Assessing the Face
When examining the patient, I look at the entire face to determine
what changes are needed to create the most aesthetically pleasing
result. I take into account the patient’s ethnic background, bony
and cartilaginous anatomy, skin thickness, general health status,
and age. Female patients should be at least 15 to 16 years old
and males should be 16 to17 years old—ages at which the vast
majority of nasal growth has been completed. Nasal surgery done
prior to the completion of nasal growth may result in developmental
abnormalities of the nose. At the consultation I may also suggest
that the patient undergo another procedure in combination with
the rhinoplasty to maximize facial harmony and balance. The
most common procedure done in combination with rhinoplasty
is chin augmentation but cheek augmentation and chin reduction
may also be done in combination with rhinoplasty.
Surgery location
The rest of my consultation includes a discussion of the different
locations at which I perform surgery. These locations include
hospital operating rooms, surgicenters, and my office operating
rooms. Patients should be sure that anesthesia given in an office
operating room is provided by a licensed anesthesiologist or
nurse anesthetist. Also, all of the same monitoring equipment
present in a hospital operating room, such as EKG machines
and blood-oxygen level monitors, should be in the office for
your surgery. Patients are usually given local anesthesia with
sedation to place them in a comfortable drowsy state, but they
remain awake. The other option is general anesthesia where
the patient goes to sleep fully. The first option is safer and has
less postoperative nausea and a quicker recovery.
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