Selecting a Surgeon
The selection of your surgeon is the most important step in the process of undergoing rhinoplasty surgery. 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. According to Dr. Samaha, 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. The surgeon’s bedside manner as well as the facility and staff are also important considerations.
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).
Skill and Experience
Has your doctor performed many rhinoplasties? 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
Is your doctor a surgeon? Is he/she board certified by the Royal College of Surgeons of Canada? Which specialty?
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, face, 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 as esthetic 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.
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 where the surgery will take place.
Is the facility accredited? Is the nursing staff experienced in assisting the surgeon and caring for patients undergoing this type of surgery? Are they selected by your surgeon? The same inquiries should be made regarding other staff and technicians.
Our Surgeon and Center
Dr. Samaha is board certified in two specialties, by the American Board of Facial Plastic Surgery and the American Board of Otolaryngology-Head and Neck Surgery. In addition, he is certified by the Royal College of Surgeons of Canada. He is renowned for his extensive knowledge and experience in both rhinoplasty and functional nasal surgery. He performs surgery at his clinic in Montreal, which is fully accredited. The clinic’s nursing staff has a minimum of 10 years of experience and work in some of the most renowned hospitals in Montreal. The procedures performed at our clinic are exclusively facial procedures and the nursing staff and technicians have worked with us for years and are very experienced in these surgeries.