When performing rhinoplasty, as with any aesthetic procedure, one must have an effective means of performing preoperative photographic documentation of the patient. Special care must be taken to create only the highest quality photographs as a preoperative record. After surgery, very precise rhinoplasty operative diagrams should be completed to record the details of the operation that was performed. The more precise this record, the more helpful it will be in the follow-up of the patient.
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November 2006With good records (pre- and post-op photographs, rhinoplasty worksheet, and operative report), the rhinoplasty surgeon can see the patient in the office, assess the outcome, and learn by correlating the patient’s records with the results. The surgeon is encouraged to engage himself or herself in a mental exercise with every patient by trying to figure out what was the direct cause of every suboptimal component of every rhinoplasty done.
Learning rhinoplasty is a lifelong process, and we all can learn from every rhinoplasty that we perform. The educational process begins as soon as the patient’s cast is removed. Every time you see the patient in the office for follow-up, this represents a single point on a continuum of healing that extends over the lifetime of the patient. It is unlikely that the contour noted at one year will be the same as the outcome at 10 years. In fact, in some cases these changes are dramatic and influenced by the forces of scar contracture that act on the nasal structure over time.
It is time for otolaryngologists and facial plastic surgeons to further develop their rhinoplasty skills and, as a result, provide an even higher level of care to our patients. This begins with elevating our expectations on rhinoplasty and intensively studying the operation to improve our outcomes. As a specialty we have the opportunity to establish ourselves as the rhinoplasty specialists. This is not given to us by default. We must earn this status.
©2006 The Triological Society