How do i find the right nose surgeon?

Rhinoplasty is one of the most challenging procedures in plastic aesthetic surgery due to the exposed position of the nose in the centre of the face and its complexity in structure and shape. Therefore, it is very important to find the "right" surgeon for your needs. Training, experience and skills of a surgeon are crucial in determining the results of rhinoplasty, however, there is no reliable method of predicting the success of your surgery. Multiple information sources may be contradictory, inadequate or confusing, but it's still worth taking the time to inform yourself - it's your face, after all, and it's not an emergency procedure.

No surgeon in the world can guarantee the perfect result, nevertheless the choice of the surgeon is essential! The nose is swollen and the tissue structures altered throughout the procedure, so there are always small irregularities or cartilage twists, no matter who performed the procedure. Therefore, stay realistic and expect improvement, but not perfection. Certainly, the choice of the right surgeon sometimes determines how extensive or insignificant the irregularities become.

The training for ENT specialist requires very good surgical knowledge of the nasal septum, the shape of which always influences the direction and shape of the nose, as well as other procedures to maintain the functions of the nose, especially breathing. The ENT specialist frequently performs functional surgery on the outer nose as well. The "license" to perform aesthetic plastic surgery in the facial area is granted to an ENT or maxillofacial surgeon after a period of additional training as facial plastic surgeon (in Germany, additional designation: plastic surgery). Maxillofacial surgeons often perform complex procedures on the so-called cleft noses in palate clefts.

A plastic surgeon can actually complete their training as a specialist without having performed a single procedure on the nose, as nose surgery is not explicitly included in their training catalogue. However, in some clinics plastic surgeons acquire a sufficient amount of experience in rhinoplasty during their training period. No specialist group has a monopoly when it comes to rhinoplasty and therefore a good rhinoplasty surgeon should be proficient in both the functional and aesthetic aspects of rhinoplasty. The " cosmetic surgeon " designation is not protected in Germany and can be used by any doctor who practices surgery, irrespective of any further training.

In general terms, it can be assumed that a surgeon who specializes in a particular area (such as middle ear surgery, liver surgery or plastic nose surgery) has a special interest in his or her field and accordingly will acquire more knowledge and skills accordingly, which will lead to better results. The general principle is that a specialist should perform more than 100 operations per year in his or her specialty. Continuing professional development on a regular basis is very important as well as publications and congress attendance as a lecturer-  all this demonstrates a strong interest in rhinoplasty.

You can consult your ENT doctor, even if he or she does not perform rhinoplasty themselves - many of them are very familiar in their area - or call the relevant medical authority.

Mouth-to-mouth propaganda:

One of the most important signs of quality for a good nose surgeon are positive recommendations from friends or acquaintances in your area whom you can trust. Several positive reports about a practitioner increase the likelihood that your procedure could also have a positive outcome.

Internet portals and forums have recently become the new kind of mouth-to-mouth propaganda, where patients exchange information about competent and less competent surgeons, support each other and prepare for the procedure. Unfortunately, there are also records containing disinformation, accusations or expressions of dissatisfaction towards the doctors.

A single, justified or unjustified, dissatisfied anonymous patient can undo hundreds of successfully performed operations because of a perceived failure, often without appropriate images or with poor photographic documentation. That's why, you have to be aware that there are always two versions of the same story when you try to assess the skills of a nose surgeon based only on internet sources.

The very first contact with your potential rhinoplasty surgeon is often decisive and the most effective way of evaluating a doctor. You should pay special attention to the before and after pictures that are shown to you during the consultation. An experienced surgeon will be able to demonstrate many different and successful surgical results and some "nose types" that have a resemblance with your nose.

A computer simulation enables you and your doctor to speak "the same language" about your wishes and ideas and what is feasible on the part of the doctor. However, a computer simulation is by no means an accurate reflection of how your nose will look after surgery - no reputable surgeon can guarantee that. Finally, listen to your gut feeling about whether a doctor understands your problems and whether you really want that doctor to perform your surgery and provide follow-up care later on.

You should always visit several rhinoplasty surgeons - this way you can compare and take your time to decide whether you want to have the surgery and if yes, who will perform it.