?

She changed her plan abruptly because of one bad review in internet.
One reviewer in a forum criticized me that I had a consultation with her for about 10 to 15 minutes during another patient's surgery and the patient was abandoned alone at that time. 

Because she was so good in writing and seems to be confident in her recommendation, my patient lost her confidence to me and followed her advice and went to another clinic that was recommended by the reviewer.
Can 10 minutes consultation during another patient's surgery be a problem ?

Unfortunately, her results of facelift was bad and her decision was proved to be bad.
She looked fierce and angry after her facelift and ear lobes were twisted.
She couldn't be taken care with enough after surgery and couldn't get kind answers from the doctor after surgery.Many doctors change their face after surgery.
That's the reason why she came to my clinic for revision.
She grumbled in consultation room.
" I don't know why I changed my mind in a sudden even though I had good results from your previous surgery.
On reflection at that time, I couldn't understand why I misunderstood you.
Now, I understand you and know that the bad review was absurd misunderstanding.
The reviewer even didn't undergo any surgery from you.
Because she(bad reviewer) seems to be so assured and her writing was so good, I blew up my precious time and face.
Now, I can fully understand that doctor can have a consultation for a short time during his surgery and that was just nothing."
Is other person's bad review more powerful than the results from the previous surgery ?

 

I usually don't read any reviews about me because I think it doesn't worth it.
But I searched and read the bad review after consulting with her,
One Australian girl seems to have misunderstood me and fabricated some facts.
But I couldn't help admitting that her writing was so fluent and persuasive.
I remember her and was shocked by her fiendish twisting of facts.
Because English is my second language and writing is not my specialty, I can't and don't want to contradict her conjecture one by one.
But I don't want many people misunderstand me and will explain about concentrating, resting, and waiting in surgeon's work.



In any surgery, concentrating to the surgery is very important to the surgeon.
Because surgery is like tightrope walking, loosing concentration in one second can make a disaster. 
But it doesn't mean that the surgeon can't take a rest during the procedure or the surgeon should do their work constantly. 
Concentrating to the whole procedures for several hours everyday is impossible.
So, effective and clever disposition of time is needed instead.

For example, I wait for about 10 minutes after injection of local anesthetics because the hemostatic(stop bleeding and minimize blood loss) ability of local anesthetics reaches its peak after 10 minutes.
In operating room, waiting for 10 minutes without doing anything is more difficult than doing their job constantly for an hour because the former looks silly and looks like he is wasting time.
As you know, time is money to plastic surgeons in private clinics.
Many of my colleagues can't wait for 10 minutes after local injection and start the surgery in bloody fields, which can make inaccurate, more difficult, more time consuming procedure and bad results of course.
I also had a difficulty in waiting for 10 minutes in my apprentice years.
To make it easier, I take off my gloves, which stops my impatient drive to jump into the surgery and get it done fast.
During this break, I do squat exercise or push up or listen to music or chat with nurses or anesthesiologist in the operating room.
I sometimes walk out of operating room and have a consultation with another patient or do follow up treatments of my patients.

I also take a break during patient's position change and when each procedure is ended in multiple procedures. 
When there is bleeding, I ask my nurse to compress the wound until the bleeding stops and take off my gloves and take a rest.
When there is unexpected situation, I stop doing my surgery and think carefully how to figure out the solution.
This kind of intermittent break help me concentrate in every seconds in real surgery and to be lively and creative in whole procedure.
I know that this kind of break might look weird to some people.
But I believe this is better to both patients and doctors.
What you see is not what you get.

----------------------------------------------------------------------------------

Every surgeon is not perfect and so do I.
I also can make a mistake and can hurt other people(especially my patients) in unintended ways.
I'm so sorry for that.
I reflect on myself and try to be a better person everyday.
I always pay attention to constructive criticism and accept it as part of my learning.
But I respond to absurd misunderstanding because I don't want my patients get hurt because of that.
I believe I have been sincere to all my patients and treated them like my family in all my career. 
Truth will come out eventually. 

