Plastic Surgeons Should Not Be Technicians

I had a patient come to me recently with a problem following a rhinoplasty performed by another plastic surgeon.  I assumed she was here because she needed reassurance that the healing process was normal, or she did surgery far away and could not fly their due to financial or work circumstances.  It turned out that her surgeon was closer to her house than I was, it was just that he refused to see her.

On examination, it appeared to be a reasonably well performed operation with a normal post operative course.  I reassured her that healing was normal, and asked her permission to call her surgeon.  He complained to me that she was very needy, asked too many questions, and took up too much of his time.  He felt there was nothing to do until her visit in several months, and that he did not need to see her.

At Yager Esthetics, the relationship between doctor and patient is a partnership that continues forever, even after the procedure is completed.  I feel a special bond with each person I operate on, and invest a lot of emotional energy in the planning, execution, and aftercare.  Sometimes, I am a plastic surgeon, sometimes a psychiatrist, and many times just a friend or confidant.  It depends on the patient’s needs.

While it is true that physically nothing would be done for this patient until her next visit, she clearly had emotional or other reasons for needing someone to talk to.  I feel that this is part of caring for the cosmetic plastic surgery patient.  You need to spend enough time with the patient before agreeing to perform surgery to know if you want to accept the responsibility of her total aftercare.

Plastic surgeons are not technicians who simply perform the indicated procedure, no matter how talented they may be.  We should be physicians who care for all the needs of our patients.


Why are Hispanic Noses Different?

While I believe that all people are created equally, the anatomic differences among the races cannot be ignored.  As a plastic surgeon who specializes in Hispanic beauty, I am keenly aware of the unique challenges that these variables create.

I have seen very poor results in rhinoplasty of the latin patient done by very competent board certified plastic surgeons.  Why?  Because they do the same surgery they are used to doing in the Caucasian population.  This does not always work for my patients.

Let me qualify this discussion by stating that the Hispanic population is tremendously diverse, from the lightest thinnest skin to the darkest and thickest.  My observations are generalities, and each patient needs an individual analysis by a board certified plastic surgeon who specializes in Hispanic noses.  Below you will find my most important tips for success.

  1. The nose has to match the face.  You can have a perfect nose, but if it does not match the face in both size and ethnic features, it will look strange.  Make sure your doctor has computer imaging to show you how the nose you like will look on your face.  At Yager Esthetics, we do this for every nasal consult.
  2. It is better to do too little than too much.  Obviously, I try to do the perfect amount every time, and my revision rate for rhinoplasty is 5%.  Once you have an overoperated nose, especially if the nostrils are too narrow, it is nearly impossible to restore a natural appearance. 
  3.  Internal support is essential for breathing.  If you remove too much structure in an attempt to get a smaller nose, it usually fails due to skin thickness.  Once support is gone, you risk a nose that cannot breathe.                                                                                                                                                                                                                                                                                                                                                   

Good luck in your quest to improve your appearance.  We look forward to seeing you  and offering a safe and beautiful solution.