Dear Patients,

As you may know, the Christmas Holiday is one of the busiest time periods of the year  as students are out of school and poeple have time off of work.  In additon, many insurance cases want to have their surgery done because they have met their annuual deductible. To accomodate this seasonal rush, the office schedule has been changed.  Yesterday,  the Surgicenter agreed to give us an additonal day of OR time.  Thus, Santa’s workshop is open and Rudolph has agreed to be our consultant as there will be many a red nose over the Holidays.  If this time works for you, call the office asap.

Some patients ask how long a rhinoplasty will take. There are several answers. Most of my primary cases are booked for 2 hours which includes the surgeon’s “cut time’ and anesthesia time. In most primary cases, I have a good idea of how long it will take based on my experience with similar cases - BUT - it doesn’t matter! I tell patients that it is like sailing - “you know what time you leave the dock, but you don’t know what time you will get back.” Nobody has ever asked me to rush through their operation. The “surgical reality’ is that surgeons have different operative tempos and a different amount of experience. Remember: any additional time spent in a primary operation is far less than doing a revision a year later. Just as there is no reason to waste time in the operating room, there is also no need to rush - do it right the first time!

I have always thought that Rhinoplasty Message Boards are very helpful as long as they remain positive and do not slip into negativity. Most preoperative patients get lots of information and once they have recovered they don’t go back to the Boards, leaving it mainly to those seeking revisions. Recently, my Staff was shocked by patients calling and asking if I am retiring soon. My Staff inquired as to where the callers had heard such rumors and it led back to the Rhinoplasty Message Boards. An in-depth sequential search indicated that it had all begun with questions as to why I referred patients to other physicians (see above explanation). Apparently one uninformed poster speculated that I referred patients to other doctors because I would be retiring soon - totally untrue. Surgical judgment and expertise only comes with experience. It is only now that I am reaching my surgical peak and have the most to offer my rhinoplasty patients. I look forward to having a “rhinoplasty only” practice for many years to come.

Patients often wonder why I refer some patients to other doctors. Quite simply, the reason is that I see far more patients than I can operate on. In a normal year, I will see approximately 1,200- 1,400 rhinoplasty consults and perform around 350 rhinoplasty operations. Fortunately, I am able to select those patients whose deformity best matches my experience and techniques. Rather than concentrate my practice in just revision surgery, I try to keep a 50-50 balance between primary and revision cases. I do a large number of teenagers during the summer and Christmas holidays. I also do a lot of patients with “difficult noses” referred by my colleagues and Middle Eastern patients referred by previous patients. Most of my revision patients have significant nasal deformities and are seeking a surgical solution. They have often seen 2 -3 other plastic surgeons and know that they need to see a rhinoplasty specialist. Rather than tell patients that they are not candidates for surgery, I refer them to colleagues who are very good rhinoplasty surgeons thus insuring that the patient will receive excellent care.