How does one choose a good rhinoplasty surgeon?

The choice of who to go with for a rhinoplasty is a personal one. I would recommend a surgeon who does a fair number of these procedures whether it be a board certified facial plastic surgeon or a general plastic surgeon. To me, I would find out what their revision rate is and whether or not they are comfortable performing revisions themselves. The best surgeons in my opinion are capable of doing not only the easy noses but the more complex ones as well. Finally, even the best surgeons in the country will have to do revisions on their patients as no one can guarantee a perfect result or that everyone will heal exactly the same way. Anyone or surgeon who tells you otherwise is most likely embellishing the truth. I hope this information helps.

Hello! Thank you for your question.  Cost will vary among plastic surgeons as well as with geographic location and what procedures exactly they will be providing to you.  Certainly, researching a board certified plastic surgeon well-versed in the procedure(s) you desire is recommended - checking the American Board of Plastic Surgery is a great start. Consult with two or more surgeons who you are happy with their postoperative photographs and those who you, most importantly, feel comfortable and confident with. Use the opportunity to ask questions as well as visit with staff and investigate the accredited facilities they work out of.  I believe fellowship-training, beyond the core plastic surgery residency to be important, as that surgeon has gone above and beyond to seek additional training specific to that area of interest and chosen to gain additional expertise in that area.   Experience should not be measured solely by the age of the surgeon or how many years s/he has been in practice.  Checking the education and training is more valuable - a Board Certified MD plastic surgeon who was accepted to and completed an integrated plastic surgery residency, in today's day and age, are excellent choices. Those are the top students who have superior training at top institutes.  Plastic Surgery is NOT a fellowship...it is a residency. Those surgeons who have actually successfully completed additional fellowship training beyond the plastic surgery residency are also passionate about that area and will likely have the most recent, innovative, and up to date techniques. These are usually the younger surgeons, who are still readily willing and competent to continue to strive for the newest material and remain up to date on literature and conferences. You must decide for yourself who you are most comfortable with and confident with who will meet your goals and expectations. Cost may differ just on expertise and the aforementioned additional training ad what that additional expertise training has afforded to his/her patients.  Hope that this helps!  Best  wishes!

Dear rhinoplasty patient from Leesburg, VA,
Having a good nose job requires a nose specialist and a skilled surgeon. You also want to take into account whether you feel comfortable with the surgeon, as well as the doctor's experience and other qualifications. Always choose a board certified facial plastic or plastic surgeon with experience in rhinoplasty. Be sure to check his before and after pictures to get a feel for the results the doctor has previously produced for other patients.
 

Hi N,

Great question, and the most important aspect of rhinoplasty from a patient's perspective.  It always amazes me that some patients take more time picking out the color of their car than they do in selecting their rhinoplasty surgeon.  When asked, “What should I look for when choosing a rhinoplasty surgeon?” I reply, “The Eye, the Hand, and the Heart”. “Eye” refers to the artistic ability to evaluate the nose and diagnose what is required to restore balance and harmony with a natural un-operated upon appearance. One needs to have a vision of natural, “average” nose. Beautiful, attractive faces are made up of the combination of average features. The nose should get out of the way of your eyes, lips, and cheek and jaw line contours. “Hand” is the ability to perform the sculpting necessary in a precise, safe, and effective manner with a skilled and soft gentle touch. “Heart” is caring about patients with uncommon professional passion and commitment to excellence. This involves close follow up care. These attributes can be used in all walks of life, no matter what your profession or job may be. Exceptional individuals have a vision of the future, ability to carry out the necessary physical steps, and passion coupled with commitment to achieve their client’s goals. When choosing your rhinoplasty surgeon (or any other service), put your trust in those who have “the Eye, the Hand, and the Heart” that is right for you. That having been said, take your time; have multiple consultations, look at before and after pictures carefully. Make sure that they are board certified in plastic surgery, facial plastic surgery, or ENT. Good luck and be well. Dr. P

 

In no particular order, here are the Top 10 qualities I believe a good rhinoplasty surgeon should have:


They are a passionate student of Rhinoplasty surgery

Communicate intently to learn about your goals

Are able to convincingly see the subtleties within your nasal anatomy (not just a hump)

Knows their limitations and is able to gage the complexity of a potential operation for you in terms of their personal experience with similar rhinoplasties

Is able to show pictures of their own operative patients that clearly demonstrate the types of changes that they are recommending for you

Understands that evaluating the "starting point" of your nose is the critical first step in evaluating options for reducing or adding to the back of your nose

Has an excellent understanding of nasal function and how rhinoplasty relates to changes in breathing

Is able to accurately relate back to you precisely what you see in your nose, educate you as to the underlying structures that cause this, and is able to educate you on options for making changes

Is not the cheapest surgeon in town (a decision based on price alone may well be the most expensive mistake you can make)

Is not too anxious about taking you on as a patient. A good surgeon will be cautious in evaluating your motivations, expectations and understanding of what they are seeing before they agree to take you as a patient



Extra credit -- I have a personal bias against using implants in the nose, as they have a higher risk of infection than your own tissues. I believe that the extra time I spend obtaining graft material from your own body is well worth the investment and the lower rate of visibility and complications over time.


