How to Prepare for Your Rhinoplasty or Facelift Consultation

Opening I would much rather you not have surgery because I can’t give you what you want than have surgery expecting to get something that just can’t be delivered. Where’s the result? It’s in the heart and in the mind. It’s that happiness. We’re also actually interviewing patients as well.

Why does a plastic surgeon interview you? So, you know that movie, The Interview, with Seth Rogen and James Franco? It’s a pretty cool movie where they go to interview the dictator of North Korea. I’m not really here to talk about the movie so much as the idea of an interview. I think it’s kind of interesting when a patient comes in to have a consultation and they say, you know, I’m interviewing a variety of doctors. And I kind of agree with it. That’s fine. You know, it is an interview. But what I think some patients don’t recognize is that we’re also actually interviewing patients as well. And we’re not interviewing patients to try to, like, I don’t know, be exclusive or to be exclusionary or what have you. And the reason I’m interviewing them, once again, is really for their benefit. It doesn’t have to do with me. I’m a doctor. I’m here for you guys. It’s my responsibility to see this through. And part of doing that well is kind of selecting the right patients, patients that we know there’s a high probability, a high probability of them being happy with surgery, right?

Why do surgeons ask screening questions? We want to make sure, for the patient’s own benefit, that we’re screening for patients who are going to be happy with surgery. So when we detect motivations for surgery that might be outside of what surgery can actually achieve, like if there’s childhood trauma that might have, let’s say, for a rhinoplasty may have centered around their nose like they were made fun of incessantly, or worse so, their family members kind of picked on them. It’s not that we won’t do surgery; it’s actually a common thing, unfortunately. But we want to make sure that they’re in the right emotional space to benefit from a surgery. So that’s a really important thing, and that’s why we actually asked some screening questions at the beginning of our consultation that tap into that.

What should you focus on in a consultation? Another thing is, we want to make sure that they’re focusing on the right thing in the consultation. The right thing is: do they recognize that this is a relationship, that there’s uncertainties? But what should be certain is that we have an open channel of communication and that we have the ability to talk to one another and that we’ve talked about goals and desires, but also that we’ve talked about limitations. Patients should really understand from me the things that we’re not going to be able to achieve. And they should be slightly disappointed with that. And that is just fine. But then lean into focus on the things that we can actually accomplish that’s so very important. And they gotta lead with that. Those things, and we usually call them the three big things. What are the three big things that we need to address in order to be happy?

What is the 85/15 rule in rhinoplasty? And I kind of call it the 85/15% rule. I want patients to make a decision to have a rhinoplasty based on the concept that they’re going to really love 85% of their result, and there may be a 15% element of it that they’re a little bit less than satisfied. I tell patients, I’ll probably be less than satisfied with those parts too. That is the reality of dealing with human tissues in surgery. We actually have a lot of control intraoperatively. It’s how the body heals afterwards that can have a big impact on the way we get our final result. When patients understand and have made peace with that 85%, 15% rule, they end up being very happy.

Are rhinoplasty simulations (morphs) helpful? Another thing that I think is important during a consultation is to not overly rely on morphs or simulations. Simulations can be very, very helpful, but they also have limitations. I tell patients that you should use this as a basis for conversation, but absolutely do not use the simulations as a way to make your decision to or not to have a rhinoplasty. And don’t use the simulations as a way to decide whether I’m the right one to do it. Okay? And that’s a really important thing. I tell patients that simulation-morphed photographs are extremely useful if they don’t actually show you what you like. Like if I can’t show you that with a simulation, it doesn’t mean that it’s a failure in the simulation or that it’s a failure in me or the process and that you’re not going to be happy with rhinoplasty. What it means is that we, that one, you may be asking me for something that I can’t physically do. And so if I’m like failing to show you what you want, then it’s for good reason. It can’t be done. And that’s important to know. I would much rather you not have surgery because I can’t give you what you want than have surgery expecting to get something that just can’t be delivered. That’s an important thing.

