How to choose a surgeon for a rhinoplasty when they gave you two different procedure options?

Question

I had a consult for a rhinoplasty. I don’t like my droopy tip and small hump on the bridge. I had two different consults, one surgeon said closed and 45 mins, the second said closed at first but when he saw the inspo pics he said 2.5hrs and open. The second doctor seemed to change his mind. And he sent me a simulation photo that I hated, the tip is too pointy. But the first surgeon offered no visuals. How do I choose?

Evan Ransom, MD, FACS · Answer

Thank you for the great question and the photos. It seems like neither of the consultation experiences that you had were ideal. It is important to have a good relationship with your surgeon and to feel comfortable about the details and goals of the procedure beforehand. Without an in-person examination, I can't give specific, detailed advice. However, here are two thoughts: 1) 45 minutes is not enough time to do a good, thoughtful rhinoplasty regardless of approach; 2) the type of changes that your nose may need, based on the photos, are best dealt with (IMHO) with an open approach. So, in summary, I think you should seek another consultation. Best of luck moving forward!

Gurkan Kayabasoglu, MD · Answer

The point you need to be careful while looking for the best surgeon is the time between the before and after photos of your surgeon. The after pictures should be at least 1 years after the operation and you need to be sure that you see too many after photos that are at least 3 years after the operation. You need to seek a professional, experienced board-certified facial plastic surgeon to get the best result. Best Regards

Eric M. Joseph, MD · Answer

Your photos arrear to show a wide nasal appearance on front view and a profile hump. Well performed rhinoplasty may lead to a smaller, less distracting and more feminine nasal appearance. The morphed profile photo shows too much bridge lowering, and a pointy tip. We perform nearly all rhinoplasties with an open approach, and that is what we would offer you. Great question, and keep searching for the closest rhinoplasty specialist near you with a large gallery of B&A photos. Hope this helps! Dr Joseph

Daniel Barrett, MD · Answer

Dear Autumn015,
finding the right Dr. is extremely challenging especially with the number of online platforms and resources available. There a lot of great Dr's available. Make sure he/she is a board-certified plastic surgeon. Definitely check to make sure your choice specializes in the procedure you want and spend the time to read through patient testimonials. There is a number of different sites where you can check for reviews (Realself, yelp, google, etc.).You can always pick up the phone and call around also, find an office you feel comfortable with and set up a few consultations. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Philip S. Schoenfeld, MD, FACS · Answer

With so many surgeons and non surgeons swamping social media with bold claims and fake outcomes it is quite difficult for the consumer to really know who they should be seeing for the best potential outcomes.  Rhinoplasty narrows the field in that you have the opportunity to look at pre and post operative photos and determine if these are the noses that you would like to have.  Giving you a perfect simulation from computer imaging can be misleading.  Your rhinoplasty surgeon needs to present to you realistic expectations of the outcome of your nose.  However, a bad simulation would indicate that your surgeon does not understand what makes a nose look natural and good.  I have yet to meet a patient who cares whether the nose was done closed versus open if the nose does not look good.  You are an attractive young woman and getting your nose done correctly will be transformative.

Zoran Potparic, MD · Answer

Based on these photos, you seem to be excellent candidate for rhinoplasty. Open or closed, it doesn't meter, leave that to a surgeon. Even most experienced plastic surgeons with expertise in rhinoplasty, may prefer one technique to another, for different reason. Also, the fact that one surgeon will do nose surgery in 45 min and other in 2.5 hours does not tell you much about their expertise. Consultation, review of before and after photos and your report with surgeon should be some of the factors about making decision where to go. Good luck.

Jeffrey Joseph, MD, FACS · Answer

Thanks for the question.  I don’t ever recall doing a rhinoplasty in less than 2 hours, so I wouldn’t worry about speed.  I would concern myself with experience and most importantly, results.  Choose someone who gets the best results!

Matthew Bridges, MD, FACS · Answer

Here are my 2 cents....
I agree that the first simulation is not good.   Therefore, i would be concerned about that doctor's aesthetic.  If you are not happy with a simulation, you should not choose the doctor.  I would also say to be very careful with doctors that anyways tout how fast they are. I do only closed rhinoplasty and i don't think I've ever done one in 45 minutes.  I promise you that to properly address your nose, 45 minutes will not be adequate.  There is a patient of mine who posted her 2 week results on Reddit who has a similar nose to yours.  Check it out. By my assessment you need a graft at the root of your nose (radix). Otherwise your bridge will be too low like is shown in the photos.  Your tip needs rotation and protection to keep it from drooping when you smile.  These maneuvers take time.  Generally, the fastest surgeons are not the best...

William Portuese, MD · Answer

Rhinoplasty is the most difficult operation to perform correctly in the entire field of cosmetic surgery,   so it is important to feel comfortable and confident in your surgeon's ability.  1-2 hours of surgical time is all within normal limits.  The closed versus open rhinoplasty debate is only about the approach on how the surgeon gets in the nose, NOT what they are performing.  All  of the maneuvers  to change your nose can be performed with either open or closed technique.  Study your prospective surgeon's before and after  rhinoplasty photos, and make sure that there photo gallery is extensive with results that you like.  Digital computer imaging is important in the communication process, but not guarantee of results.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and photos and if you have concerns go on some more complimentary consultations with experts that use digital photography to show you what can be accomplished with your nose and how it might be done and then look at photos of similar patients and become fully informed about the desired procedure

Dr Corbin

Dr Corbin

How to choose a surgeon for a rhinoplasty when they gave you two different procedure options?

Answers (10)

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