In almost every case, it is best to have one surgeon perform your rhinoplasty procedure. While there are exceptions, the disadvantages of having two surgeons working together on a cosmetic procedure such as rhinoplasty usually outweigh the benefits. However, it is important that you do your homework and choose a surgeon who has the ability to execute all aspects of the procedure.

Let’s look at the issues surrounding this question.


Possible Benefits of Having Two Surgeons                            

Although there are few scenarios in which having two surgeons perform your nose surgery would be beneficial, one exception would be if your nose surgery involves both aesthetic and functional alterations, and a general plastic surgeon (i.e., not a board certified facial plastic surgeon) is performing the aesthetic component of the procedure. While I strongly advise against having anyone but a facial plastic surgeon complete your procedure, if you do, it would be preferable to have the functional aspects of the procedure performed by an otolaryngologist, or ENT (ear, nose and throat surgeon), many of whom are also facial plastic surgeons. For example, if you are undergoing septorhinoplasty (septoplasty and rhinoplasty in one procedure) with a general plastic surgeon, he or she may enlist the services of an ENT to do the part of the procedure involving the septum.


Disadvantages of Having Two Surgeons

But the truth is that you shouldn’t have two surgeons perform your nose surgery. There are several disadvantages to this approach.

Importantly, the two surgeons may have differing aesthetic viewpoints. Part of being a facial plastic surgeon is being an artist. Would Picasso and Matisse work together on the same painting? Of course not, and neither should two facial plastic surgeons. This is the main reason I choose to perform rhinoplasty and other procedures without the assistance of a second surgeon.

Another disadvantage to having two surgeons operate on your nose during the same procedure is that most surgeons who enlist the help of a second surgeon are general plastic surgeons. Commonly, these surgeons do not have as much training relating to the structures of the nose as facial plastic surgeons. This is because, unlike general plastic surgeons, most facial plastic surgeons have a background in otolaryngology; that is, they have undergone extensive training to perform surgery on the internal and external components of the nose.

You can eliminate the need to have two surgeons working on your nose by choosing an otolaryngologist who is board certified in facial plastic surgery and specializes in procedures of the nose. These surgeons have extensive expertise relating to the inside structures of the nose as well as its external appearance, and understand how to alter both depending on the patient’s needs. Board certified facial plastic surgeons are trained to handle both functional issues, such as breathing, as well as the external aesthetic structure of the nose.

Following medical school, the path of a facial plastic surgeon typically begins with a residency in general surgery or otolaryngology/head and neck surgery, the latter of which includes rigorous training related to the nose and nose-related problems. Contrast this to general plastic surgeons, who normally do not have this expertise or training and also spend their time operating on other areas of the body, such as the breasts and stomach area.


pics Male patient before and after rhinoplasty


What Is the Ideal Setting for My Rhinoplasty?

When choosing a facial plastic surgeon, make sure that he or she has a state-of-the-art surgical facility that is accredited by the appropriate accreditation organizations. The best facilities have customized equipment such as ventilation systems, as well as high-definition, computer-assisted 3D technology, which allows the surgeon to view the inside of the nose better. Your rhinoplasty surgeon should have the ability to use a telescope to project an image of the inside of your nose onto a TV screen in the operating room, which helps him or her to perform precise excision of nasal bone and cartilage. This, in turn, leads to more natural outcomes because there is less trauma to the internal nasal tissues. It also leads to reduced bleeding.

If general anesthesia is being administered, it is important that an anesthesiologist be present. It’s also a good idea to have board certified nursing staff specializing in plastic surgery, to assist with the procedure.