Consultation review: Degrading, dehumanizing, and very arrogant.

Treatment Provider

Provider Review

• 28 Apr 2017

I'd describe my consultation for revision rhinoplasty with Kotler as degrading and humiliating. I read reviews of how warm and fuzzy the experience with him is, but that can flip off like a light switch. That's the short version. After a thorough cry about what happened, I composed a long version for those interested: I have a condition that has involved many doctors, as I've moved around a lot. Also, both of my parents are doctors. And I worked for 3 plastic surgeons (also TV "celebrity" doctors). Trust me when I say that I know doctors. Keep that in mind at the end of this post. Positive: his support staff, Mary and the woman who does the imaging (sorry, can't remember her name), were great. You can see in other reviews how scary surgery is. Maybe you already know, and are looking for help fixing some damage. Despite having the means and desire many times over the past decade, I only had the courage to go through with my rhinoplasty last year because I served as a class rep for a $6million class action lawsuit. I earned a fee for working on it for 4yrs, and I felt good about that money. I had a chance to have rhinoplasty when I was younger and needed a septoplasty, but I didn't do it. At the time, an ex who violently tortured me with a knife and threatened to kill me for 3yrs called me some colorful names for even considering it. Only after winning the lawsuit that helped so many people did I feel at peace with doing this for myself. The surgery did not go well. I was crushed. My appointment with Dr. Kotler was sudden, and it was the first revision consult I had, since my original surgeon just cleared me. I rushed to find tools to help me communicate with him as clearly as possible. I hadn't spent the previous 10 mos obsessing over what I wanted. If anything, I avoided thinking about it since I didn't know what would be possible. With my first surgeon, I thought we had a total, mutual understanding of what the plan was. Not only was nothing from that plan accomplished, he made everything I disliked about my nose worse. When the imager at Kotler's office saw my before/after photos, she said, "THAT'S your AFTER photo?!" It's truly awful. And Kotler agreed. He took one look at my nose and essentially said, "Yep, that's bad. And I know how to fix it." He often interrupted as I talked, and it became clear that this is because he views himself as an Ultimate Authority on rhinoplasties. Ok, great. I get it. I told him about my decision not to have rhinoplasty when I was younger, and how traumatic this disaster has been. He gave a "you've come to the right place" vibe, along with a spiel about how I need a "superspecialist", i.e. him. He showed me some special breathing tubes that would go in my nose post op. Ok, sure. You're proud of what you do. I get it. I said my previous surgeon--also a face specialist--got defensive when it became clear that something went wrong, and that in my experience many doctors can be defensive. Kotler interrupted, "Not all doctors." I said, "Of course not, but a lot of them--" "Not all doctors," he repeated, being defensive about doctors being defensive. Ok, fine, I'm thinking. I know how arrogant doctors can be. My parents are perfect examples. As long as he's an amazing surgeon and good person, it's fine. I went to the imager, and she manipulated photos of my nose as usual, asking if I liked this or that. In the middle of it, and in the middle of an important conversation, I was rushed back to the exam room and asked to wait. Mary checked in after a while to say they didn't forget about me. Cool. Waited more. She came back, said they couldn't finish my appointment because of another patient with a complication. No problem, I said. Patient care comes first. She said I could finish the appt via Skype or come back at 4:30. I opted to come back later that day. Got there on time and had to wait another hour. They took me straight into the imaging room, with the pictures onscreen that weren't finished from before, and Kotler sat as a witness to the rest of the process. He talked about these images as if they were the final product of the imaging session. As I tried to articulate things that concerned me on the screen using my limited surgical vocabulary and the reference photos I brought--that the imager herself had said were good choices--he grew grim. He cut me off frequently. His response to my concerns was, "It won't be like that. It just won't." After a horrific first surgery, I need more than that, and I'm not going to apologize for it. Throughout this conversation, start to finish, I gave caveats: I know you can't replicate another nose. I know the imager is an approximation. I know you're not entirely sure what you can do about xyz. I'm just trying to be clear about what I'd like, then you, as the person who operates, can tell me what's possible. He stopped the conversation abruptly and took me back to the exam room. His warmth switch had flipped. He said he was declining my case because I'm the type of person who would be impossible to satisfy. I almost laughed out of shock, but just said, "Really?" He said I was too particular, and he could tell I'd been over-obsessing. He made me sound like a woman with too much time, money and neurosis on my hands, who would want someone to cut into my face yet another time over something minor. He said that he didn't just know surgery. HE KNEW PEOPLE. In other words, he doesn't work with people like me. He said with a shrug that he won't do it, but "maybe another surgeon will." Maybe. Wow. So in a span of--idk, seconds? minutes? who knows--I went from someone he praised as being very smart and beautiful who was in the right place after a terrible fate to being unworthy of him. I quickly realized that I hadn't been evaluating him to be my surgeon at all. He was auditioning me for the privilege of paying him over $10k to cut my face open. I'm an actor. I know what a casting feels like, and that was it. I also know doctors, and no, Kotler is not humble. He is not The Best. He is not a warm, compassionate soul to all he meets. I'm sure his surgical skills are good, but he has almost all glowing reviews because he casts his patients to fit his ideal, apparently low-risk/high-reward patient personality. If you read the first review of the "not recommended" section on his yelp page, where many negative reviews end up if they aren't deleted (some businesses aggressively hound a platform until an excuse is made to remove negative reviews), he wrote a long, wild response full of accusations, denials, blame AND placating promises, concluding with him saying he prefers to "take the high road". Who knows what his response will be to this. As he proudly proclaimed to me during the consult, he "knows everybody", so maybe he'll review me, too. One thing I learned working for plastic surgeons is that they talk about their patients with each other in gross, mocking detail. A lot. All while still cashing those checks. But no, Dr. Kotler, I'm not remotely impossible to please. I don't send back food at restaurants unless it's the completely wrong order. I don't complain on terrible flights. I don't get upset at people who are just doing their best when they make mistakes. I didn't even write a negative review for the doctor who horribly messed up my nose in the first place. But I did write this, because you made sure I knew you viewed me as a lesser person. You dehumanized me, and that crosses a line no doctor--or person--should cross, especially in your field. There's a big difference between "I'm not right for you, because even I have limitations" and "You aren't right for ME, it's your own fault, and I doubt anyone else will take you". But declining a case (that was never offered to you, btw) while taking responsibility for your own limitations--such as being closed-minded, impatient, presumptuous, and/or so scared of losing your perfect ratings that you won't take any chances to help people--requires actual humility and compassion. Your surgical skills may be high and long-learned, but go back to basics and first do no harm. Side note: There is a replica of an old, extremely racist cartoon about Native Americans using all manner of slurs I won't repeat that is framed in one of his offices. It was about wind of all things. Totally out of place in a doctor's office. I seriously questioned his world view when I saw that.