Would an ENT who specializes in rhinoplasty and facial reconstructive surgeon be good enough for a septorhinoplasty?

Question

An ENT who specializes reconstructive plastic surgery, would that be good enough for a septorhinoplasty and open reduction? All I want is my nasal bones to be repositioned in a more symmetrical position and some cartilage added to make up for lost cartilage .

Carey Nease, MD · Answer

That's actually a funny question. Of course, the training we get as facial plastic and reconstructive surgeons make us the most qualified to perform the procedures you are listing as we get the most training during our residency. There are lots of plastic surgeons and even oral/maxillofacial surgeons who would also be qualified. The main question you should ask is "how many of these procedures do you perform each year" and "how long have you been doing them?"

John Michael Thomassen, MD · Answer

Plastic surgeons also perform this procedure.  A more detailed description of your concerns and maybe photos would help determine exactly what would be recommended.

Gianfranco Frojo, MD · Answer

I always recommend a board-certified plastic surgeon with rhinoplasty experience. The difference between ENT and Plastic Surgery is that ENT is a completely different surgical training focused on the ears, internal/external nose, and throat. Plastic surgery is focused on all aspects of the body including the external/internal nose and ears. The most important thing is that you review your surgeon's credentials/training, reviews online, before/after photos, and meet with them in person. I truly think it is critical that you like your surgeon and the surgeon likes you. Rhinoplasty is a long journey and you need to do it with someone who will be there for you and who you actually want to see in the office on the regular visits.

Oakley Smith, MD, FRCSC · Answer

Hi, It is better for you to consult with a ENT, "facial plastic surgeon" who can examine you and give you opinion based on your needs and expectations.

Andrew Miller, MD · Answer

If you are planning a septorhinoplasty, then you need an expert in that procedure who does them every week. This could be an ENT surgeon that specializes in rhinoplasty specifically, not just reconstructive plastic surgery. You must be able to see a lot of photos of his/her work and get a good feeling that this surgery is performed every week, not just once in a while. Same goes for a general plastic surgeon. He or she may be great at breast surgery, but not so great at rhinoplasty. Find an expert or two to consult with.

Lexie Wang, MD · Answer

You definitely want to assess if they are comfortable with doing rhinoplasties. Even though everyone in ENT learns how to do them and esp if she is a FPRS surgeon, noses are not easy surgeries so you want to have someone who really feels comfortable doing them.

Eric M. Joseph, MD · Answer

Your particular question comes up with frequency, and we made a video to address this specific question. Issues to consider are years in practice, frequency of nasal surgeries performed, before and after galleries, and online reviews. I hope this helps. Sincerely, Dr Joseph

Zoran Potparic, MD · Answer

A good rhinoplasty surgeon is a board certified plastic or ENT surgeon, usually. More than nominal speciality it is the experience in rhinoplasty that makes someone an expert. It is always good to check a website with before and after surgery photos to have some idea about level of expertise of particular surgeon; word of mouth as well. Good luck.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. There are many different types of surgeons who can do this procedure, but you should really be going to someone who truly specializes in Rhinoplasty and does this procedure every single day. Here are some general advice when selecting a surgeon.  I highly recommend that my patients focus much more on real longterm before and after photographs rather than 3D imaging.   I encounter so many patients in my practice who see me for revision rhinoplasty who previously had surgery elsewhere who feel like they were mislead into surgery by surgeons who relied heavily on 3D imaging without adequate real before and after pictures to back it up.  Photoshop is easy but real surgery is very different.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag.  If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, that can also be a red flag.   Long-term results are much more meaningful than on table results or 1 week post-op results. 
I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Stephen Prendiville, MD · Answer

Otolaryngology training does include Facial Plastic Surgery, especially aesthetic and functional rhinoplasty.  Some programs emphasize this more than others and some Surgeons have a greater interest and are more adept at Rhinoplasty.  Usually, Otolaryngologists who have a special interest in Facial Plastic Surgery will do a fellowship or at least focus their practices on Facial Plastic Surgery.  I would ask to see examples of that Surgeons work, because there is no such thing as a "simple rhinoplasty"; it is the most complex procedure that we perform.

Would an ENT who specializes in rhinoplasty and facial reconstructive surgeon be good enough for a septorhinoplasty?

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