Interns Involved in Rhinoplasty Without Prior Patient Knowledge?

Would an expert Facial Plastic Surgeon allow an intern to perform or be involved in a Rhinoplasty procedure without first consulting the patient? I never saw my surgeon before I went under, and when I came out I was laying there while two interns chatted over me applying my "bandages." I'm concerned they may have been involved in the surgery without my knowledge...

Doctor Answers 6

Interns Involved in Surgery without Patient Knowledge?

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Often times, “expert” and reputable facial plastic surgeons teach other doctors their techniques in rhinoplasty and other cosmetic procedures. By sharing experience and techniques, doctors learn. Doctors may participate by observing, assisting or participating in the overall patient care (such as changing dressings). Unless the patient was made aware and consented to the surgery being performed by others, it is very unlikely that surgery is performed by someone other than the specified surgeon. It is best to discuss your concerns with your surgeon.

Interns Involved in Rhinoplasty Surgery

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It is appropriate for Interns or residents to be present or assist your surgeon during surgery. Because rhinoplasty is a very difficult procedure, I learned a great deal watching senior, practicing surgeons before i ever did my first operation. Although I do everything myself on my patients, a physician in training may do some things such as placing a dressing. Have your surgeon address your concerns.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

"never saw my surgeon before I went under" Rhinoplasty

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With the exception of unexpected OR findings or massive trauma requiring calling in a Plastic surgeon unexpectedly for assistance, I can think of NO situation where a patient should subject herself/himself to being operated on by an unknown surgeon they have not met before. This simply does not happen.

It is also uncommon for surgeons not to see their patients just before surgery. Many of us make a point of standing next to you, often touching your arm in support, as you are being put to sleep because we are the only person a patient knows in the OR suite. Sometimes the anesthesia medications erase recent memory and patients forget what happened just before the operation. I am not saying this is the case here but that this MAY be a possibility.

If you have your surgery in a teaching hospital, the surgeon may be assisted by one or two assistants who facilitate the operation and learn by watching. While small parts of an operation may be done by the assistant, they are not the ones performing the operation. It is unethical and illegal for another surgeon to perform your operation without your consent. This is especially true in complex operations such as a rhinoplasty. On the other hand, the finding of two residents placing the dressing is not proof that your operation was done by one of them.

If you want to know who performed, ask the surgeon.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Assistants in rhinoplasty

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I would not be alarmed. A rhinoplasty is not an operation that is done by an intern but by an experienced plastic or facial plastic surgeon. They may have been adjusting your bandage and they may have been in the surgery ASSISTING by holding retractors and observing your surgeon's work. If you really are concerned why not ask your doctor so you can have peace of mind. Enjoy your new nose!

Rarely do either interns or residents do any real surgery when it comes to rhinoplasty

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Rhinoplasty is a very exacting procedure. I believe that it is very rare for anyone other than your chosen surgeon to be performing your surgery. This can be confirmed with your surgeon before surgery.

An assistant is necessary to hold retractors and cut sutures, though. Personally, I even put on my own dressings and casts since this needs to be done precisely as well.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Role of other surgeon in rhinoplasty

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Typically, at a teaching hospital, there are residents and interns who assist with the surgery, which means that they may hold instruments while they observe the surgery.  It would be very unlikely that they would ever be allowed to perform your surgery.  They also help with minor duties, such as placing dressings and writing orders.  This is always overseen by your surgeon.  I suggest just asking your surgeon about the role of the interns you saw, and he will be able to reassure you on this concern.  Best wishes, /nsn.

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.