Calf slimming exercises

Calf slimming exercises  Many people are scared to do exercise in the fear that it might cause bigger calf. If they know which exercise can make calf thinner, they can be more active in their lives and become healthier. Let's find out what you can do to lose weight and slim calves. 1. Gait Before delving into calf slimming exercise, we should check our gait first. Habit affect our body. Conscious and unconscious repetition of our habitual walking can affect the shape of calf more than we think. Keep your heels down and avoid walking on the front of your foot like ballet dancer. High heels can make Gastrocnemius muscle shorter and bulkier and can can make calf look thicker and shorter. Flat shoes can make Soleus muscle bigger and make lower calf look heavier. The best height of heels for calf is 1 or 3 cm (0.5 to 1.2 inches). 2. Calf slimming exercise Walking and running slower but for long distances will slim down your legs and body. Compare legs of marathoners and sprinters. Endurance runners like marathoners usually have thin legs, as opposed to sprinters who have very well developed calves and thigh muscles. Endurance cardio like running on flat ground when outdoors or keeping the resistance / incline low on cardio machines in the gym can reduce not only the size of leg muscle and but also fat tissue in leg (in whole body). In addition, it can keep your legs firm and shapely. Remember there is no such thing as spot reduction. If you need to lose fat around your calf muscles you can only do so through diet, cardio or even liposuction of calves. But you cannot do exercises that will reduce the fat around the calf muscles alone. Elliptical trainer in low resitance is an effective tool for low impact cardio which can burn fat faster. Swimming slims down the lower legs, lengthens the muscle at the back of calf, and improve the flexibity of body. Stretching makes big muscles appear longer and leaner. You can do your leg stretching by wall push-up, yoga, or Pilates. Stand with your front foot approximately one foot from a wall and your back foot about three feet from a wall. Your back leg should be straight, the front leg bent and your hands resting against the wall, while you lean forward. Your feet should point straight ahead and your heels should touch the ground always. Hold for 1 minute and switch legs and repeat. You can do this stretching with both legs also. Upsidedown bicycle movement with supported shoulder stand can reduce the swelling in legs and stretch legs at the same time. This is especially useful to whom has swelling in legs in the afternoon. 3. Calf thickening exercise Exercise which call for strength, power, and speed from your legs muscles will make bigger bulkier muscles. Short intense cardio workouts, inclining exercise, hill running, high resistance exercise, stepping machine exercise, jumping, lifting heavy things, fast cycling all can make calf bigger. This reminds me a patient who complained about her calf thickening after going into her college at hill. Environment can affect your body shape. Ballet dancers usually have big Gastrocnemius muscle because they should stand on tip toe. Job can affect your body shape also. Many people are unhappy with the size of their calves. But it doesn't mean that all they should undergo calf reduction surgery. (If you consider calf reduction, you should undergo partial resection of Gastrocnemius muscle of course) Howeber, there are other less invasive(but less effective of course) ways than calf redution to slim down calves. This kind of habit change and calf slimming exercise also can be helpful to the patients who will undergo or underwent calf reduction surgery also. ------------------------------------------------- The last one is a quiz. Is squat good for calf slimming or not ?

Optical illusion for calf reshaping

Longer and slimmer calf using optical illusion (Partial resection of Gastrocnemius muscle) Optical illusion in calf reduction Fashion and plastic surgery have many commons. Optical illusion can maximize the effect. Dark colored suits and vertical stripes which can make people look taller is one of the easiest dressing tricks. Double eyelid surgery which can make eyes look bigger and augmentation rhnoplasty which can make face look smaller are optical illusions in plastic surgery. Optical illusion play a big role in calf reduction surgery. Not only reducing the circumference of calf but also making calf look taller and slimmer can make the best results. That's the reason why I prefer this 'partial resection of Gastrocnemius' as 'calf reshaping' rather than 'simple calf reduction'. Denervation atrophy of calf can't predict the amount of reduction and can't control the shape of calf. But muscle resection can adjust the amount and site of muscle resection easily and the result is predictable. That's the reason why my patients have much slimmer and longer looking calves than other patients. 1. Optical illusion No.1 A famous optical illusion. All lines are the same length but the line on the right looks the longest. Protruding Gastrocnemius muscle makes inverted arrow in calf and makes it look shorter. Reducing calf circumference at mid calf can make it look straight tubular shape and makes it look longer. 2. Optical illusion No.2 Slimmer rectangle on right looks taller. Slimmer calf always looks longer. 3. Optical illusion No.3 As you can see in the illustration below, the box which has been cut in the middle looks the widest and the shortest while the box in the right looks slimmer and narrower. The longer an eye travels up or down calf before it is interrupted by a horizontal line, the taller and slimmer your calf will look. Calf which has shorter muscle bulk looks longer. Lower bulging in calf by protruding Gastrocnemius muscle makes it look heavier and shorter. This is the most important optical illusion in calf reduction surgery. By moving the center of gravity of calf upward, the calf can look longer and slimmer. That's the reason why I remove the lowest portion of Gastrocnemius most excessively. 4. Optical illusion No.4 Curved, rounded, circular line increase the size and shape of the figure. Vertical up and down looks taller and thinner. Less curvature and straighter line makes calf look more attractive and longer and slimmer. See the straightening of curvature in calf outline in right. Like this, calf reduction is not just slimming of calf. This can make calf look much longer, slimmer, and straighter. So, calf reshaping is the right term for this surgery. Let's see before and after picture of my patient. Calf circumference decrease about 4 cm. But the change looks more drastic because her calf looks much longer, slimmer, and straighter by optical illusion. Center of gravity in her calf moved up a lot. Copyright reserved for OZ Cosmetic Clinic Hyuncheol Park MD www.ozclinic.com

No recurrence in calf reduction

No recurrence in calf reduction ?

