Hello, everyone. Today, I would like to share about marionette line and fixing this sagging cheek skin. The focus will be on the invasive method of thread lifting.
We call this part marionette line.



There are many reasons on why this marionette line is formed but the first reason is that there is a ligament in the face that holds the cheek skin. This can be looked as a dam. These ligaments on the face act as a dam by holding together the fat so that the fat does not drop down. However, as you age, the skin not only lose elasticity but the ligament tissue also weakens therefore the skin drops down and start looking like the marionette line. The water is supposed to flow downwards but remains collected because of the dam.



Nasolabial fold, Indian band are all the same. The dam holding the skin weakens, making it look like a furrow instead and the skin collects above it, making the cave look bumpy.

Then how can we improve on this weakened skin and the fat collected? The best solution would be to pull it back to the original place. This improvement is difficult when conducted with a surgery.

We would need something to pull up the skin and maintain that pull. We call these two point, anchoring point and suspension point.

The anchoring point is normally at the side of the head. This is like nailing on the wall therefore the wall must be strong and hard. A good spot would be somewhere higher than the ear.

The suspension point is one where we want to pull up the skin. For this case, it would be where the marionette line is.

Usually, we would use thread with lumps but if we have Indian wrinkle, nasolabial line, or dense skin around the marionette line, such parts would be pulled first therefore there would not be much strength to hold onto the marionette line. This would not have any effect.

So, at times tunneling is necessary to destroy the ligament of the Indian band or those that are near the cheekbone.



The most commonly used thread for lifting is the one with bumps. We call this Cog thread.

We need about 3 to 6 cog threads to lift marionette line on one side of the face.
However, there are many cases where this cog thread lifting is not enough to maintain long lasting effect. If these threads are to have long lasting effect, we need another source of power that would pull the threads to different directions. So we use another thread in parallel called PDO. About 10 threads are necessary.





This is how we correct the marionette line. At times, we would need to remove the fat around the marionette line, if the cheek is too chubby. We apply fat transplantation as well.

Today, we looked at the details of marionette line.
I hope that the information has helped you.
Thank you and have a great one.

There are many athletes who visit our clinic.
Today, I would like to share few tips for those who enjoy sports, those who are professionals or do sports for living.



1. Weight control
This is the first topic that I share with, with those who enjoy working out. This is very important for such people. There are many who lose weight in a sudden before an event or a tournament.
Once this is passed, they tend to become less sensitive on the diet.

This type of weight control repetition is not good for the breasts. Gradual loos of weight is better. You should not try to lose much weight at once. If such gain and loss of weight is repeated, you will tend to lose elasticity on the breast tissue, and your breast would age.
Breasts that lose elasticity, cannot be recovered. The problem is here. Also, the breast correction required for this is very complicated and risky.

Health instructors, body builders, fitness, ball-related athletes, Yoga/Pilates, and Jazz/Belly dancers all needs to avoid sudden loss of weight when considering the beauty aspect of their breasts.
Anyway, there are those who ask if they should lose weight before or after the breast augmentation. There is no answer to this question. One cannot know how much weight would be lost, and how much influence the weight would have on the changes made on the breast.


There is homeostasis in our body.
When you shake a water bottle, the water inside makes waves, but as time passes, the water calms down.
When there is such a shake or complication in the body, it takes some time for the body to get used to the different environment and get back into stable condition.
It is important to control body fat, weight and rhythm before the surgery in order to minimize any chances of complications that may be caused after the surgery.

2. Harmony in the breast
Breasts have been one of the core parts of the body regarding a woman’s body beauty.
A good, healthy looking body would include breasts also.
The muscle volume and edge would be important for male fitness athletes, but for a woman, it would be important to have good looking breasts along with developed muscles on the body.



The lines formed by the breasts need to be in harmony with the upper body shape and size. A high volume breast would not look natural on an average body.
The position of the nipple is related with the cup size but is not related to the beauty of the breast. A breast without symmetry, balance, and ratio would not make the body look good.

3. Selecting surgery method
There are many who ask where the incision should be when considering problems caused when exercising. But I don’t think that this is an important factor to consider. The plane where the implant lies is more important. Deciding if the implant room should be above the pectoralis muscle or below the muscle is more important.

If the room is formed above the pectoralis muscle, there would be no pressure on the implant and no problem with the implant moving to another location. However, if the skin becomes thin, then one would be able to see the implant and feel the edges also.
If the room is formed below the pectoralis muscle, then the contraction on the muscle would pressurize the implant. The repetitive contraction leads to movement and rotation of the implant. However, there is low possibility of capsular contraction and low possibility of being able to feel the implant.


I have been thinking a lot about this problem with athletes.
In conclusion, I think it is better to conduct the surgery under the pectoralis muscle. (Below the muscle is a popular spot for dual plane as well)
When I observe the results of dual plane surgery, the movement of the implant has been less severe for athletes who conducted vigorous activities. These athletes tend to reduce fat and gain muscle. If the implant is place above the pectoralis muscle and can be felt, there is no way to solve this issue.



For athletes, the best plane for breast implant would be the dual plane. The incision location of the armpit / areola / inframammary fold are less important than this.

4. Cautions to take after the surgery
When can I start working out?
You would need some time to recover to the state before the surgery.
You should not start exercising at same density as before the surgery.
Simple stretching and light workout for one week would be good enough to bring up the pace however, the recovery time period is different from one person to another.
Also, it takes about 3 ~ 4 weeks for the capsule to form around the implant, in order for you to start exercising.
After 3 months, there is nothing that you cannot do.



Athletes do not have subcutaneous fat and have tight skin therefore it takes much time for the breast to get into proper shape.
Massaging and using correction bra helps this process. Sport activities are not restricted during this stage

Today, I shared few tips for those athletes or related personnel who want breast augmentation. Thank you for reading.

Rhinoplasty Korea KIES-U Plastic surgery

The doctors are mostly worried about the inflammation and bending in a nose surgery (especially cosmetic surgery).
Why do these complications (inflammation, bending, changing, twisting) exist? I would like to share about this today.

How is the Physiological match?

The first problem is that the foreign substances enter the body and restrict normal circulation.
The nose is a part of the body, and all the parts of the body has blood circulating with supply of nutrition and oxygen, and removing of body waste.
If there is no such circulation in any part of the body, then the body becomes weak to

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Implant / Body waste, other waste, carbon dioxide / Oxygen, nutrition, immune system
It’s like having a upper pipe and a lower pipe, but there is something stuck in between. Although there is water circulation, the circulation is slowed down by the substance that is stuck. What happens to the water that does not flow down the basin? The basin would turn dirty and mold can be formed. If you use the water and let it flow down, this would not happen.

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As the implant gets bigger or thicker, such delay in circulation becomes worse. This would lead to damage in supply of nutrition and in removing waste. Finally such happening would cause weakened immune system and higher possibility to infection.
The usage of implant does not always lead to infection. There are other variables as well. The more important issue would be how well the implant physiologically matches the surrounding skin tissue in a nose surgery.

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The implant should not make a dead space between the bone below and the skin tissue on top of it. It should structurally fit into the body. Also, there should be minimum bleeding in the desquamated skin around the implant. If there is much damage and bleeding, then there would be much capsular formed making the implant move to another position. The implant would not fit properly with the surrounding skin tissue. If the surrounding tissue remains undamaged and functional, there would be no problem caused. However, if the skin tissue is pushed, pressed down, or if there is a deal space, then the skin tissue cannot remain healthy and functional.

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This physiological match of the implant with the nose is the life or death matter. The same applies to the cartilage, skin, or fat transplant as well.

