When it comes to plastic surgery, listen to your doctor


Every generation has a different concept of beauty, and it appears the V-shaped face is now in vogue. But how far would you go just to look like your favourite K-idol?

The Korean influence is clear, seeing how the V-shape jaw, big eyes and narrow nose has become so popular, says consultant plastic surgeon Dr Mohd Ruslan Johan.

“Even having a double eyelid procedure can be a big change. It’s fine if one wants to look entirely different and is prepared for the change. However, your family and friends may not be. You may have to change your passport if the difference is too drastic and unrecognisable compared to your old self. If you don’t value that (your old self), then that’s a different issue,” he says.

According to consultant dermatologist Dr Ko Chung Beng, many patients who ask for the V-shape are in their 20s and 30s, and some have even lost their lives due to complications.

“After a nose job in South Korea, one patient’s prosthesis was sticking out of her nose. Another had to push her prosthetic nose back in place every morning or when she laughed too hard,” he describes.

“Too narrow or too high a nose bridge looks unnatural, but to them, it’s beautiful. Some patients who had eye surgery to make their eyes look bigger experienced scarring (thickening keloids) and needed help to reduce this.”

Dr Mohamad Nasir Zahari, medical director of Beverly Wilshire medical centre.
Dr Mohamad Nasir Zahari, medical director of Beverly Wilshire medical centre.

Shaving the bone for a narrower jaw can result in major bleeding, nerve damage and paralysis. Some don’t want the risk of surgery, opting for injectables instead, says Dr Ko. But when done wrongly or if silicone is used, it may cause the face to become unbalanced or lumpy.

“As doctors, we try our best to educate patients. If we reject them, they will go somewhere else. We don’t want to change you into someone else; you should be the best version of yourself. With this Korean trend, though, everyone ends up looking the same.”

It’s understandable that everyone wants to look good – but at what cost, he questions.

“Some even take up loans to pay for their surgeries and end up in debt because of herd mentality,” says Dr Ko.

Dr Mohd Ruslan says that it’s worrying how some people are taking plastic surgery as lightly as going to the dentist. Craniofacial surgery, which used to be for congenital and acquired deformities, is now regarded as part of the beautification process.

“There are serious risks as the bone structure is affected; there can be breathing problems and a lot of nerves are in that area.

“Not every doctor is competent enough to conduct such major surgery. But some dental surgeons and ENT (ear, nose and throat) doctors have ventured into craniofacial surgery, and this is very alarming as it’s a different specialty!”

What’s even scarier is how some patients go to South Korea and do everything in one sitting.

“This is strongly not recommended as stretching anaesthesia beyond eight hours can be worrisome. Usually, this is reserved for emergencies, such as heart surgery and other serious cases. Most surgeons prefer to make gradual changes instead.

“It takes years of experience to handle such a complex surgery, so it’s important that you select the right plastic surgeon,” he says.

Also, most surgeons are reluctant to repair other people’s work as there are many complications, and patients could have unrealistic expectations. Some strive for perfection, and frankly, being able to achieve a level of normality would be good after a botched job, explains Dr Mohd Ruslan.

“Some women put unnecessary pressure on themselves. Even when they have a supportive husband, their own insecurity eats at them. Ask yourself whether it’s worth risking your life for cosmetic surgery. Do your research, as the result is irreversible. This type of surgery can’t be trivialised and must be conducted in a hospital setting,” he adds.

Consultant plastic surgeon Dr Mohd Ruslan Johan.
Consultant plastic surgeon Dr Mohd Ruslan Johan.

Consultant plastic surgeon Dr Mohamad Nasir Zahari also discourages patients from doing multiple procedures at one go as the end result may be a shock to the system.

“Doctors draw a line when patients become obsessive. And they may not be satisfied with the end result. As plastic surgeons, we have to moderate the industry so that we don’t get dragged down by trends. Some want to look like their idols, yet still aren’t happy after achieving that.

“Half of our job is counselling and managing expectations, ensuring that patients are aware of the complications. We need to determine the motives – is it for a promotion, family or relationship issues, ageing, changing a flaw – and also decide whether you are physically suitable for this kind of surgery,” he says.

Jaw surgery (maxillofacial) is permanent and, besides cutting the jaw bone, sometimes a silicone implant is added to make the chin look sharper, and muscles removed at the side to sculpt the face and make it narrower.

“Botox and fillers are less invasive, and can also give an appearance of a more prominent cheekbone and upper face. Eye surgery (blepharoplasty and canthoplasty) to open up the outer and inner corners of the eyes, is wholly cosmetic and can make up to 5mm difference in eye size.”

Dr Mohamad Nasir suggests that when the facial structure is changed, it’s possible that the genes can sometimes go “a little haywire” as the way the face ages may change, in response to the new bone structure.

“You may end up looking disproportionate and imbalanced, and need corrective surgery after that,” he concludes.

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