Partial resection of Gastrocnemius muscle has no risk of recurrence . 

1. How does muscle resection work ?

Partial resection of Gastrocnemius muscle removes muscle directly and reduce the number of muscle fibers in Gastrocnemius muscle.
Surgical removal is the only way to reduce the number of muscle fibers.
Because the number of muscle fiber doesn't change after adolescent, the result of surgery is permanent.

In calf reduction, about 70 % of Gastrocnemius muscle is removed and only 30% remains to maintain the shape of natural calf.
The remained 30 % of muscle fiber can become bigger in volume with excessive exercise like body building, the change is minimal after surgery because there are few remained.
So, patients can do any exercise after calf muscle resection without fear of recurrence. 




2. The other muscles in calf
How about the other muscles in calf ?
Can it grow more after calf muscle resection ?

The other muscles in calf can grow bigger with exercise of course.
But the other muscles in calf are deep muscle which is encircled in strong muscle fascia.
So, growing of other muscles in calf is not noticeable.
Because Gastrocnemius muscle is superficial muscle, slight volume change in Gastrocnemius muscle is noticeable and makes calf look awful.
In other words, reducing Gastrocnemius muscle effectively change the shape of calf and makes calf look much thinner and longer.

 

3. Recurrence in nerve ablation and radiofrequency
Nerve block to muscles in calf can make the muscle atrophied.
Why is nerve block recurred so frequently ?

Even though muscle can't be regenerated, nerve can be regenerated very easily.
Nerve is the most easily regenerating structure in our body.

As you can see in below picture, nerve injury can make the distal muscle atrophied in 2 weeks.
After 3 weeks of nerve injury, the atrophy of muscle becomes peak.
That's the reason why most calf nerve block pictures are taken after 3 to 4 weeks.
After 3 weeks, nerve can grow and innervate distal muscle easily and muscle can become normal again.
This means nerve block is destined to be recurred.

 

During this atrophy and regeneration of nerve, the distal muscle loose some volume.
But the change is so inntoceable that most patients can't be satisfied with the result of calf nerve block.
In the second nerve block, the effect is less noticeable than the first trial.
This means repeated nerve block has little meaning.

Most patients seek muscle resection after disappointing and being tired of repetition of nerve block.
What a waste of time, money, and pain !
In addition, this patients may have less satisfactory result with muscle resection because of the scarring from nerve block.

Even though most people know nerve block is ineffective, many patients still undergo this because it is less scary, cheaper, and simpler.
But that is not wise choice for calf surgery.
The more you know, the better you can choose.

4. 2 years after surgery
One of my patients visited me after 2 years of calf reduction because of other procedures.
Not only her upper calf but also her lower calf looked slimmer. 
Before surgery, she had muscular and heavy looking calf with circumference of 36 cm.
After 2 year of surgery, she still had slimmer and longer looking calf with circumference of 32 cm.
Her Achilles tendon in lower calf was reduced also in size because it was atrophied with smaller Gastrocnemius muscle.
In addition, she is no longer afraid of recurrence and is actively participating in her extreme sports.
What a surprise !

She asked me to advertise this calf muscle resection more because many patients are still wasting their time, money, and pain for ineffective calf nerve ablation.
If she knew this procedure earlier, she should have been happier in her younger days and didn't have to undergo many times of nerve block. 



copyright reserved for OZ Cosmetic Clinic
Hyuncheol Park MD
www.ozclinic.com

The simpler, the better ?

