This varies widely. In an academic institution (university/ medical school), the surgeon will likely be assisted by a resident or fellow. In private practice, many surgeons will be assisted by the surgery center's surgical assistant or surgical first assistant. I have a full time employee that assists me in the operating room as I feel having someone who knows my technique and my patients is well worth the extra expense of employing a surgical assistant. This is a position licensed by the State of Colorado but the rules vary from state to state. If you're considering rhinoplasty, ask your chosen surgeon who will be assisting them. They, obviously, should do your surgery but it might put you at ease to know exactly who else will be helping them in the operating room. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon