Is a virtual consultation enough for rhinoplasty?

But it has to be an excellent virtual consultation. (I'll base my answer on how we handle our out-of-town and out-of-country patients.)If you live outside of the United States, for example, and want to have surgery in the US, it's terribly impractical, and unnecessary, to narrow your choice of surgeons by traveling all across the US, visiting doctors in person. In this field, you can see who might be excellent by seeing his before and after photos.Then, you send your photos to the doctor, along with your comments. The doctor makes some morphs, to show what he thinks is possible with surgery in his hands.You look at his before and after photos, to see whether he has been able to accomplish for others what you want for yourself.And more. See the "Learn more" link at the bottom of my post.If the changes seem, from the photos, to be meaningfully large enough, and predictable enough, the surgeon schedules an operation for you, with an in-person consultation the day before surgery. At that consultation, both you and the surgeon have veto powers over going ahead with surgery the next day. The surgeon might decline, because on physical exam he doesn't think he can make the changes he hoped. You might decline because of any number of reasons. I do this all the time, and we have never failed to go to surgery the next day, probably because of making reasonable decisions of when we make arrangements like this.So it's a combination of the virtual consultation and the in-person consult after surgery has been scheduled. You can also use the virtual consultation just to narrow down your choices, and then have fewer doctors to go visit.Be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon, and how to tell whether your previous surgeon should be performing your revision. You should only have surgery if you are able to make yourself very confident in your surgeon's skills. Read that page very carefully. Most plastic surgeons are quite poor at this operation, and I believe my advice will go a long way toward keeping you safe.
As I mentioned, I usually make computer morphs when I'm answering questions like this, to show the changes that are possible for a nose with a rhinoplasty, but of course you didn't post photos with your question. At the *very* bottom of the "Learn more" page is a link to instructions on taking and sending photos that are comprehensive and useful for an online consultation like this, in case you'd like a more complete evaluation.

Thank you for sharing your question. While a virtual consultation is a great way to gain more information about rhinoplasty and to learn about your candidacy for the procedure, an in-person evaluation is strongly recommended prior to surgery.  There are many reasons it is important to have an in-person consultation. For example, if you also have breathing or sinus problems, a CT scan may be recommended to determine if any medical/functional procedures need to be performed in tandem with your rhinoplasty. I also like to use 3D morphs in my practice to communicate realistic surgical outcomes to my patients. This is best done in person so that they photos are accurate and a discussion can be had regarding the desired aesthetic. Most surgeons will require an in-person pre-operative appointment within a week or so of your procedure. This is a good time for you and your doctor to finalize the treatment plan and make sure all of your questions are answered. Best of luck, Dr. Kian. 

A virtual consultation is a good start in terms of getting advice on what may work for you in regard to rhinoplasty.  Sometimes traveling is the best option to seek care from a surgeon you feel will do the very best operation for you and you feel most comfortable with.  However, there is no substitute for an in-person consultation.  If you are happy with the virtual discussion with your potential surgeon and decide you want to go forward with surgery, be sure to meet with him/her in the office at least the day before surgery as a formal consultation to discuss everything in greater detail with a complete physical examination.  You may consider traveling even more in advance to be sure you are satisfied with everything and had enough time to discuss with the surgeon face-to-face before going forward.  This will allow the surgeon to thoroughly
examine the inside and outside of your nose from different angles, feel the
tissues, better understand your goals, and make more specific recommendations
to achieve the natural look your desire.
Also, be sure to have a plan in mind for adequate follow-up and what you will do if longer close follow-up is needed in the case of an unexpected outcome.  I would caution against medical tourism in which you do not meet your surgeon until it is time to go to the operating room, especially on an extremely intricate and complex procedure such as rhinoplasty.  Best of luck.
Ziyad Hammoudeh, MD