English edition

The practice

We choose the layer, the path and the tool before we choose how small the incision will be.

Book a consultation Axis 01

Endoscopic forehead lift

The brow, not the eyelid · since 1999

Heavy eyes

Some heavy eyes are not explained by the eyelid at all. We first ask which way the brow has come down, and by how much.

Clinic explanation

Axis 02

Endoscopic malar reduction

One incision · two dissection planes

Limits first

A small incision is the result of choosing the right plane, not a goal. Where a large movement or rigid fixation is needed, the intraoral approach may suit the face better.

Clinic explanation

Axis 03

Revision rhinoplasty

Reading the last operation

What remains

Whether a twelfth operation is possible is decided by the tissue that is left and its blood supply, not by the number of operations before it. A septum that has given way, an implant that was set too high, inflammation that has not settled and cartilage already taken from the ear are each a different problem, and they are separated before a plan is made.

Clinic explanation

We publish in
peer-reviewed journals.

Ten papers, four of them as first or sole author, and three of those on the one operation this practice is built around. The list, the identifiers and what each paper does not show are set out in the record rather than repeated here.

The three papers, read in order The complete record, 1997–2022

Heavy eyes, wide cheekbones, noses operated on many times — first we find out what the problem actually is.

3D CT analysis

Before any facial bone operation the skull is analysed on 3D CT — bone, muscle, fat and skin together. It shows the shape and thickness of the bone, the foramina the nerves leave through, and where the cut will fall and how deep. The course of the nerve itself is not imaged; it is inferred from the landmarks and found under the endoscope.

Four causes of a heavy eye

Brow descent, excess eyelid skin, ptosis and frontalis compensation are separated first. Which one leads decides the operation and its order — and sometimes the answer is not a forehead lift at all.

Anterior or lateral

Whether the prominence is anterior or lateral, how far the bone must move, how the cut surfaces will meet, whether fixation is needed, and whether the face has been operated on before — five questions before a technique is named.

Temporal access, two planes

From one incision inside the temporal hairline, two planes are separated — one to the arch, one to the body — under a magnified endoscopic view, without an intraoral incision. Nerves, vessels, fascia and periosteum are identified before the instrument passes.

L-rotation

Rather than freeing the fragment entirely and moving it a long way, the cortical connection that is left in place becomes the axis of rotation. Not less surgery — a decision about what to leave, so that stability and movement are both kept.

Seven checks before a revision

Remaining septal and ear cartilage; skin thickness, blood supply and scars; previous materials; inflammation and time since the last operation; contracture and shortening; breathing; whether rib cartilage or dermis can be harvested. The count of previous operations is not on the list.

The limits, then the plan.

Every technique page on this site carries a section on the faces it does not suit. A beginner talks about advantages; experience talks about boundaries. Three numbers from the record show how that habit was formed.

Selected

0

Patients in the first series, 1999–2001 — a narrow indication, stated as such

Revision

0

Revision malarplasties set down as sole author, 2013

Checks

0

Findings checked before a twelfth nasal operation is planned

Endoscopic malar reduction, explained

Watch the film

https://www.youtube.com/watch?v=wdbYVxuIe-s

Reconstruction before aesthetics.

The passage was learned on cleft lips in Da Lat before it was widened in Seoul. The record below is how it was widened — three times, on paper.

How it was widened, three times on paper

Consult with us.

Book a consultation Consultation

First, the layer. Then the limits.

Consultations begin with examination, 3D CT and, where needed, ultrasound, to establish the layer, the bone and what tissue remains before a plan is explained. Noses operated on many times and faces operated on before are within scope. Where the findings say that not operating now is the better course, that is said first.

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