Rhinoplasty is one of the most surgically and aesthetically challenging procedures performed today. It requires not only a complete knowledge of nasal anatomy, but also an artistic sense of how the nose is best harmonized with your other facial features.
An expert plastic surgeon must have a feel for harmony, as well as a rich experience and knowledge of how different facial structures interact together. You can have a “cosmetic surgeon” shape a beautiful nose for you, but if it isn’t in harmony with the rest of your face, you will look unnatural and ultimately be unhappy.
There are many different types of specialists who are well trained and qualified to perform surgery of the nose or other parts of the face. For example Ear-Nose-Throat (ENT) surgeons might have the knowledge and experience to do so. However, they might lack the knowledge base and expertise of the rest of the facial structures. The beauty and the function of the nose are intertwined with that of the rest of the facial aesthetic units.
In other words, it is best to have your surgery performed by a highly experienced bona fide plastic surgeon – not simply by a physician with another specialty who also practices “plastic surgery.”
An experienced Board Certified Plastic Surgeon, unlike an ENT surgeon, or “Facial Plastic Surgeon” has had the broadest training and expertise in all different aspects of the facial aesthetic and functional units and has the knowledge of how these different units interact together. An experienced plastic surgeon’s job is not only to look at your nose, but also to consider your entire face and how these different units affect each other. This is the only way that you can achieve a Rhinoplasty result that is harmonious with the rest of your face.
When you interview physicians, be certain that they can share legitimate “Before and After” photographs of their work. Discern your comfort level with this physician, and whether all of your questions are willingly addressed. Also importantly, consider the quality of his or her staff and of the facility where surgeries are performed.
Is a board certified “cosmetic surgeon” the same as a board certified “plastic surgeon”?
The American Board of Plastic Surgery (ABPS) is one of 24 boards recognized by the American Board of Medical Specialties, and it is the only one that certifies physicians in the full spectrum of plastic surgery, including all cosmetic surgeries.
When you choose an ABPS certified physician (www.abplsurg.org), you are guaranteed the services of a specialist who has endured the most rigorous training. This includes graduation from an accredited medical school, five to seven years of internship and residency, including three to five years of training in general surgery and two years of training in plastic surgery. The physician must also complete demanding written and oral exams.
Absolutely not! Unlike a fully trained board certified plastic surgeon, many so-called “board certified” cosmetic surgeons have often completed only a brief course in one cosmetic surgery procedure. This does not provide the physician with the depth of knowledge and experience of a plastic surgeon who is certified by the ABPS. That is why The American Board of Medical Specialties does not recognize as legitimate the “board of cosmetic surgery.”
You wouldn’t have your wisdom teeth pulled in your dentist’s living room. Why not give equal consideration to your physician’s surgical facility? Your very life could depend, not only upon the skill of your surgeon, but upon the quality of this facility.
Your surgery should be performed at an accredited ambulatory surgery center, or at a hospital. It is unwise to have your surgery performed merely in a physician’s office, or procedure room. If your physician operates in a surgical facility, there are five crucial factors to consider:
Is your physician credentialed to operate at a local hospital? Does your physician have privileges to perform your chosen surgery in a hospital? If a hospital does not approve a surgeon as qualified to perform your procedure in its facility, this is a significant factor to consider for your safety. Has he or she been barred, disciplined, or suspended from any hospital?
Rhinoplasty can be performed under general anesthesia or sedation. I find when majority of patients are given the choice, will choose general anesthesia because they don’t want to wake up during the procedure and don’t want to be aware of the procedure when it is being performed on them.
You should pay special attention to the anesthesiologist who your plastic surgeon uses during surgery. Like your surgeon, the anesthesiologist literally holds your life in the balance. It is therefore critical that you put your life in the best hands.
Many patients have preconceived notions about the type of anesthesia that is best for them. Unfortunately, these thoughts are often based upon hearsay, or upon informal research that has no scientific basis. While you are the final arbiter of your treatment, only an experienced physician can guide you properly in making the crucial decision about your anesthesia.
Many facilities employ trained nurse anesthetists. However, it is optimal to have anesthesia administered by an anesthesiologist rather than a nurse. Preferably, your anesthesiologist should be certified by the American Board of Anesthesiology.
The anesthetized patient must be monitored meticulously and constantly, with consideration for all medical conditions. The best person to do this is a physician who is trained and experienced in the practice of medicine, in the specialty of anesthesia. This is especially important in surgical facilities that operate independently. In freestanding facilities in particular, a nurse anesthetist might not have the adequate supervision of a physician anesthesiologist, or the support system required to properly address emergencies.
You should be skeptical about promises that extensive cosmetic surgery procedures can be performed under local anesthesia in an office, procedure room, or even in an office surgery room. Having an extensive procedure performed under local or “twilight anesthesia” is not safer than having it done under general anesthesia. On the contrary, the risks of this “twilight sleep” might be greater because procedures that take two hours under general anesthesia will take several more hours when you are inadequately anesthetized locally. The risks that your condition will become unstable will increase under this circumstance. Also, you will then have to deal with the side effects of the longer acting anesthetics that remain in your system, even after you go home.
Dr. Younai is a Board Certified Plastic & Reconstructive Surgeon with experience in all aspects of Facial Cosmetic Surgery including that of the Nose. He is skilled and experienced in all techniques of Open & Closed Rhinoplasty and strives to create noses that are natural and normal looking. During your consultation he will discuss all details including: if you are a good candidate, surgical options and techniques, potential risks and complications of surgery, pre- and post-operative instructions, recovery course, as well as what to expect after surgery. At that time Dr. Younai will also show you before-and-after pictures of other patients with Rhinoplasty, who might be similar to you.
Dr. Younai performs Rhinoplasty on both children and adults who come to the California Center for Plastic Surgery from the Northern as well as the Southern California region.
Dr. Younai performs his surgeries at the state-of-the-art Regency Surgery Center which is certified by Medicare, AAAHC, and AAAASF.
Having said all of this, many people live for years with noses they feel self-conscious about, or with disabling, painful and unsightly nasal injuries. For them, Rhinoplasty can be a truly liberating experience. I look forward to making your nasal surgery a safe, comfortable and successful experience.
With best wishes,
S. Sean Younai, MD, FACS
Board Certified Plastic & Reconstructive Surgeon
Our center also includes the Regency Surgery Center which is a state-of-the-art outpatient surgery facility certified by Medicare and accredited by the Accreditation Association for Ambulatory Health Care (AAAHC) and the American Association for Accreditation of Ambulatory Surgery Facilities, Inc., (AAAASF).
Thank you for taking the time to visit our Web site. Our staff is always available to help answer your questions regarding any plastic surgery procedures and financing options, as well as with your travel to our center. Plastic surgery has truly become a way to better ourselves. It allows us to take control of our lives, and to give ourselves the body and look we always wanted, and truly deserve. Why not! We deserve the best.