Will my Surgeon Be More Likely to Do a Better Job on my Rhinoplasty if I'm His First Surgery of the Day or the Last?

As you can see from the answers, it totally depends on the surgeon. Some surgeons feel they can deliver consistently good results whether first thing in the morning, or last surgery of the day. Others have a strong preference on what time of day they operate. Personally I will only schedule surgery if I feel like I can give it my best, no matter what time it is starting. If I have a difficult or long surgery, I prefer to schedule it first thing in the morning. I prefer to do a combination of complex and simple cases on any given day, rather than multiple long complex cases in one day. It depends on what your surgeon is accustomed to, and what he or she prefers.

 

some doctors like to operate in the morning and see patients in the afternoon.  Others prefer to operate all day.  I find that those that choose the later typically do so because they are so energized from the surgery that they can do several in a day.  If they are as good as you think, then they will not over commit and perform more surgeries than they feel comfortable doing.  

Every surgeon will have his or her own answer to this question, and each of us will likely be different. Some surgeons actually do prefer their longest or more difficult cases to be first or last, since there are mental and physical challenges with each and every operation, no matter how "routine" or "easy." It just depends on how you wish to address them, and whether or not you prefer to be "done" after a hard case, or get the difficulty out of your mind so you can concentrate on the subsequent "easy" work.

In fact, I would suggest that there IS no "easy" case--each patient deserves our utmost attention to detail no matter if it's a mole removal or a lower body lift!

I've been asked this question for as many years as I have been a surgeon (31 since medical school graduation and the start of my surgical residency). And I've truthfully answered that for the first case the patient gets me when I'm "fresh." The last patient of the day gets me when I'm "warmed up." Adrenaline and focus still make me as good on my last case as my first, but I do sometimes arrive  home exhausted. It helps if your surgeon has the capacity to compartmentalize each patient's issues rather than dwell or "stew" on them, because this is one trait that could intrude on another patient's care. I compartmentalize fully between each case, but that's just me.

Ask your surgeon--he or she has been asked this before, and will have an answer ready. Then you can decide where you want to be in the rotation!

In my opinion a rhinoplasty should be treated as a complex precision oriented sugery.   Good rhinoplasty requires a significant degree of attention to detail and focus.  If your surgeon beleives he/she can do a good job as the first or last case that sounds reasonable.  Perhaps you coudl ask your surgeon when he/she would schedule a family member or friend.

The maximum number of nose jobs I will schedule for a morning is three. As long as your surgeon is expert at rhinoplasty, you should be fine if your case is within the first three of the day. 

Rhinoplasty may take around two hours, and after 6 hours of intense concentration (3 cases), I'm ready to leave the surgicenter. Other surgeons may have different levels of mental stamina: this commentary is based on my personal preference.

Hope this helps.

Dr. Joseph

Competent rhinoplasty surgeons should perform well throughout the day regardless of the first or the last rhinoplasty of the day.  The timing of the surgery during the day has no effect on the results of the rhinoplasty in a very experienced rhinoplasty surgeon’s hands.

Dear Rhandy:

You are not the first patient to raise this issue.  The most specialized nasal surgeons often will operate on several noses in a given surgical day.  They never want to operate tired.  Yes, some patients believe it is best that they be the first case of the day because the surgeon is “fresh”.  Other patients believe it is best to be in the middle or the end of the operating schedule because the surgeon and his team are “well practiced”. 

Do not worry about that.  What you should be concerned about is that you are a good candidate for rhinoplasty surgery and that the cosmetic plastic surgeon you pick is highly specialized.  That would be a surgeon who majors in nasal surgery; not a once-a-month rhinoplasty surgeon, but ideally at least one or two a week.

Robert Kotler, MD, FACS
Facial Plastic Surgeon
Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
Author, THE ESSENTIAL COSMETIC SURGERY COMPANION

I do not think it matters what number case you are in the day.  To me, I take a break between cases and I an re-charged between.

Actually, according to studies done in a variety of fields of surgery there was no difference in complications between the first and last case.  Now that doesn't mean you can't have a preference.  Personally, if I have a long and a short case, I would do the short case first, but every surgeon has their own preferences.  Discuss your concerns with your plastic surgeon.

I'm completely agree with you.

Not only for the fact of being "the first", but there is important the fact that "cortisol" (an hormone that everybody excrete 90 min. post awakening, makes the difference -not only in your surgeons "hands"- but in your response to a nose surgery (a surgery).

Ten years ago I used to operate 3-4 rhinoplasties in the same morning. Nowedays, one day, ONE NOSE!