Why Do I Always Ask My Patients to Sit Up Before I Design Their Lifting Treatment? (1) - Introduction
(The answer is already in the title.)
By Dr. Bowon Lee (Dr. Bull Fox)
Medical Director, Spring Day Clinic Sinchon
The Difference Isn't the Device—It's the Design
People often ask me a simple question:
"Doctor, why do you always ask me to sit back up after I've already been lying down on the treatment bed?"
It may seem like an unnecessary extra step.
Many clinics begin designing and performing lifting procedures the moment the patient lies down. From a workflow perspective, it's certainly faster and more convenient.
But I don't.
In fact, I intentionally ask every patient to sit upright again before I even pick up the treatment handpiece.
That single decision has become one of the defining principles of my lifting philosophy.
Because no matter how advanced the device is, no machine can replace careful observation, anatomical understanding, and individualized facial design.
A Lifting Procedure Is Not About Firing Energy—It's About Designing a Face
Today, aesthetic medicine has become remarkably standardized.
Patients browse treatment menus on their smartphones almost as if they were shopping online.
- Ultherapy® 300 shots
- Thermage® 600 shots
- Shurink® Special Promotion
Numbers dominate advertisements.
Many people come into the consultation room saying,
"Doctor, I'd like 300 shots of Ultherapy."
Whenever I hear this, I silently remind myself of an important truth:
There is no such thing as a universally perfect number of shots.
Because faces are not manufactured products.
Every patient has:
- different facial proportions,
- different ligament strength,
- different fat distribution,
- different skin thickness,
- different aging patterns,
- and different aesthetic goals.
Even identical twins gradually develop different facial aging because of lifestyle, sleeping habits, muscle activity, weight changes, and gravity.
That is why aesthetic medicine should never become a factory production line.
The Biggest Misconception About Lifting
Many people believe that results come primarily from the device itself.
In reality, the device is only a tool.
A Stradivarius violin does not create beautiful music by itself.
It still requires an experienced violinist.
Ultherapy, Thermage, or any other energy-based device is no different.
The same machine can produce dramatically different outcomes depending on:
- where energy is delivered,
- how energy is distributed,
- how treatment vectors are designed,
- which anatomical structures are targeted,
- and which areas are intentionally avoided.
These decisions are made by the physician—not by the machine.
That is why two patients receiving the exact same number of shots can experience completely different results.
The Problem With "Standardized" Treatments
In high-volume aesthetic clinics, efficiency often becomes the highest priority.
The workflow is usually predictable.
A consultation is completed.
The treatment plan is predetermined.
The patient lies down.
The physician enters.
The device begins.
The required number of shots is delivered.
The treatment ends.
While this approach certainly increases efficiency, it inevitably reduces one critical element:
Individualized facial analysis.
A human face cannot be reduced to a fixed protocol.
One patient may need stronger lifting around the mandibular retaining ligaments.
Another may require conservative treatment to avoid excessive facial hollowing.
Someone with thin cheeks may benefit from preserving facial volume rather than aggressively tightening every region.
Someone with heavy lower-face tissues may require the opposite strategy.
The number of shots alone tells us almost nothing.
The design determines everything.
Every Face Deserves Its Own Blueprint
At Spring Day Clinic, I don't simply perform lifting procedures.
I design them.
Before I begin, I study each patient's facial anatomy as if I were preparing an architectural blueprint.
Where has gravity altered the face?
Which retaining ligaments have weakened?
Where should lifting vectors originate?
Which areas should receive more energy?
Which areas should be intentionally preserved?
Only after answering those questions do I begin treatment.
Because lifting is not simply about tightening tissue.
It is about restoring balance.
It is about respecting each patient's natural anatomy rather than forcing every face into the same template.
And that philosophy begins with one seemingly simple request:
"Please sit up and look straight at me."
That is where the real design starts.