Surgeons, in general

[LeeAnn]

    The other day I was just randomly looking at rhino photos by various surgeons.  I just did a "rhinoplasty photos" net search.  All of the photos were primaries.  After looking at about 200 photos, I know why revision docs are in business.  I just know that if I'd had my primary at age 15 or 16, like I wanted, I'd be a rhino revision sugeon now.  I truly believe that rhinoplasty is (as I've read) the most difficult cosmetic surgery after seeing (and hearing about) various results.  Anyone agree?

[88Brian88]

Hi LeeAnn

Yes definitely, when you think about it, we're talking about a protruding 3d feature in the middle of the face.  The surgeon has to think about 180 degrees or 180 VIEWS from 1 side to the other!!!

It's no wonder it's the hardest procedure to get looking right.  Even so, it doesn't excuse surgeons from making total botch jobs of us.  Maybe results won't be perfect every time, but that's the problem, half the time results are disastrous!

Being from the USA, can I ask LeeAnn what your degree/higher education system is like for doctors?  I wonder how it compares to our MB BS degree in the UK.  I've noticed alot of our surgeons don't have this basic degree to show after their name, do yours normally display similar letters?

Best wishes

Brian

[Leah]

Hi Lee Ann:

I've also seen some photos online and thought "hmmm, this is representative of their best work??"

What the doctors always stress is "improvement".  I saw on a site where they rated noses 1 to 10 and said a surgery could improve the nose 3 notches, or something to that effect, but they couldn't take a 1 to a 10.

I realize there are limitations, I'm not a fool, but we only want to be limited by our existing facial structure, not the skills and knowledge of the doctor.

After my primary, my doctor said (when I complained) that he had improved my nose and I should be happy.   However, I'd take a big nose over a botched nose any day.  One is what nature gave you, the other is what someone with poor judgement gave you.

This whole improvement thing makes me nuts -- I wouldn't mind so much if they didn't promise you the moon and stars during the initial consultation!!  If my primary doc could have showed me the EXACT nose I'd get from him, I would have run screaming from his office.  I would have gone elsewhere, I would have paid double, I would have done whatever it took to get the nose I have now!

[Tex]

Leah was so right - "This whole improvement thing makes me nuts -- I wouldn't mind so much if they didn't promise you the moon and stars during the initial consultation!!"  When I had a consultation with Ellenbogen in L.A., he told me that he could have me "photographing" again, and he promised me that "I would be 100% happy with my nose" after a revision.  I went to a consult with Gunter in Dallas, and he told me that he couldn't give me a fantastic nose, just "some improvement."  Then he told me that he thought I would never be happy with my nose - not because of his skill level but because I was a perfectionist.  (It is probably comments like this which make people dislike the man.)  One reason I liked Gunter, DESPITE his attitude, was because he didn't promise me anything.  Maybe that is the key to picking out surgeons - find one who promises you improvement, not happiness.

I had another thought about surgeons today.  Maybe we should only look for docs that are affiliated with a hospital.  I don't mean those that have privileges there, I mean the ones who have some sort of position there.  For example, my last doctor taught surgical residents.  (For the record, it was Dr. Neil Deleeuw in Delaware. I think he does a good revision, but there was no way he could have fixed everything the first surgeon botched.)  Has anyone else thought about checking into whether the revision docs are on staff at a hospital, whether they teach, etc.?

[88Brian88]

Yes Tex, that is a good point.  Certainly docs who work in a large hospital (as opposed to a clinic) are likely to deal with a lot more patients, and are more likely to be well known in the area.  Also, they probably have a fairly good reputation or they wouldn't be there still working.  

I think though that you can only eliminate the really awful surgeons by this method, it won't mean you necessarily get a great result.  Does E do work at a local hospital, or is he clinic-based/his own private consults only?

I think Gunter, Toriumi, Dr Paul all sound like realistic, genuine people rather than the smarmy smooth-talking ones which are all too common.   But it's still risky even with them.  Why won't we all accept this whole thing is too unpredictable, why is that so hard for us to register in our brains?  

[Tex]

88Brian88- We won't accept that it is unpredictable because we all have great hope that someday we will finally find the perfect doc to give us the best possible nose (with no complications.)  It's like Santa Claus - so maybe he's not real, but do you really want a world without a Santa Claus?  Do you really want a world without a surgeon who can 100% fix your nose?

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One major factor for me (and for most other people too I am sure) is the amount of money that you have to invest in something like this. Spending 5+ grand on something that is as unpredictable as it is yet totally necessary is something that i find very hard to accept.