Nose surgery can be thought of as three dimensional example of a building being remodeled. You cannot change the foundation such as the electricity, water pipe, and others in order to change the shape of the building. Changing the foundation would lead to side effects. The most representative side effect would be infection and bending of the nose.

There is a possibility of hindrance in circulation due to the usage of the implant.
If the surrounding tissue of the implant is not healthy, then there is a breakage in the physiological match.

These two situations would be the source or the cause of infection on the nose after the surgery.

If you are already infected, 

Not all infection, including that from microorganism, lead to symptoms. Most infections have more sleeping effects underneath such as that of an iceberg. If the infection causes itching, edema, fever, oppressive pain, then there is something much larger under the iceberg.


If there is clinical symptom that pops up and disappears often, this means that the iceberg is rising then going down repeatedly. It’s not that the iceberg is getting smaller and larger again.


All the infection or the bending of the nose caused with the movement of the implant are caused by the physiological mismatch of the foreign substance and the original nose skin tissue. The treatment to this would be returning to the original state.

If the implant is the problem, then it should be removed or changed. If the implant is pressurizing the cartilage or the skin then there should be changes made in order for it to be physiologically matching with the nose.

If the outcome of the first surgery leads to severe damage to the skin tissue and inability of the nose resisting the changes, then the implant should be completely removed without any hesitation.

It is best to go back to the original state and hope for the better future, then to leave it as it is.


Today, we looked at the core issue in structural nose surgery. A good nose surgery would lead to good physiological balance between the nose and the implant used.

There would not be any infection / bending / twisting of the nose, and the skin would not change form also.

Thank you for reading. Have a great day.

Many male patients come and ask me this question and I, too, ask this questions to myself often as well.
What is the difference between a man nose surgery and a woman nose surgery, and also what is the technical difference?

The biggest difference is that the female patients usually want barbie nose line, i.e. a nose with curved line but the male patients do not like this but want straight, tall nose.
Another difference, which is even more important, is that all women, no matter how their original noses are, all want something clear and common, but the men do not. There is no one simple answer to how a man’s nose should look like. Its all a case by case situation. Individuality is more important for men.

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But there is one commonality here. The nasion should not be low and should extend from the forehead and downwards. This is why many men use implant or filler to make the nasion taller.



Let’s look at Tom Cruise’s nose for an example. It looks like Greek sculpture. “Sculpture” means that the nose from the eyes, nasion, and the nose tip is in a straight line and all are naturally connected.

If a Korean man wants such as nose, an implant or other tissue must be used to make the nasion taller.



But, Brad Pitt’s nose do not look like a sculpture. The nose tip is spread out as well. The nose itself is not narrow but wide. The nose whole is wide as well.

This is not a “pretty looking” image. But Brad Pitt is a very popular person. He is sexy and attractive. Very popular in US as well.

Sometimes when I look at Brad Pitt, I feel that he does not need a taller nose, but need his nose to be made narrow.

I feel that Leonardo DiCaprio’s nose is an ideal nose. It is better looking than any woman’s nose. If there is a patient who wants such a nose, then narrowing of the nose might be necessary.



In summary, a man’s nose surgery should include making the line connecting the nose root and the forehead taller. But slimming the nose is not necessary. There are at times when just inputting the implant is enough for man’s nose surgery. piggy nose correction, alar reduction are not necessary. A good choice must be made.
There are many men who want to correct a short nose. Many are satisfied with their looks after the short nose correction.



Short nose (if the angle on the nasion-forehead is big, then it does not look manly)
If the hump nose is severe, then this has negative face image.

But there are many who feel that they need to correct hump nose. A severe case of 매hump nose may look woman-like…
This is why a man’s nose surgery is not as simple as it looks. There are technical difficulties also, but one needs to consider the overall face shape and image of the male patient and then decide on the surgery plan.

Today, we looked at the difference between a man’s nose surgery and a woman’s nose surgery.
Thank you for reading. Have a good evening.