Cookie Cutter Nose Job

Some rhinoplasty surgeons have made great careers (and lots of money) out of a particular looking nose. Years ago, having a rhinoplasty was a "status" symbol. In the early years of rhinoplasty, patients and their surgeons actually wanted the nose to look "done".
When "all the noses look the same afterward" there is an obvious "done" look to the nose. The technique used is usually the same without regard for the individuality of the nose with relation to the other facial features. The local surgeon who you speak about above has patients who notice his/her "done nose job" and want that look.
In my opinion, today's beautiful nose gets out of the way of the other facial features so that the focus of attention is drawn towards the eyes. Ideally, one should not be able to tell that someone has had a rhinoplasty; it should look natural and fit the individual face. This requires making a diagnosis of what is distracting about the nose, creating a unique surgical plan, and carrying it out.
I agree with your friend that I would stay away from the cookie-cutter rhinoplasty surgeon, unless you like that "done" look.

A nose job is a very complex operation and one that is difficult to predict due to the forces of healing and patient to patient variation with wound healing. Once a surgeon gains experience with a technique that provides him/her with a greater degree of reliability, the surgeon will tend to use the same technique over and over to deliver a consistent albeit clone-like outcome.

My personal philosophy when it comes to rhinoplasty is to create noses which are well balanced, functional, and blend with the other features of the face. There is no single best nasal shape which is appropriate for every individual. So many factors come into play, including gender, ethnicity, age, height, chin projection, facial shape, skin thickness, and most importantly, individual aesthetic desires.

The best way I have found for patients to communicate their aesthetic sense to me during the consultation is through the use of computer imaging. I spend quite a lot of time with patients during this process to create a shared cosmetic goal and then use the images during surgery as a guide to indicate when the surgery has been completed. It also allows me to communicate in visual form what I feel is a realistic goal in primary and revision rhinoplasty, given the patient's anatomy and all the factors I mentioned above.

I would advise you to seek out surgeons who offer this computer imaging during the consultation, to ensure that your aesthetic sense is being considered, not just the surgeon's. The ideal endpoint of this or any surgery should be a happy and satisfied patient. 

" Cookie Cutter " noses were more common in the old days. While some surgeons still practice in this fashion, you should consult with several surgeons to see what their aesthetic is. Your gut should tell you when you have found the right one, provided he has a proficient rhinoplasty practice.

The aesthetic goal of rhinoplasty is to improve harmony between one's nose and face so other features (like the eyes) are accentuated. If everyone had the same face, then creating the same nose for everyone would work just fine. But we know this is not the case. Faces, as well as noses, differ so much, so there is no cookie-cutter solution. Performing the same maneuvers for every nose is not appropriate and may indicate a surgeon's limitations or lack of experience. Visit with a surgeon who has extensive rhinoplasty training for a proper evaluation.

Some surgeons can have strikingly similar rhinoplasty results among their patients. This generally occurs if they do the same routine on every patient paying no respect to their actual anatomy, desires or other facial features. 

Tailoring the procedure to the patient leads to a more natural and individual result. I find that by performing preoperative computer morphing with my patients during our consultation we can come to a great mutual understanding of what results the patient desires and what results I think are possible given the patient's specific anatomy.

Some surgeons may have limited background in rhinoplasty, which limits how they can treat the nose.  Surgeons with a wide breadth of rhinoplasty training can address the nose with a variety of techniques to help customize a nose which fits your facial features.  

As you probably have learned by now rhinoplasty is one of the more difficult procedures for a surgeon to master.  Some surgeons are able to perform rhinoplasty in one specific fashion, thus all the noses look the same.  It is imperative that an experienced and talented surgeon thoroughly assess the patient's facial anatomy and proportions, only then an appropriate surgical approach can be planned.  The goals is to create a beautiful nose with nice proportions that face that particular face.  In my practice we offer computer imaging to our prospective rhinoplasty patients, so that the goals and aspirations of the patients can be communicated.  Of course not all surgeons that can created changes on the computer can produce those changes in the operating room.  Pick you rhinoplasty surgeon carefully.

You might find it insightful to read my article "The Art of Sculpting the Nose"  which can be found on my web site under "publications"

It is actually unclear why any plastic surgeon performing rhinoplasty in this day and age would perform the same 'signature' nose job on nearly every patient. The hallmark of good rhinoplasty is a surgical result that doesn't look anything like a surgical result. The final appearance of the nose should be one that looks like the patient could have been born with it.

In order to achieve natural appearing rhinoplasty results like this the surgeon must take into account the surrounding facial features. Since we are all different with regard to facial appearance, you cannot possibly put the same nose on every face and expect to achieve a natural looking, balanced result. Look for a plastic surgeon who specializes in rhinoplasty and revision rhinoplasty and make sure to review plenty of patient photos.

Proper facial aesthetics demands that each nose operation (rhinoplasty) is planned individually. I like to use the computer to make measurements and then correct the nose so the patient can have an idea how things will turn out. Any surgeon who does every rhinoplasty the same way needs a course in facial aesthetics and anatomy.