The rhinoplasty consult

Overview

A crooked nose is one of the most common reasons people seek a first or repeat rhinoplasty. The author describes the consultation as a two-way process: the surgeon learns what the patient wants and what is achievable, and the patient learns the likely surgical outcome and the likelihood of being satisfied with it.

Sections of note

• Descriptive review; no patient data, measurements or outcomes appear in the abstract.
• Correction of a crooked nose is described as a common request in both primary and revision rhinoplasty.
• The consult is presented as an opportunity for both parties to understand possible outcomes.
• Two outcomes are distinguished: the possible surgical result and the potential for patient satisfaction.
• Effective physician-patient communication is named as the cornerstone of a successful consult.

What it means for a patient

• The consultation is where expectations are set; a crooked nose may be improved but not always made perfectly straight.
• A good consult covers both what the nose will look like and how likely you are to be happy with it.
• This is expert opinion from one surgeon; it presents no evidence on which consultation methods produce better results.

Why this paper matters

The paper belongs to a Facial Plastic Surgery issue on the crooked nose and addresses the non-technical step that most often determines satisfaction. It does not test any structured consultation tool or report satisfaction rates.

Terms

• Crooked nose: a nose that deviates from the facial midline, from injury, development or previous surgery.
• Revision rhinoplasty: a repeat operation on a nose that has already had surgery.
• Consultation: the pre-surgery meeting where the problem, options and expectations are discussed.
• Patient satisfaction: the patient's own rating of the result, as distinct from the technical outcome.
• Informed expectations: an understanding of realistic results and limits before agreeing to surgery.