I assume that you have already done a reasonable amount of research on the front end prior to your consultation. You shouldn't be sitting in the consultation chair unless you have already confirmed that the doctor has the proper specialty training and credentials required, and also has a good reputation in the community. During the consultation it is important to determine if rhinoplasty has been, and continues to be, a major part of the doctor's practice. Rhinoplasty is the most challenging cosmetic procedure and requires a career long commitment to excellence. Many plastic surgeons make a living performing breast and body surgery. You want to avoid the 'occasional' rhinoplasty surgeon. The doctor should listen carefully to your concerns and be able to explain the procedure to your satisfaction. I believe that computer images are helpful to make certain that you and your doctor share the same intentions. You should look at a good number of before and after photographs (of the doctor's prior patients) to see if you share their aesthetic taste and to confirm that the doctor can achieve consistent good results in a variety of patients. You should also assess the office staff and nurses to see how you will be treated over the course of your recovery. Finally you should receive a quote for your procedure and you should find out how the practice handles minor complications or the need for a revision procedure.
What Should I Ask my Doctor During Rhinoplasty Consultation?
Doctor Answers 32
The Rhinoplasty Consultation Explained
Questions to ask your rhinoplasty surgeon
1. What board are you certified by and what societies are you a member of? Plastic surgeons should be certified by the American Board of Plastic Surgery and members of the American Society of Plastic Surgeons.
2. How many rhinoplasty surgeries have you performed in the last year?
3. Have you had to perform any revisions to your own work and if so, do you charge additional fees for that?
4. Can I see before and after pictures of several previous patients?
5. Do you think my expectations are realistic and achievable?
You want to make sure your potential surgeon is honest and that he or she cares about you. You should be able to tell within a few minutes just based on the interpersonal interaction. This is an important choice. Don't be afraid to ask about anything that is on your mind.
Questions to Ask Your Plastic Surgeon About Rhinoplasty
Questions to Ask Your Plastic Surgeon Before Rhinoplasty Surgery
Credentials and Experience
Are you board certified? If so, by what board and for how long?
Have you ever been disciplined by the board or by the state?
How many rhinoplasties have you performed?
How many revisions of your own work, on average, do you have to perform?
How many rhinoplasties do you perform on average, annually?
Can I look at a portfolio of before-and-after photos, and not just your perfect ones?
May I speak with any of patients who have had rhinoplasty by you?
Preparation and Recovery
Would there be any reason that I would not be a good candidate for a rhinoplasty?
What are the complications for rhinoplasty?
How far in advance is it necessary to schedule a surgery date?
How long do you recommend I take off from work, school, etc. to heal properly?
What medications will I be given; which pain medications do you normally prescribe?
What tips do you have for me to ease some discomfort and pain?
After surgery, will my nose be packed? With what type of packing? For how long?
When should I expect to look "normal" again?
Will I have scarring? If so, how bad will it be?
Must I follow any special diet, both preoperatively and postoperatively?
I wear eyeglasses. Will I be able to wear them the day after surgery on top of the cast? When can I wear my glasses normally?
I take (birth control, diet pills, antidepressants, etc.). Will I have any adverse reactions from the prescribed medications or anesthesia?
What are your routines and appointments for postoperative care?
If I will need sutures, when will they be taken out?
If I need anything after-hours after the surgery, how can I get in touch with you or your staff?
If I have an emergency the night after surgery, what should I do?
If such an emergency arises, will you be the attending physician?
How long after the surgery will I be able to exercise, run, or participate in contact sports?
Technique and Anesthesia
What kind of anesthesia do you use for rhinoplasty? Why?
Do you offer any other anesthesia options?
Who will administer anesthesia and what are that person's credentials?
What structural changes to my nose will you need to do?
Will I need a graft? If so, what kind?
Do you prefer to perform your procedures open or closed? Why?
Where will the surgery be performed?
If the surgery will not be done in a hospital, is the surgery center or suite accredited?
Do you have hospital privileges and, if so, at what hospitals?
If you don't have hospital privileges, why not?
Do you believe my expectations can be met?
What if I have a complication?
If my results are not what I wanted, what is your policy on a revision?
What if I change my mind and back out, will my money be refunded?
Are there any other costs for lab work, postoperative check-ups, prescriptions/medications?
Do you offer financing?
When is payment due?
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Things you should ask during a rhinoplasty consultation
1. Are you board-certified?
2. How many rhinoplasties have you done?
3. Do you do a lot of revision rhinoplasty?
4. Do you have computer modeling to discuss what my nose may look like?
5. Do you have pictures of other patients you have done?
6. Do you have references I can get in touch with?
7. Where do you operate? Is it accredited? Who does your anesthesia? Are they board-certified?
8. How long do you think my case will take?
9. Can I have copies of my preoperative and postoperative instructions?
"Form and Function"
The two main considerations to be addressed in nasal surgery are form and function. Rhinoplasty alone looks principally at form. The elements to be considered when looking at the form of the nose include:
• the shape of the nasal dorsum- correction of a dorsal nasal hump is perhaps the most common goal in Rhinoplasty surgery
• The width and contour – is it straight, symmetric, boxy, or bulbous?