The simpler, the better ? Of course, I like simple things. But the simple is not always the better. In calf reduction, simple procedures don't mean better procedures. Even though there are many simple methods in calf reduction, partial resection of Gastrocnemius muscle is the only effective and safe method of calf reduction surgery. Long recovery period, complex procedures, higher price are worth it surely. Modern people are easily seduced and fantasized by exaggerated advertisement, fake reviews, and cooked up before and after photos in SNS nowadays. And they end up in wasting their time and money to ineffective procedures and make their revision surgery more difficult.  Even if simple procedures have shorter recovery and are safer usually, it is not true in calf because calf has big muscles with little fat. Simpler calf procedures are not only ineffective and can make severe sequela (aftereffects). Liposuction on calf, Botox on calf, nerve block on calf, radiofrequency calf reduction are examples. Even if these procedures are cheaper, simpler and recovers faster, these are not only ineffective but also not so safe. I can't recommend these calf procedures to my family and acquaintances at least. Some people make the plan to try simpler procedures first and try muscle resection later if the result of the first surgery is disappointing. But that is not wise strategy because the simpler calf reduction can make muscle resection more difficult and complex. Always, it is the best to undergo right procedures in the first place. Liposuction on calf is not only ineffective but also harmful to calf except extremely fatty person. Because the fat layer in calf is very thin, liposuction can make irregularity so easily and can't make noticeable change in calf. Thinned fat layer in calf can make the outline of muscle more noticeable and can make the calf look more masculine. You can't see noticeable change after Botox injection to calf muscle because calf muscle is too big. Botox in calf means just a waste of money. Nerve block to calf muscle is simple and has some effects. But it is recurred in most of cases because the blocked nerve can be connected by themselves easily in calf. About half of my patients underwent many times of nerve block before coming to my clinic and gave up to the recurrence. In some cases, recurrence is happened in one leg and can't be cured with repeated nerve block. Radiofrequency muscle ablation should be avoided because it makes a lot of scar tissue in calf which is very hard to be removed in calf muscle resection. Because contracted and burned muscle (like too much cooked steak) are in calf, it is hardened with scar tissue in irregular shape. One of the saddest moment in my office is to see the patients who can't be improved much with muscle resection because of the sequela of the previous ineffective calf procedures and regret their previous unwise choice.  If they could come to my office at first... Fear arises from ignorance. If you understand calf muscle resection better, you may have little fear for this. Because muscle is encircled in strong fascia and there is no important structures in the facia, the other muscles and important structrues like vessels and nerves in calf are not injured in calf muscle resection and there is no risk of walking difficulty. Because muscle resection doesn't leave any residue or foreign body in calf muscle, it doesn't make much scar in calf muscle and the result is permanent and predictable. Because 30 % of Gastrocnemius muscle is remained, calf can maintain the natural shape of calf and compensatory hypertrophy is not happened. Because the site and amount of muscle resection can be adjusted, calf shape can be improved more accurately and effectively. Simple procedures don't mean better and safe procedures. In calf reduction, partial resection of Gastrocnemius muscle is the most effective and the safest method. I add one funny picture from my former patient. Her purpose of calf reduction was to be able to buy boots on the street without tucking in the middle of calf. (Because she had very big calf, there was no available off the rack boots for her). She sent me her pictures wearing off the rack boots after 1 month of surgery. LOL Hyuncheol Park MD OZ Cosmetic Clinic www.ozclinic.com

Transportation to OZ Cosmetic Clinic

1. To Incheon International Airport

2. Incheon International Airport to OZ Cosmetic Clinic

OZ Cosmetic Clinic KangNam Center is conveniently located in the middle of downtown Seoul, Korea, within KangNam area. The hospital can be easily reached by subway, limousine bus, taxi and airport pickup service.

3. Limousine bus from Incheon International Airport

You may obtain information on limousine buses and purchase a bus ticket at the Transportation Information Counter (near the exit No. 2, 4, 9, 13) on the arrival floor (1st floor) of the passenger terminal.

Airport Limousine #6009 to come to my clinic directly

Incheon International Airport to Garak Market

bus stop number: 5A, 11B

interval: 10-15 min

traveling time: 70-90 min

fare: 7,000 won

stop: Nonhyun Station

Airport Limousine Hotels (Gangnam) to go to your hotel first

To hotels in Gangnam area

bus stop number: 4B, 11A IIA

interval: 20-30 min

stop: Palace HTL, Ritz Carlton HTL, Novotel HTL, COEX Inter Continental HTL, Grand Inter Continental HTL, Renaissance HTL Seoul

fare: 12,000 won

4. Taxi from Incheon International Airport Taxi Information

Say "NonHyun subway station" or "YoungDong Market" to a taxi driver
Traveling time: 60-80 min (to Gangnam area) in normal traffic flow
There are 2 kinds of taxisThe difference is fare and service
Regular Taxi :
estimated fare:40,000 ~ 60,000 won
Deluxe Taxi :
estimated fare:60,000 ~ 110,000 wonluxurious car and usually friendlier servicebut about double the fare

5. Airport pickup service

When you make a reservation to Yong Dong hotel, ask them the availability of airport pickup.