Hope this helps.

Nick Slenkovich MD, FACS

Find a surgeon who is very experienced and makes the kind of noses you like, since that is the ultimate means of getting the "best results". Meet with patients the surgeon has done. We have our patients meet with other patients who are in the office that day since we have been doing noses for 35 years. Patients that like "natural" noses come to us and Patients that like a more turned up nose go elsewhere.

Chosing the right rhinoplasty surgeon can seem to be an insurmountable task. Here are some things to consider:

1. Find a surgeon who is board certified to perform rhinoplasty surgery. This would involve either a board certified facial plastic surgeon, plastic surgeon or otolaryngologist.

2. Find a surgeon who is experienced in performing rhinoplasty. Just because someone is board certified to do a certain procedure doesn't mean that they are very proficient at it or get good results. Rhinoplasty is a very difficult operation to master.

3. Find a surgeon who enjoys performing rhinoplasty. You'll find that among plastic surgeons some of us have developed a niche as rhinoplasty specialists. This is often a good indicator that the surgeon has a talent for the procedure, does a lot of them, or both.

4. Do you like the surgeon's posted before and after surgery results? Like it or not, some rhinoplasty surgeon's results can begin to look surprisingly similar. Some of this is based on their aesthetic, but it can also be related to the fact that they do the same maneuvers during the procedure no matter what. A surgeon can have a lot of experience, perform lots of rhinoplasty cases a year, but if you don't like how the noses tend to look, then you probably want to look elsewhere.

5. Have more than one consultation. Meeting a potential surgeon for a consultation where your concerns are discussed, options outlined and computer morphing performed is invaluable. This is where you can best get a sense of whether you trust the surgeon to do your surgery. Based on your nasal issues you'll probably also be able to see before and after patient photos similar to your own nose (that may not be available on the physician website).

6. Finding reviews on specific surgeons is fraught with bias (either good or bad) so it's not as easy as looking up a product in consumer reports to get a rating. If you're considering surgery with a specific surgeon ask to speak to prior patients and/or read patient testimonials. Certainly, having friends who have had surgery in the past is also a great way to find the right surgeon.

There are many ways to find the right Rhinoplasty surgeon for you and it can be a daunting task initially.

However, if you clearly define your goals early on in the process, that can be a great help.

Every Rhinoplasty surgeon has their own variations in technique as well as personal aesthetic. This will translate into a consistency in their results. There are often subtle differences between outcomes when comparing different surgeons. You should have a sense of how you would like your nose to look before you intestigate and go for a consultation. Also, the nose is a dynamic and functional part of the body, so it is important to define whether that issue is important. There are also financial considerations to consider.

When you think those issues through, then start to look online and visit websites. Look at the photo galleries to see how that surgeon's results are typically. Remember that what is posted online is usually what that particular surgeon feels is a great result. Ask friends of family members for a recommendation but DO YOUR OWN RESEARCH. While a personal recommendation is probably the best and most valid information you can receive, your personal goals and aesthetic may be different from that person. If that person is the patient, be quietly critical of their result and pass if you don't like it.

Consider function and whether that will translate into some insurance based work. Research whether that doctor is participating or non-participating with your plan. That can make a big difference in cost.

Finally, go for a consultation and make sure you feel comfortable. You should have a sense of trust when you leave and feel that your concerns or questions were answered. Pay attention to whether the doctor or their staff spends the most time with you. That usually represents what will happen after surgery too.

Best of luck

Check to see if they are board certified. The ABPS and the ABFPS are two certifications to look for. However, board certification alone does not provide assurance the doctor is an expert at rhinoplasty. This operation requires lots of experience. See the doctors before and after photos of HIS or HER own patients. Some doctors may allow you to speak to some of their patients.

Look for a surgeon who is certified in ear, nose, and throat surgery so that they understand the functional portion of the nose, i.e., breathing dynamics. Search for a surgeon who has completed an additional fellowship or residency in facial plastic surgery and is board certified by the Medical Board of Facial Plastic Surgeons. Find a surgeon who has performed thousands of rhinoplasty surgeries and has demonstrated in their office a before and after photo gallery or on their web site. Even in the hands of an experienced rhinoplasty surgeon, the touchup rate is still approximately 10%. It is important to make sure that your surgery will take place in a center that is certified by one of the main accrediting agencies, such as Medicare, and that a board certified physician anesthesiologist will be in your attendance during your anesthesia. Also, look for a surgeon you have good repoire and clear communication with. It is also important that the patient has realistic expectations going in to this type of surgery.