• The distance that the nose protrudes from the face, known as “projection”
• The length of the nose- this commonly contributes to the appearance of a nose that is either too big or too small for the face.
• The angle of the junction between the nose and the upper lip, known as “rotation”.
When both form and function are considered in nasal surgery, the procedure is known as Septorhinoplasty. The Septoplasty portion of the nasal surgery refers to correction of any abnormality of the tissue that divides the left side of the nose from the right side- known as the nasal septum. Functional nasal surgery can also be used to minimize the size of swollen intranasal turbinates (on the outer sides of the nasal wall), or to address collapse of the side walls of the nose during breathing, known as “nasal valve collapse”.
It is important to ask any plastic surgeon before...
- It is important to ask any plastic surgeon before rhinoplasty how many procedures he performs a year (usually 50 or more a year).
- Rhinoplasty is one of the most difficult operations in plastic surgery, and the risk of complications and poor results is less in surgeons who specialize in this area.
- Doctors who specialize on facial plastic surgery and rhinoplasty are Board Certified by the American Board of Facial Plastic and Reconstructibve Surgery (www.abfprs.org) and members of the American Academy of Facial Plastic and Reconstructive Surgery (www.aafprs.org).
- Another question that you should ask a plastic surgeon is the approach he uses.
- There is a closed approach in rhinoplasty which has all internal incisions and an open approach that involves a small external incision under the nose that requires 3 fine sutures to close.
- Any good rhinoplasty surgeon should employ both approaches.
- Certain changes in rhinoplasty require a closed approach and more extensive rhinoplasties, such as revision rhinoplasty or rhinoplasty requiring a lot of nasal tip modification, require an open approach.
Questions to ask your rhinoplasty surgeon.
- Is the surgeon board-certified in plastic surgery? This is perhaps the most important question you can ask. Some surgeons are board-certified, but in non-surgical cosmetic procedures or even in other areas, such as ear, nose and throat. These doctors sometimes say that they are “cosmetic surgeons” but they lack the intense training and specific skills that the plastic surgeon may offer. Make sure to ask if the doctor is certified with the America Board of Plastic Surgeons and a member of the American Society of Plastic Surgeons.
- Ask to see the doctor’s board certification document. A board-certified plastic surgeon will be happy to show you their certification. Other doctors, when asked, will tell you why it doesn’t matter and their certification is just as good. A certificate from The American Board of Plastic Surgery is the real thing. A doctor with a certificate from the “American Board of Cosmetic Surgeons” is not a plastic surgeon. 10% of our practice is occupied with fixing the results of bad surgical work by people with insufficient training.
- Has the doctor had fellowship training in breast surgery? After four years of medical school and a four year residency, the best plastic surgeons then have fellowship training in breast surgery. This is the kind of doctor you want to be operating on you.
- Does the surgeon specialize in rhinoplasty?This may sound like an obvious question, but there are surgeons out there who just do everything and do not have a lot of experience in nose surgery.
- Ask the doctor how long they have been in practice.
- Ask how many rhinoplasty surgeries they have performed.
- Ask the doctor why they became a plastic surgeon.
- Which hospitals they are affiliated with? In case of an emergency, which hospital will they refer you to and who will take care of you? Some doctors may just turn you over to the emergency room because they have no relationship with a suitable hospital. Doctor Ali would actually continue to assist you, in such a case.
- Ask many questions about the details of the procedure
- About about recovery time.
- Ask to see before and after pictures of work they have done.
- Ask to speak to previous breast surgery patients.
Your Rhinoplasty Consultation
Your pre-surgery consultation is a critically important time to get a feel for your plastic surgeon and achieve a better understanding of how your particular procedure can help you achieve your specific aesthetic goals. Always ask about their board-certification. At a minimum, they should be certified by the American Society of Plastic Surgery (ASPS). Discuss how much experience they have performing your specific procedure and ask to see before & after pictures from their previous surgeries. You should also found out if your plastic surgeon has hospital privileges.
Thank you for your question.
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you may have, medical treatments you have received, previous surgeries including repair of nasal injuries, and medications that you currently take. Your plastic surgeon may also ask whether you have difficulty breathing through your nose, suffer from allergies that may cause nasal stuffiness, or are a chronic user of nasal spray. It is important for you to provide complete information.
In evaluating you for rhinoplasty, your plastic surgeon will conduct a routine and painless examination of your internal nasal structures. Your skin quality as well as the size and shape of your nose and its relationship to your other facial features will be carefully studied. In some instances, your plastic surgeon may recommend surgery of your chin, making it either more or less prominent, to improve facial balance. This procedure can be done at the same time as your rhinoplasty. Best of luck!
Dhaval M. Patel
Double Board Certified