They'll provide it in cheap cost.
Usual Fare : 60,000 KRW (about 50 USD)

6. Nearby international hotels
1) Super deluxe grade hotel
Ritz Carlton Hotel http://www.ritzcarltonseoul.com

2) Deluxe grade hotel
Novotel Ambassador Gangnam http://www.ambatel.com/gangnam/index.php
Seoul Palace Hotel http://www.seoulpalace.co.kr

3) 1st & business grade hotel
Youngdong Hotel (most recommended) http://www.youngdonghotel.co.kr/hotel/korean/index.htm TEL. 82-2-542-0112Special rate of standard room for OZ Cosmetic Clinic: about 60 USD including pickup service to my clinicIt is clean, cheap, close to my clinic and has English speaking staffs. If you ask airport pickup service when you make a reservation to this hotel, they'll let you know the availability.If you stay longer than 7 days, they'll apply more discount and provide free airport pickup service.
Best Western Premier Gang Nam Hotel http://bestwesterngangnam.com 82-2-6474-2000
New Riverside Hotel 82-2-3444-4971
Friend Hotel http://friendhotel.co.kr 82-2-521-7111
Sunshine Hotel http://hotelsunshine.co.kr 82-2-541-1818
Centro Hotel http://centrohotel.co.kr 82-2-3486-6000

4) Serviced apartment
Human Starville Yeoksam http://www.humanstarville.com/en/mainpage/TEL: 82-2-553-0050about 100 USD per night including breakfast

7. Hotel to Clinic
Print out Korean map and give it to taxi driver.
It'll take about 10 minutes by taxi and about 20 minutes by walking.

If you stay at Yong Dong hotel, they'll provide you free transportation to and from my clinic.

Preoperative and postoperative instructions

Preoperative instructions

1. If your surgery is planned under local anesthesia or IV sedation, you can be discharged immediately after surgery.
   If your surgery is planned under general anesthesia, you can be discharged 4 to 6 hours after surgery.
   In some cases, you can be hospitalized for 1 day.
2. DISCONTINUE alcohol, recreational drugs, and smoking several weeks prior to surgery.
   If your lungs are congested or have wheezing, the surgery cannot be done as the risk of pneumonia and poor healing is too great!
3. DO NOT take aspirin, ibuprofen, large doses of Vitamin E, or algae-containing food supplements for at least 2 weeks prior to surgery. They may act as a blood thinner and promote excessive bruising. You may use Tylenol or similar medications.
4. DO NOT eat or drink anything after midnight on the day before surgery, if your surgery is planned under general anesthesia.
5. DO NOT bring rings, watches, other jewelry or large sums of money to the surgery center or hospital; leave these items safely at home.
6. Laboratory tests or "blood work" may be required several days prior to surgery if your surgery is planned under general anesthesia or you have some diagnosed illness.
   Prior to surgery, should you develop any fever, chills or other signs of a cold or other infection, call the office immediately.
7. Wear loose fitting clothing to the surgery center.
   The shirt should button or zip down the front.
   Bring shoes with 1-2"heels with flat bottom if you plan calf reduction.
8. If you live in USA, Canada, Australia and Europe, prepare Arnica product to minimize postoperative swelling and bruise. (Sinnech from alpha pharmaceuticals in America, Arnica from Nelsons in England )
   

Postoperative instructions

1. Discharge: You will be discharged approximately 1 hour after surgery if your surgery was done under local anesthesia.
   You will be discharged about 6 hours after surgery or the day after surgery if your surgery was done under general anesthesia.
2. Prescription: Begin taking the medicine as soon as you return home or as your surgeon instructs.
   The medicine will last about 3-7 days and will generally not be refilled.
3. Bandages: You will have compression bandages or stockings on after the surgery.
   Do not remove them. They will be changed during your first office visit.
4. Office Visits: Your first post-operative office visit will be 2-3 days after your surgery.
   Your next visits are usually scheduled every 3-4 days for 2 weeks, weekly intervals for 2-3 weeks, then monthly for 2 months.
5. Showering: You may shower 3-4 days after the surgery.
   DO NOT get the bandages wet.
6. Activity Level: You can resume your daily activity within a week after face surgery.
   Calf Reduction : Bed rest for 24 hours with the legs elevated.
   After that you may move about but no strenuous activity.
   You will be more comfortable in shoes with 1-2" heels.
   Do the stretching exercise in every 30 minutes.
7. Sun Exposure: DO NOT expose the wound to the sun (or tanning bed) for at least 2-3 weeks after the surgery as severe burns can occur from minimal exposure.
   Scars must be covered when exposed to sun or tanning bed (so as not to hyper-pigment) until all redness is gone, about 3-6 months. You may use tanning creams.