What to check before having a treatment in Korea

A patient from Canada once showed me a booking confirmation from another clinic. Three treatments and a total price were already written on it, and nobody had seen her face. She asked me what they had based that on. I told her I was wondering the same thing.

Consultations with patients who fly in are always tight. You have a few days to decide and be treated, there is no room to take it slowly, and a pre packaged set looks convenient for exactly that reason. I have seen that convenience turn into a result that is hard to undo more than once.

Here is what is worth checking before you come, in order. These are not criteria for choosing a clinic; they are things you can verify on the spot at whichever clinic you go to.

A consultation where the quote arrives before the examination

The quickest reply to an enquiry is usually the price. But a price requires that what will be done and how much of it is already settled, and that is settled after someone looks at your face. With the order reversed, the examination becomes a step that confirms the quote.

So when patients ask about cost in advance, I give a range and say the exact figure is decided once we meet. It looks like I am putting off the answer, but the other way round makes it hard for both of us to change what has already been written.

Why a package with the device already chosen deserves a second look

There are a lot of bundles aimed at visitors. Lifting, injections and a laser on one line with a single price at the bottom. Not all of them are bad. The problem is that the bundle was decided before anyone looked at your face.

After the examination it is common to find items in the bundle you do not need right now, while what you actually need sits outside it. You end up receiving what you did not need and paying separately for what you did.

If you arrive with a bundle in mind, there is one thing to confirm at the consultation: whether items can be removed or swapped according to the examination. If they cannot, that is a product rather than a medical decision.

Choosing treatments by counting backwards from your flight home

Ask about the schedule and most patients say only that they leave in a few days. I ask the date and time of the flight, whether you go straight back to work, and whether there is a photo to be taken in between. What can be done today depends on those answers.

Treatments that leave marks for a day or two, such as toxin or a hyaluronic acid skin booster, fit a short trip. Fractional lasers and thread lifts leave redness and swelling for several days. Flying itself is fine, but if you are meeting people the moment you land, it is better to leave those out this time.

One more thing. Flying long haul while still swollen makes the swelling look worse, because of the dry cabin and the pressure. So for treatments where swelling is expected, I schedule at least three days before departure, not the day before.

What happens when several treatments are stacked into one day

Some patients have only one day and ask for everything at once. I understand the impulse, but this is where I split things up. Overlapping recovery adds redness to swelling and lasts longer than expected, and if something goes wrong there is no way afterwards to work out which treatment caused it.

And putting heat into an area on the same day as an injection means the material you just placed takes that heat. Some combinations have to follow an order and an interval. Even when you want everything in one day, those combinations get split or moved to a later visit.

What to bring to the consultation

What you bring changes the quality of the consultation. What you have had before matters most. If I do not know where filler is sitting, it is hard to decide whether heat can go over it.

Photos help more than people expect. Clinic lighting usually comes from above, so shadows read deeper than they are. Seeing a photo taken in ordinary daylight lets me separate what is lighting from what is an actual change.

Five questions to ask at the consultation

When you are working across a language barrier, it helps to write the questions down in advance. These five sort out most of it.

• Who is performing the treatment today · whether the person who consulted is the person who treats
• Why this method was chosen · the grounds for this rather than the alternatives
• How many sessions are needed · whether today alone reaches the level you described
• How many days of recovery · how long redness and swelling last
• How to make contact if something goes wrong · including after you have flown home

If the second question gets no answer, I tell patients to look at that consultation again. What was seen that led to this direction is something the person treating you has to be able to put into words.

What gets lost through an interpreter

A few things go wrong repeatedly in interpreted consultations. First is recovery time. The day the swelling goes, the day makeup covers it and the day no trace remains are different days, and when all three come out as one word, the two sides end up thinking of different dates.

Second is the number of sessions. Some treatments are done once and some are built up, and if which number today is out of the total goes missing, you think it ends here. Third is duration. The point at which the result peaks and the point at which you need it again are not the same.

So I do not say these three out loud only; I write them down as numbers. How many days, which session out of how many, how many months. Numbers survive an interpreter.

When no treatment is done on the first day

Some days I send a patient away without treating, even though they came a long way. The first case is a face still swollen from arriving recently. The day after a long flight, the face is not itself, and deciding how much to fill in that state leads to overcorrection later.

Skin that is red and inflamed or flaking is another reason not to treat that day. Overlapping irritation leaves pigment, and that pigment lasts longer than the thing you came in for. I suggest calming it for a day or two and meeting again.

I say the same to patients who have only that one day and want something done. Not treating today is not a loss. Problems that appear after you have flown home are ones I cannot look at in person.

The flight home and the days that follow

Cabin humidity is low. Skin already dried out by a treatment spends a dozen or more hours in that, and the tightness and flaking get worse. I tell patients flying after treatment to reapply a moisturiser that spreads easily, several times during the flight. I do not recommend sheet masks; the sticking and peeling is its own irritation.

A window seat lets sunlight straight in. If you have had a pigment treatment, those few hours count for quite a lot. Better to pull the blind down or move to an aisle seat.

Once you land, jet lag and fatigue take your routine apart. But the first week after a treatment is the week that decides the result. Do not start any new product; moisturiser and sun protection are all you need to keep to.

The signs to contact us about once you are home

Before you leave I set out what to watch for. Without that, patients are alarmed by what is fine and let the thing that matters pass.

Contact us for these: swelling that grows from the third day onward, pain or heat on one side only, skin at an injection site turning white or mottled like a net, and blurred vision. The last two are time critical signs, and you should find a local clinic where you are, immediately.

I also write down what you can simply wait out: slight asymmetry, bruising that darkens over two or three days, and a treated area that stays palpable for a few days. Photographs taken a few days apart make the later check far more accurate.

Treatments that do not finish within one trip

At the end I divide up the expectations. Some treatments are assessed within days and some need months of watching. Toxin at four weeks, collagen stimulating injections at six weeks to two months, lifting coming up over two or three months.

Which is why judging by the mirror on the last day of your trip usually ends in disappointment. When treatment is finished I write down the dates on which to take comparison photographs. Three of them: today, four weeks, three months. They have to be taken in the same light at the same angle to be comparable.

If it is a treatment built up over sessions, I also say in advance that this visit will not finish it. We look together at whether starting a course makes sense when you do not know when you can next come. If it looks like a single visit, I choose something that completes in one.

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