Rhinoplasty - why do some surgeons seem to do the same nose for everyone?

I remember growing up with similar memories. There were surgeons in my  area that did very "cookie cutter" type procedures.  Everyone had an over-resected looking button nose. Unfortunately, this often left the person as a "nasal cripple" in terms of function. That is to say, they could not breathe.  

My goal is to provide a patient with a natural aesthetically-pleasing looking nose but as importantly maintain excellent function.  And, I would like to think that the majority of my colleagues want the same.  I don't know why some may still perform the cookie cutter approach, but it is like a shoe maker, not everyone wears the same size or style shoe, and you have to accomodate and change your ways to provide the best possible result for very different situations.

There is no one perfect nose which works for everyone.  Modern Rhinoplasty techniques are all quite different so that each Rhinoplasty surgery is tailored to fit the patient’s unique facial features.  Many years ago there were not as many techniques available to surgeons, so that many noses did look the same.

Some rhinoplasty surgeons have made great careers (and lots of money) out of a particular looking nose. Years ago, having a rhinoplasty was a "status" symbol. In the early years of rhinoplasty, patients and their surgeons actually wanted the nose to look "done".

When "all the noses look the same afterward" there is an obvious "done" look to the nose. The technique used is usually the same without regard for the individuality of the nose with relation to the other facial features. The local surgeon who you speak about above has patients who notice his/her "done nose job" and want that look.

In my opinion, today's beautiful nose gets out of the way of the other facial features so that the focus of attention is drawn towards the eyes. Ideally, one should not be able to tell that someone has had a rhinoplasty; it should look natural and fit the individual face. This requires making a diagnosis of what is distracting about the nose, creating a unique surgical plan, and carrying it out.

I agree with your friend that I would stay away from the cookie-cutter rhinoplasty surgeon, unless you like that "done" look.

The information your friend gave you about the local surgeon can either be a positive or a negative review, depending on your perspective.

Rhinoplasty is one of the most challenging operations in plastic surgery. Everyone's nose is structurally different and there are certain apects of healing that can not be controlled by the operation itself. Short and long term outcomes in the same patient can be different, depending on how healing progresses, what the original nose looked like, and what was done to change it.

Every plastic surgeon is guided by their own personal sense of aesthetics, the specific techniques they like to use, the desires of their patients, and current trends within the field of plastic surgery and fashion. Plastic surgeons also strive for consistency in their results, so they can provide patients with accurate projections of their outcome. This can sometimes result in a surgeon having a certain look to their noses if they tend to use the same techniques over and over again. This repeated use of similar techniques is often a reflection of a surgeon's confidence in achieving a particular outcome, rather than a lack of experience or creativity.

While plastic surgery is becoming more individualized and natural appearing, it is still critically important to provide patients with consistent outcomes and realistic results. That is likely why your local surgeon produces similar noses: he or she has a particular technique that they feel very confident in using.

With all that in mind, the most important question is this: Do you like the noses that this surgeon is creating? If the answer is yes, then schedule a consultation and ask to see before and after photos. Try to see if the other patients appear to have problems that are similar to yours. If a similar nose is not obvious, then ask the surgeon to show you someone that represents your likely outcome.

• If the surgeon does computer imaging, then have that done and see if the projection is similar to your aesthetic goal.
• Then ask if he or she will show you other patient's computer imaging and outcomes to see if they are closely matched.

If you don't like the nose that this surgeon is producing, then find another surgeon. Either ask around or look on line for the names of other physicians. There are many before and after photos on the web, which will demonstrate to you the wide variety of outcomes that are possible.

Many surgeons, like myself, take an individualized approach to rhinoplasty. This philosophy should be reflected in their website and in the office consultation. Doing all of this research will help to educate you about the procedure, refine your goals, and help in achieving the result you desire.