Patient Jasper Goh had recently undergone multiple surgeries for the face with Dr Samuel Ho of Allure Plastic Surgery. These are some highlights of his journey.
Jasper: Firstly I am doing my double eyelids using TST (Triple Suture technique). I am doing rhinoplasty with cartilage. I am also doing buccal fat removal and chin implants. For my eyes, I have done it once last year under a different doctor, but I felt that it was too low and I wanted it higher. Dr Samuel is correcting by stitching it higher to get the effect that I want. 
Jasper: For my nose, I thought it was way too big and bulbous, so I thought I had to do an alarplasty but Dr Samuel recommended that I’d only need to use cartilage to push it up.
Jasper: I always thought that I have a very weird smile because my cheeks come out way too much so I’m getting it removed.
Jasper: For the chin implants it wasn’t something that I was thinking of doing but I wanted to shave off the zygoma cos I think it was too big. Dr Samuel gave me the recommendation to elongate my chin and my face would be symmetrical.
Dr Ho then proceeds to explain in detail the positioning of the incision and how it would look after Jasper recovers.
Dr Ho: There is a little more fat that I will take out from the right side since it is a little fuller. The marking is more towards the back as when you lie down, the fat flops to the back.
Dr Ho: The little flaps at the end makes sure that you will not have any bulges. Since this is an anatomical implant, it will follow your jawline
Dr Ho: For the eyelids, we will do it a little bit higher because it will drop.
Jasper: What about the existing line?
Dr Ho: It will disappear. We will do it higher so it will be a bit more parallel. You have wide eyes when the line is parallel, it’ll make your eyes bigger and nicer.
Jasper: You will insert the cartilage from inside the nose? No cutting?
Dr Ho: No cutting, we will minimise the downtime. We don’t have to do too much of a height increase (at the nose bridge) but we do need to do a lot more projection and length at the tip.
Jasper: When will I start feeling pain?
Dr Ho: The next morning when you wake up, you’ll feel some pain. The oral painkillers will help you.
Jasper: After the oral pain killers I should feel no pain? I can eat as per normal?
Dr Ho: Yes, you can but you should stay away from deep-fried or spicy foods.
Jasper: I can chew as per normal? Cos I was told I need to wear a band.
Dr Ho: Yes you would need to wear a ban for the swelling and to keep the chin in place. When you shower or wash your face you can remove it. It’s Velcro, so it’s very easy.
Post Surgery
Something that I liked about this whole process was that Dr Ho had ever once failed to clarify any doubts Jasper had. He had also made recommendations that would benefit Jasper’s aesthetic needs instead of simply following his requests.
Dr Ho had taken extra effort to explain how the procedures would complement Jasper’s anatomical features which I imagine must be very reassuring instead of simply going into a surgery blind.
For the readers who are not as familiar with the techniques mentioned by Jasper and Dr Ho, I will be doing a summary of them.
Firstly, Jasper mentioned the TST (triple suture technique) for his double eyelid surgery. There are two main techniques for double eyelid surgery – the suture method or the cutting method. Both methods require the use of sutures to create adhesions between the muscles of the upper eyelid and the overlapping skin.
| Suture method | Cutting Method |
| Requires three to five tiny stab incisions along the crease of the upper eyelids | A long incision between 35 – 45mm along the upper eyelid crease |
| 15 – 30 minute procedure | 45 – 60 minute procedure |
| 5 – 10 days of downtime | 14 – 28 days of downtime |
| Results are seen within 4 – 6 weeks of surgery | Results are seen within 8 – 12 weeks of surgery |
| Double eyelid permanence depends on the strength of the suture and the adequate formation of scar tissue | Results are permanent. |
With the triple suture method, patients can get natural-looking results in a shorter period. Furthermore, the impermanence of this method allows the patient to reverse his/her decision should they be unsatisfied with the results.
Next, Jasper mentioned how he wanted to get an Alarplasty but was recommended a closed rhinoplasty instead. An Alarplasty targets peoples who are looking to reduce the size of their nostrils by removing a small section of the wing of the nose. This results in a smaller base giving an overall narrower and sharper look to the nose. However, the drawbacks of this procedure are that it is a highly invasive surgery with significantly longer downtime and visible scarring. However, with the closed rhinoplasty, cartilage is taken from Jasper’s ears and implanted in the tip of the nose from the inside of the nostrils. This reduces the downtime needed and ensures that it is essentially a scarless procedure.
Lastly, Jasper’s Buccal fat removal was done via an intraoral method ensuring that this procedure is yet another scarless one. The buccal fat pad is naturally occurring deposits of fat that accumulate around the cheeks. This gives a generally ‘baby-faced’ appearance or as Jasper mentions, a weird smile. The incision is made between the gum and the mouth ensuring that there will not be any scarring on the face. The buccal fat pad is then removed and the wound will be carefully sutured close. Furthermore, the buccal fat removal is permanent ensuring that chubby cheeks will no longer be one of Jasper’s woes anymore.
