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.
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.