Yanhee Hospital (Bangkok), Lower Eyelid Blepharoplasty (Remove Bags Under Eyes)

Healed nicely. I am very happy with the results.

The Dr. Pramote used absorbable sutures but I did not know this, so I left Thailand the day after the surgery thinking my doctor in Japan would be removing sutures. No need for that.

I went on vacation before the operation then left just after (the very next morning actually). The hospital requires a week stay after then the post-op follow up but they have no way to enforce this, of course. Do what you want.

Dr. Pramote did say most patients never return after the operation for the post-op check-up so they are used to this. You will, however, lose your warranty for any post-op corrections by skipping the post-op follow up...

But, as promised, I sent Dr. Pramote the 1 month post-op pics and will do so at 3 months as well.

I just returned from Thailand. I have no good or bad feedback about the results because it will take months to heal to see how it turned out. Right now I look pretty beat up though, as expected.

I do want to share my experience with Yanhee, the doctor I chose (Dr. Pramote), and the details regarding the procedure I had (lower blepharoplasty - fat removal only for "baggy eyes").

I am writing this detailed summary to help people with their decision, not as a promotion or recommendation. Again, I have no end result yet to speak of.

I read about the doctors before arriving. I chose Dr. Pramote because his schooling abroad and thus strong English, I assumed. All true I am happy to report. An interpreter was present during the pre-op consult but not needed at all. She watched the doctor and I talk.

He explained the three options I had:

At 43 years of age, I am in the "grey area" for this procedure he explained, which is 35 - 45. Sometimes tightening the muscle (to remove wrinkles when smiling) is desired. I did not know this was even an option. I had assumed it was only fat removal.

Option # 1. fat removal only

Option #2. fat removal and muscle tighten via pulling muscle tight then stapling it to the periosteum or

Option #3. remove fat then fold the muscle over, onto itself, and suture the new fold together to make it tight.

He explained advantages and disadvantages of all the options.

The muscle tightening essentially regarded wrinkles only, and only when smiling, as he explained. Both muscle tightening options would also require a much longer scar, laterally.

I opted for the least invasive procedure (fat removal only) since most of our time is not spent smiling. It was nice he gave me the options to choose from though. He easily could have just told me about fat removal only. This seemed ethical on his part, especially since all 3 options cost the same (30,000 baht) but the latter two would take considerably more time in the OR for him to complete.

I asked for "after pictures" of his previous patients which he could not readily produce. He showed me THE DAY AFTER pics for one patient, an Asian woman (I am a white male), which was the worst idea possible for him to show a prospective client, as the scar is fresh, purple, and with swelling too. He could not provide a 3, 6, or 12 month pic. I chastised him a bit about lacking this sales and promotion point to help patients feel better about his work and with their own decision. He was understanding and seemed to agree. He then explained most patients leave to their countries and never send feedback or pics after. I then offered to send him my after pics to use for promotional purposes for future patients like me. I said, "let's make a deal, if you do a good job, I'll send you my recovery / after pics to use as you please..."

I was persistent in getting my questions answered and he seemed to respect this. A couple times he launched into pre-canned explanations without answering my question so I asked again to clarify. He was responsive with the re-direction and always answered my question.

We consulted for 20 minutes at first. Good English, honest, open. Then I left his office, still unsure whether I'd do it or not. I thought it over for 45 minutes more then came back to ask some final questions. I asked him to cut close to the eye lash to conceal the scar. 1 - 3mm is the norm. Too close and you can harm the muscle and also run into the eye lash roots. After asking my follow up questions, I felt good to go ahead with the operation given the detail he provided and the options he gave me, something he doesn't usually give patients he told me. This, I assumed, was because I was in the grey area regarding age and muscle / wrinkles, not because he was doing me a special favor. Again, this seemed very ethical.

One thing I requested was that he talk to me during the operation to explain everything he was doing. I also do this with dentists so I am informed in matters regarding the alteration of......... my own body!! I also enjoy learning. But unlike dentists, I was able to talk back to him, which was nice. We had some Q & A during my own operation...

From other reviews I read, many seemed rushed through the consulting process and later unhappy. Not sure how anyone would spend (or let the doctor spend....) just 2 minutes talking, regarding an operation on their body but I recommend taking your time and researching the procedure before hand so you are better informed to ask questions relevant to you and your body.

After this was payment and paperwork. I paid in Japanese yen, where I live. The exchange rate was spot on as I checked the rates that morning.

I requested for copies of the paperwork (doctors notes, 6 month warranty, and consent forms). I had to walk over to the legal department office to sign a consent form for medical records release. They agreed to give me copies at the 7 day follow up when sutures were removed (so the doctors final notes would be included). This was reasonable.

Just after your payment and paperwork intake is completed but before you enter for operation, you go into a personal property room where you are too give all your valuables, which are logged by a staff, photographed, then locked away into a locker until you return. Wearing a concealed waist belt, I was very hesitant to give my passport over. I did in the end. I was just taken aback by this step initially beause I did not expect it but I calmed down after. I did write all that I entered into a note on my ipad to double check everything later.

During procedure, he told me details that were not discussed during the pre op consultation. I was pleased that he explained these nuances during the operation, which let me know he was very experienced with this eye operation. I was very glad to have asked him to talk me throughout the process. I felt reassured that he was competent and that I made the right decision.

During the operation there is a blood pressure cuff and hr monitor placed on your index finger throughout. BP is taken randomly, multiple times during the procedure and the cuff is pumped VERY tight for the systolic read. much tighter than in the USA or Japan. Velcro wrist cuffs were also fastened to keep my hands / arms restrained.

I chose local anesthesia only and no sedative. The anesthesia shot was very very painful!! Excruciating, sharp pain for a good minute for each eye. It was the worst of it all honestly, even worse than post op pain hours later, after the anesthesia wore off, which was a very dull throb but easily manageable.

Most of the operating time was spent cutting / separating muscle to access the fat compartments below, lower down in the orbital. Lots of vascular bleeding so he was cauterizing (burning) as he went to control the bleeding. Smelled burning flesh much of the time. This was most of the procedure. He also hit a capillary, he informed me, and thus lots of bleeding on left side.

He also "released fascia" (I think he pulled it? at least I felt a pull...) to fill the gap / void I had, which was a little sunken space below the fat bags but above the bone structure. The idea being it would smooth out to be even months later.

So he described in detail as he worked. At the end, he showed me all the fat that was removed from each eye and from each compartment... middle, medial, and lateral. He had neatly created 6 distinct piles of fat in a grid on the gauze he used to show me the fat he removed. Proof of my money spent. Oddly satisfying.

Immediately after I had severe discoloration from internal bleeding. All normal, especially with the capillary opening on my left eye.

I was wheeled into (via wheelchair) a post op room and laid on a gurney with ice packs on my eyes for an hour before being given meds and leaving.

Received all meds free, included in the 30,000 baht price. Had to buy the ice pack for 200 baht though (Really?).

Was able to walk out of the hospital and was quite lucid and normal since I skipped the sedative. I went to eat actually. Just outside Yanhee is a great little food market area that feeds the hospital staff. 40 baht meals! drinks too...

So we will see how it heals and perhaps in time I will respond here to let you all know how it ended up.

The take away is, you get what you put into this experience. Make some effort and get involved with your decision to feel comfortable in your decision.