Is This Surgeon Being Realistic or is He Letting Me Down in Advance? (photo)

10 months ago,I got headbutted in the nose.My right middle valve (shown in top picture; 2nd pic is my old nose) collapsed.My nose still hurts from time to time.I consulted a board certified sub specialist.When asked if he could give me my old nose back,he said,"I will do my best.It's like taking a test.No matter how much you study,you do not always get an A." He also said "imagine a broken vase.Even after you glue it,it's never like the way it was before." I am scared to have the surgery now.

Doctor Answers 8

Predicting outcome in rhinoplasty.

Thank you for the photos.  It appears that the "old nose" photo is a computer simulation obtained by manipulating the "current nose" photo and therefore represents the target that surgery is aimed at.  I think that this is a realistic goal, particularly if there is no  nasal obstruction associated with the upper lateral cartilage collapse that also needs to be addressed.  The result will be much improved although may not be exactly like the photo provided.

Mario J. Imola, MD, DDS, FRCSC.



Denver Facial Plastic Surgeon
4.8 out of 5 stars 117 reviews

Honesty with rhinoplasty

It does not sound like your surgeon has said anything untrue or unrealistic.  Try not to focus on the old nose but the type of correction you want to have with your current nose.  There are a lot of manipulations and adjustments that can be done to change the shape and appearance of your nose.  Discuss the type of changes you would like to do with your current nose and hope for the best.

Best Wishes

Dr. Peterson

Marcus L. Peterson, MD
Saint George Plastic Surgeon
4.6 out of 5 stars 38 reviews

Surgeon Being Realistic

Yes, he appears to be realistic in that he promises you that he will give it his best effort but is honest enough to admit the results cannot be guaranteed


Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Realistic Rhinoplasty Results

What the surgeon was saying is both accurate and appropriate. While the goal of the surgery is the best result possible, you can rarely get someone back to exactly the way they looked before the injury. He was simply adjusting your expectations so they are realistic. That way if you proceed with surgery, you will not be disappointed. You should only undergo surgery if you can live with improvement and not perfection. You, like the surgeon, want perfection but it does not always happen even in the best of hands and with the most thought out plan.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Sounds like an honest surgeon

The surgeon you saw sounds like an honest surgeon and was correct in his evaluation. If you are unhappy with the way your nose is now you should not be afraid to have the surgery done. Make sure you see a board certified surgeon in plastic surgery or facial plastic surgeon that specializes in rhinoplasty and will be able to show you pictures of his previous work!


Best of luck! 

Rhinoplasty after trauma: getting your old nose back

While what your surgeon has told you is responsible, there is no reason why you cant end up with a very similar or subtly improved nasal appearance compared to your pre-injury nose.  Although I cannot give a complete evaluation without seeing your entire face, The primary problem appears to be a disjucnction of your cartilagenous and bony nose resulting in a collapsed midvault and obstructed internal nasal valve.  This problem can be easily corrected with a grafting technique from your nasal septum called spreader grafts.  A word to the wise : avoid an open approach to this rhinoplasty.  you will be assured at least a year of risidual swelling if the columella is cut(the difference beteween an open and closed approach).  A closed approach will yield better aesthetics, no signs of surgery and a more rapid recovery.  I hope this helps!



All the best,


Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Physician
4.9 out of 5 stars 75 reviews

Rhinoplasty and Honesty

An ethical Surgeon should try to under-promise and over-deliver, especially with a challenging surgery like Rhinoplasty.  I think the advice you received is honest and your Surgeon shows wisdom in avoiding guarantees.  The most important factor in results is the experience of the Surgeon.  This has nothing to do with the approach, which can be open or closed.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 95 reviews

Honesty from your surgeon

Your surgeon is totally right - you cannot have "your old nose back."  All he can do is the best he can to make it better.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.