The authors' philosophy of rhinoplasty focuses on achieving two essential goals. The first is to make the patient happy. Hand in hand is the second goaldfor this to be their only cosmetic nasal surgery. With these goals in mind, this article presents the authors' personal philosophy and approach to reducing complications in rhinoplasty.

Cosmetic rhinoplasty patients: esthetic nasal examination

When the patient arrives at the office, he or she is greeted and are asked to fill out a detailed history form. The patient is taken to the photography room by a nurse assistant, who takes digital photographs and escorts the patient to the examination room. The nurse downloads the photographs into the network computer.

Next, the surgeon meets the patient. The surgeon asks what the patient does not like about his or her nose and what he or she would like the surgeon to fix. After the patient has explained his or her goals, the surgeon reviews any prior medical records. After a review of the medical history, the surgeon performs an examination.

Detailed anatomic analysis of the nose is an essential initial step in achieving a successful surgical outcome. The author's approach to rhinoplasty analysis in a primary rhinoplasty is well described [9]. Box 1 presents a partial list of specific considerations.

Rhinoplasty analysis

A thorough physical examination and accurate preoperative analysis are crucial to achieving the desired long-term postoperative rhinoplasty result. Some degree of mental organization assists in the execution of the physical examination. Visual examination and finger palpation are equally important in the nasal evaluation. Throughout the evaluation, a mental image of the potential outcome and surgical limitations inherent in every individual case should be visualized. In effect, the potential rhinoplasty operation is rehearsed even as the physical examination proceeds [9,11].

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