Pre Rhinoplasty FAQ

Q: If I were to have a rhinoplasty and septoplasty, would I go a facial plastic surgeon, ENT or Plastic surgeon?

A: Performing both a quality septoplasty and rhinoplasty is dependent on the individual's training and experience. Generally, facial plastic surgeons start with ENT training before they move on to facial plastic surgery. Although they are not formally trained, many plastic surgeons can also be experience and qualified to perform septoplasty procedures. The main focal point should be how much training they have received and how much experience do they have performing the procedures together and separately. There are subtle signs that could indicate if the proposed surgeon is right for you:

• Did the surgeon look inside my nose? (As surprising as it sounds, in a number of my revision consults, patients often say that their original surgeon never looked inside their nose.)
• Do they have specialized instruments to tackle the procedure? (A special headlight, nasal instruments, etc.)

Q: What do you tell patients that have anxiety about the reaction that they might receive?

A: That is a very difficult question to give advice on. First off, having a cosmetic procedure is a very personal decision. Your decision to have this procedure is a personal matter but you would hope that your friends and family would support that decision.

In the hands of a skilled rhinoplasty specialist, the results will be more subtle and natural looking so looking "fixed" should not really be an issue. There will always be people that asks questions, but displaying a good self image and comfort with yourself will go a long way to answering those questions, before they are asked.

Q: Can you get a quality rhinoplasty overseas?

A: There are many qualified and skilled surgeons outside of the United States. A great resource to find them would be the International Federation of Facial Plastic Surgery Societies. Although this is the case, if the procedure does not go as expected or a revision is needed, a follow up and comprehensive care may be difficult to obtain.

Also, if things do not go as expected and legal recourse is necessary, international laws may not be on your side. With a revision rate that ranges from 5% to 15% for even the most skilled of surgeons, it is vital to have a continuing line of communication and follow up with your surgeon. My suggestion is to do your research and simply weigh the pros and cons of going overseas.

Q: Can I get a rhinoplasty for $1,000?

A: Cosmetic surgery, like all surgery, needs to be taken seriously. Searching for a bargain might not get you the results you are looking for. The top surgeons charge more because there experience and trainings lends them to quality surgery with superior results.

The real question is: Do you want to gamble with your face?

I think it is better to save and see an experience and qualified surgeon than to look for the cheapest cost. The nose you have, though can be somewhat altered with surgery, is the nose you will have for the rest of your life. Like most consumer products, you usually will get what you paid for. Experience and quality cost more, but the results will be much better.

There is one avenue to get quality results for a lower price. If you search for a reputable Plastic Surgery or ENT training program, the residents are taught by reputable specialist and would perform the procedure under close supervision.

Q: Can a rhinoplasty be performed safely with sedation?

A: Any anesthesiologist will tell you that sedation has a higher risk of breathing and medical complications. I have had patients that have expressed a fear of "general" anesthesia. In the first 12 years of my private practice, I safely did many rhinoplasty procedures under sedation. Now, with the advent of LMA, a happy medium is here. The anesthesia used is practically the same as in normal sedation; the one difference, there is just a smidge more. LMA is a triangular "mask" that fits over your voice box that is tolerate well by most patients. Using this mask has allowed my patients to breathe on their own yet made them unaware of the surgery. In a minority of patients, the threshold between and breathing and not is very small under sedation. By using the LMA the anxiety from this and awareness of the surgery are greatly reduced.

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