Selecting a Surgeon
The selection of your surgeon is the most important step in the process of undergoing rhinoplasty surgery. The techniques used in this procedure have greatly evolved over the past 20-30 years and continue to improve. A surgeon who has significant experience in performing rhinoplasty surgery with consistent, good results, and who is current on the latest techniques and updates, is the ideal choice.
Skill and Experience
The two most important factors in selecting a surgeon are the surgeon’s background and training, and the surgeon’s skill and experience. How does one find out about these important criteria? Simply ask your surgeon about his/her background and training. The discussion with your surgeon should be open and frank. If you are not afforded the opportunity or comfort to ask such questions, consider seeking another surgeon (see the consultation process).
Is your doctor a surgeon? Is he/she board certified by the Royal College of Surgeons of Canada? Which specialty? Once you have considered training and credentials, ask about the number of rhinoplasty procedures the surgeon has performed. Although the number of procedures performed is important to evaluate his/her experience, it does not necessarily indicate the results of these procedures. Therefore, also ask to see examples of the surgeon’s work. Surely, most surgeons will show you their best results, but it does provide you with an insight into the surgeon’s “style” (see the nasal esthetic). Do they tend to favor an “overdone” look with a pinched tip and a sloped profile? Does that coincide with your vision of your nose? Ask to see photos of patients with nasal features similar to yours (a hump, a large tip, etc..) so that you can have an idea of the final result.
Another measure of a rhinoplasty surgeon’s success is his/her revision rate (re-do surgeries). What percentage of patients has required a revision surgery? How many were mere touch-ups and how many needed to be completely re-done?
Training and Credentials
Although most specialist doctors practice the full spectrum of their specialty, some obtain subspecialty training in one area of their specialty, called a “fellowship”. An example is an orthopedic surgeon who has obtained a fellowship in hip surgery. This subspecialized hip surgeon tends to use the most current techniques and perform the more complex hip surgeries. The same applies to many fields in medicine and surgery, including esthetic surgery.
There are mainly two types of specialists who perform rhinoplasty surgery: facial plastic surgeons whose training background is head and neck surgery (also known as ENT surgery); and plastic surgeons whose training background is general plastic surgery. Whereas other specialists, such as ophthalmologists, dermatologists and maxillo-facial surgeons occasionally perform some facial esthetic procedures, they do not perform rhinoplasty surgery because of its complexity. Although statistics are not available as to which specialists perform most rhinoplasty surgeries, it is generally accepted that in North America, most rhinoplasties are performed by facial plastic surgeons.
Facial plastic surgeons are trained in ENT (ears, nose, and throat) and head and neck surgery. Their surgical training lasts 5 years, during which they master a variety of facial and nasal procedures. Their specialization is focused exclusively on the head and neck region, including functional, reconstructive, as well as esthetic surgery of this region. At the conclusion of their training, most of these physicians perform non-esthetic ENT and head and neck surgery while others will focus on facial plastic surgery.
General plastic surgeons also undergo 5 years of training. During this time, they perform non-esthetic procedures such as hand surgery, treatment of burns, reconstructive surgery, as well asesthetic surgery in different areas of the body. At the end of their training, some general plastic surgeons will perform esthetic surgery that is not limited to one region of the body. Most will practice general non-esthetic plastic surgery.
Selecting a surgeon does not rely on one specific factor. Board certification is very important but alone does not guarantee a successful surgery. For example, a board certified plastic surgeon who has a great reputation and performed an excellent breast augmentation on your friend may not be the most skilled rhinoplasty surgeon. Board certification therefore needs to be used in conjunction with other factors mentioned here. However, the absence of board certification should be a deciding factor to seek another consultation with someone else.
If you have nasal blockage due to a deviation in the nasal septum (the wall that separates the two sides of the nose), it can be fixed through a septoplasty at the same time as your rhinoplasty. In North America, septoplasty procedures are performed by ENT surgeons, including those surgeons subspecialized in facial plastic surgery.
Bedside Manner
Aside from the surgeon’s surgical skill and results, a very important factor is the patient’s confidence in the surgeon. It is important that the doctor is honest and realistic with you and that he/she makes you feel comfortable about asking questions. Do you have a sense that the surgeon will provide you with good care? In the event of a complication or an unforeseen occurrence, will he/she take care of you and provide you with the necessary support?
The Facility and Support Staff
Details often overlooked by patients in making a choice of a surgeon are not related to the surgeon himself/herself, but to the facility and staff. It is important to inquire about where the surgery will take place.
If it is at a hospital, is the nursing staff there experienced in caring for patients undergoing this type of surgery? Nursing staff highly trained and experienced in assisting with open heart surgery may not be as skillful in caring for you during or following your rhinoplasty, if they are assigned to your surgeon that day. Will the operation be performed under local or general anesthesia? If general anesthesia will be administered, is the anesthesiologist selected by your surgeon or is the he/she randomly assigned to your surgery?
If the procedure is performed in a surgical centre, is the facility accredited by an organization such as the Canadian Association for Accreditation of Ambulatory Surgical Facilities (CAAASF)? The same inquiries should be made regarding the nursing staff and the anesthesiologist, if general anesthesia is used.
If you would like to learn more about selecting a surgeon you may contact our office for more information.