Facial Plastic Surgery FAQ

Facial Plastic Surgery Miami | FAQs | Dr. Anthony Bared

Have questions and need answers? get a better understanding of your procedure or treatment. Dr. Bared has answered multiple plastic and cosmetic surgery as well as aesthetic questions to help give our patients a better perspective of how they will benefit from there desired procedure or treatment.

What is a good rhinoplasty?

Full Question: How do you personally define a “good” rhinoplasty and do you have any memories about learning how to do the procedure?

I define “good” Rhinoplasty as I do every other facial cosmetic procedure: one whose result makes my patient happy and more content with their appearance. My response to this question, by my definition, is limited and incomplete. My answer to this question, as the surgeon, does not completely answer the question posed— a “good” rhinoplasty is defined by my patient. It is my job as their surgeon to ascertain from each patient what their goals are from the rhinoplasty and then to try my best to meet and surpass those goals. Importantly, given my background as an otolaryngologist (Ear, Nose and Throat), one of the goals which I bring to every rhinoplasty is to improve and/or maintain the ability to breath well through the nose: a goal which cannot be compromised with any rhinoplasty. For those patients who suffer from nasal obstruction, a result of the surgery needs to be the improvement of nasal breathing and, for those who do not have breathing issues, the rhinoplasty procedure needs to preserve this ability. A “good” rhinoplasty whether from the patient’s or the surgeon’s perspective needs to have this as an outcome. Additionally, a “good” rhinoplasty needs to not only make the patient happy in the short term but throughout the life of the patient. Too often patients are ‘satisfied’ with the results of their rhinoplasty as soon as the cast is removed or in the short term period only to notice changes to the nose years later causing them to seek consultation for a revision. These changes which take place over time may also lead to compromises in nasal breathing. This is what I think is the most challenging aspect of rhinoplasty—to achieve good and long-lasting results. It is why I believe that long term follow-up is essential after rhinoplasty. I have immersed myself in the study of rhinoplasty. I am passionate about this procedure. My passion stems from the very challenges the surgery poses. Rhinoplasty is a very challenging procedure to perform both technically as well as artistically. Given this challenge, I am very fortunate to have received training from one of the most well-respected rhinoplasty surgeons in the world, Dean Toriumi, M.D. My experience with Dr. Toriumi was invaluable in that it exposed me to extremely difficult revision rhinoplasties. Oftentimes, Dr. Toriumi was performing surgeries on patients who had already had multiple previous revisions from other surgeons. As a surgeon, I feel that you learn a great deal about a procedure by seeing and exposing yourself to the complications from the procedure. Given that most of my training was alongside surgeons who performed a lot of revision rhinoplasty, I was exposed to patients who sought consultations secondary to their dissatisfaction with their previous procedures. Many of these patients presented for their revision rhinoplasty years after their initial procedure. Oftentimes you heard the concern that they were, at first, happy with their surgery but over time their nose began to change to the point where they were now concerned about its appearance or the inability to breath well through it.

If there is one memory I have preserved from my learning to perform this procedure is that the nose will continue to “heal” itself years after a rhinoplasty has been performed. The healing process after a rhinoplasty entails, as it does throughout the skin in our body: by contraction. It is for this reason that I have a firm belief in the modern approach with regards to rhinoplasty which is a structural approach to rhinoplasty. Simply stated, you need to set a strong, structural foundation to combat the normal scarring and healing that is expected after the surgery. I have had the privilege of learning under the tutelage of some very talented surgeons who have themselves made great contributions to the body of knowledge we have of rhinoplasty. Throughout the time I have been performing this procedure, I have drawn from this knowledge and executed techniques that produce long-lasting results to try and exceed each individual patient’s goals.

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