Friday, September 12, 2014

Is Your Korean Surgeon Qualified?

In my recent public talk on eyelid surgery, a patient shared a cautionary tale with the audience. Her friend was impressed with the Korean cosemtic surgery because of the omnipresent advertisements and news showing fantastic outcomes. 

So she contacted an agent who promised her they can get her a facelift in a top Korean cosmetic  centre. The fee came to USD25,000. Off she went and had the operation in a centre near Seoul which she can’t pronounce the name and the operation was done by a surgeon who was not the one who consulted her in the cinic. The consultation was done through a Chinese interpreter as the doctors could not understand English or Mandarin. She was discharged five days after the operation and flew back home. However, the result was unsatisfactory with unsightly scars. In addition, the wounds got infected and she was admitted to a local hospital for one week of intravenous antibiotic. She contacted the agent who said they can arrange for her to return to Korea for revision but she needed to pay another USD15000. At the end, she had scar revision by a local Malaysian plastic surgeon and the surgeon checked out the name of the centre where she had the operation and found that the centre was not a cosmetic but an orthopaedic centre and the doctors were orthopaedic not cosmetic surgeons.
South Korea has 1,400 registered cosmetic surgery clinics which received over 150,000 clients from other countries in 2012. However, the popularity of Korean cosmetic surgery expertise has given rise to a number of incidents and disputes over the results of the procedures, as well as the clinics' fees and agencies who arranged the trip and the surgery as a package. Some of the clinics were found to be unqualified to perform surgery and some agencies have been found to be running scams. Many patients said they also had inadequate understanding and knowledge about the procedures they underwent.
People who plan to undergo cosmetic surgery in South Korea should go to reputable clinics and research these clinics beforehand through the internet or reputable agencies. As many surgical procedures involve advanced medical terminology and knowledge, many non-Korean patients have problem communicating with Korean doctors even if they can speak English. Therefore, it is essential that patients should select experienced travel agencies with medical knowledge to help with communication.
End note:

A recent article from theMalaysian Chinese newspaper Sinchew Daily reported that as many as 90% of theoversea clients who visited Korean Cosmetic Centre were operated by unqualified surgeons.  (see below). Many agents used the names of established cosmetic surgeons to attract business but the operations were performed by trainees. Many agents take almost 90% of the fee paid by the clients.



Tuesday, September 9, 2014

How Do I Know if the "Doctor" is Legal?

I saw two patients over the weekend who had had disastrous silicone injections performed by "doctors" in beauty saloon and hotel respectively. I asked them why they did not verify the credentials of these doctors before having something done to their face (Not that these "doctors" need their credentials verified as not decent doctors will perform surgery in beauty saloons or hotels as there are against the laws). But most of the public are ignorant of these and often pressured by agents into having unsafe procedures. In addition, most people don't know where and how to check if somebody is really a doctor.

Complications from silicone injections. Patient at the top had lower
 lid injections three years ago to give her good cheekbones but the 
silicone has migrated downward. Unlike hyaluronic acid which can 
be removed by injecting enzyme, silicone is integrated into the facial 
tissues and removal usually leaves scars. Patient at the bottom had lip 
silicone injection which got thicker with the passing 
of the years due to inflammation. 

In Malaysia, only doctor is allowed to carry out medical procedures. And all qualified doctors must register by laws with the Malaysian Medical Council. You can verify if the person is really a doctor by visiting:
and type in the real name of the doctor, if the name is not found the person is practising illegally in Malaysia. 

Hopefully these simple verifications can save some patients from life-long disfigurements. But again never have medical procedures in beauty saloons and hotels as they are not the safe places for surgery.

Tuesday, September 2, 2014

Total Upper Eyelid Removal in a Patient with Lid Cancer

This 72 year-old woman from a remote village presented with a one-year history of a rapidly growing lesion of the upper eyelid. The lesion bled easily and contained cheesy substances. Biopsy showed sebaceous cell carcinoma. Untreated this condition can grow rapidly and cause death by either spreading to other parts of the body or destroy the surrounding tissues (see pictures below). In this patient, the upper eyelid was removed and reconstructed using lower eyelid (Cutler-Beard's technique). The flap was left for 6 to 8 weeks to allow formation of new blood supply before being open.

A rapidly growing mass in the right upper lid 
destroying most of the eyelashes. 

The mass involved nearly all the upper eyelid and biopsy 
showed this to be sebaceous cell carcinoma. 

A young man who ignored a rapidly growing left eyelid lesion which turned up 
to be sebaceous carcinoma until it invaded deeply destroying 
most of the ocular tissues. 

Another case of sebaceous cell carcinoma which invaded 
the brain despite previous surgery. 

Steps of upper eyelid reconstruction in this patient. a-c. The upper eyelid
 was excised with normal looking tissue to ensure the margin is free 
of tumour. d-g. Full thickness lower eyelid was used to cover
 the defect. This was done in 3 layers: conjunctiva of lower lid 
to conjunctiva of upper lid; orbicularis muscle of lower lid 
to levator of the of the upper and skin to skin. 
h. End of the procedure. 

Appearance of the eye at one week post-operative. The patient was
discharged and given date for opening the flap in 2-month time. 

(To be continued)

August Lectures on Eyelid Surgery

Common Eyelid Problems given on the 25th August, 2014 to Penang Optometrists and
on the 31st August, 2014 to 19th Sarawak Optical Trader Society (SOTA).

Public talk on the 30th August, 2014.