Q: Dr. Eppley, thank you for your presurgical consultation today regarding my rhinoplasty tomorrow. I know we have been over my nose surgery numerous times and you have done a lot of computer imaging for me. I know that no surgery can create perfection but I still need to know if my nasal tip projection will really be shortened by the 2mms that i need. I also need to make sure my nostrils shape will not change in any way. I don’t want to seem pedantic at this point but I am concerned.
A: I would not use the word ‘pedantic’ or even over analytical. Those are patient behavior’s that are common and largely understandable. The concern that I always have with such behaviors is what may lie behind them…unrealistic expectations.
It is important to really understand that surgery is not Photoshop or any other completely predictable method of facial manipulation. Such efforts are important preoperatively but what they really represent is a method of communication as to what the patient’s goals are. Surgeons need goals to try and accomplish what the patient wants. They are, however, not completely accurate representations of what the results may be even though that is the goal. The manipulation of tissues, how they respond in surgery and how they heal afterwards, is not like manipulating images on a computer screen. It is far less predictable and no result will end up perfect or completely symmetric no matter how hard the surgeon tries. Patients who are most satisfied with their plastic surgery have an inherent understanding of realistic and not always predictable outcomes.
As an additional note I must make reference to the type of patient who is at greatest risk of having unrealistic expectations in plastic surgery and one of which I have an enormous experience…the young male patient who is having elective facial surgery. Often times an overanalytical preoperative behavior is a set up for postoperative disappointment…as any result can not withstand the scrutiny and degree of perfection such patients often seeks.
I pass along these thoughts as a note of caution as you are about to proceed into rhinoplasty surgery and hope that your expectations fall in line with what surgery can actually achieve…improvement but never perfection.
Dr. Barry Eppley