Why can front-view simulations mislead? Another important thing is that simulations in and of themselves are imperfect. And so sometimes, and I tell this to patients all the time, is that actually if you kind of like this, you’re probably going to like the final result better because it’s real, it’s physical, it’s three-dimensional in front of your face. So don’t overly rely on simulations, especially the front view. Front views of simulations are notoriously problematic. Now, I use basic Photoshop because I like actually going through it without an algorithm one, it forces me to see things I might not have seen in three dimensions with the patient. But also, as I’m doing that, I’m asking myself: am I actually representing something that I can do? That’s really important, right? So, I like doing it, but Photoshop has some notorious limitations on the front views. So, if you’re trying to make a decision about whether to have a rhinoplasty based on the front views, you’re either gonna not have the rhinoplasty with the person you probably should have had it with, or you’re just not gonna have it at all, maybe be disappointed because you didn’t have a surgery that you might have really benefited from. So that’s really important, okay? Honestly, sometimes I’ll tell patients we’re focusing too much on the simulation. I think you should take the simulations I’ve given you, go home and kind of study them, think about them a little bit, and tell me what you learned from them. And if I feel like, based on your comments, we can rework them in a way that’s realistic, then we’ll do that. But if not, you need to make peace with the fact that I’m trying to show you what can and can’t be done. That’s so important. I never want to take someone’s money based on a false premise. I want to make them understand in advance what they actually should be expecting. And that in and of itself is a little bit of an imperfect process, but when we spend time on it and when patients really dig into it, they really have very positive results afterwards.

Where is the real result of surgery? Where’s the result? It’s in the heart and in the mind. It’s that happiness. It’s not exclusively in the eye and the post-op photograph. That’s not exactly where the result is. It’s: are you ultimately satisfied with the result?

How do I prepare for my consultation? So, there you go. Those are the things that we, as plastic surgeons, some of the things we look for when we’re doing a consultation for rhinoplasty. And what I think is important about me telling you this is this is a great way for you to prepare for a rhinoplasty consultation, I want you to be in the right framework to benefit from a surgery that you really should benefit from, to benefit from a consultation leading to that. And there are some financial motivations here. We actually do same-day booking incentives, and the reason we do that is that it actually entails kind of less work, you know, and so we want to pass that efficiency on to the patient. So the better you’re prepared for that rhinoplasty consultation or for facelift consultation for that matter, it’s really in your best favor. While we’re on that topic, a couple of other things that you can do to prepare is find out when you can get off from work. Do some research. I have so many resources out there. How much time you may need to take off. A lot of people return to work after rhinoplasty at about seven to eight days, so that’s an important thing to know. Facelifts, a little bit more like two weeks, also Another important thing to know.

Should I bring my partner to my consult? Another thing I see hanging people up frequently is the idea of, well, I need to run this idea past a loved one, my parents, my partner, the person who’s going to help take care of me. Do that heavy lifting in advance. If your partner, your husband, your wife, your roommate, your best friend, if they’re going to be part of your decision making and even your recovery and their opinion is important, they should be there at the consultation, right? You could be saving thousands of dollars. So, what I ask of you guys is: bring them physically to the consultation. And if they can’t be there, have them be present virtually. We can do FaceTime, we can do video through our own app, we can even do a phone call on your phone. All of those can be very helpful to help you really kind of take the initial momentum and the excitement and translate it at the end of the visit to a decision that you’re going to be happy with. Another really important thing for the consultation, once again, is prepare as much in advance as you can. Start to answer your questions with the resources that I have online. That’ll save time for the more important conceptual issues, the evaluation and discussion of a plan. That’s super important.

Do I need to understand everything first? But another thing is go into the consultation with this particular thing in mind. You are never going to be able to understand everything about you know, the decision making or the recovery, the ins and outs complications of a rhinoplasty or a facelift, let’s say, for example, in advance of a consultation, even at a consultation or afterwards. So, if you’re waiting for like an aha moment, you’re like, oh, I totally get everything, it ain’t gonna happen. So, if you’re waiting for that moment, you might stand in the way of yourself. Taking advantage of the momentum and taking advantage of the opportunity to proceed with the surgery you’re going to benefit from, and then also do so in a way that actually is advantageous to you financially. So you got to go in with that mindset, knowing that you make one great decision that is to do the surgery you’re going to benefit from, and then

What happens after the consultation? We have an extensive post-consultation process where we make sure that we’re addressing all your questions, we’re further educating you, we’re getting you additional materials. That’s all part of the whole process. And I’ve created a PDF to help you with this called Facelift and Rhinoplasty University, where I go over some of the key concepts, I get it to you in advance, and then you can, after the fact, kind of study it and make sure that it’s filling in the gaps. So anyhow, that’s a super important thing to understand about consultations. And I really hope you learn from it. Follow my YouTube channel. Follow me on Instagram. Comment if there’s other topics that you would like to learn about. See you later. I got to get to a facelift and neck lift.