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During the “Golden Age” of surgical training, roughly from the end of World War II to the early 1980s, plastic surgeons in training had plenty of chances to learn surgical skills at their university hospital.
Many patients were willing back then to go to university hospitals for cosmetic surgery by novice plastic surgeons working under a professor. The procedure usually took much longer than would veteran plastic surgeons or even established plastic surgeons taking a day off to teach as a volunteer.
But time and economics changed in the ‘80s; insurance companies became sticklers, paying less and less so plastic surgeons could no longer volunteer a day a week. University budgets also tightened while medical school tuition easily soared into $60,000 yearly. That meant plastic surgeons in training had to concentrate on:
- Reconstructive surgery
- Hand surgery
- Burn care
- Post cancer reconstruction
- Birth defect correction
So training in cosmetic procedures was scarce.
Without doubt, cosmetic rhinoplasty is the most difficult, complex and challenging of the 137 cosmetic operations the American Board of Plastic Surgery expects graduating surgical residents to be familiar with and capable of doing.
But – and this is a huge however — cosmetic rhinoplasty or other functional nose surgery cannot be mastered in just a couple of years. Any nose job has surgical openings that are very tiny. Where body surgeons can put a hand into their openings, nasal surgeons barely have room for a single pinky.
(See some permanent, non-surgical nose job before & after pictures.)
So where do beginning plastic surgeons get the experience to master nose surgery? Well, they can spend a year at the side of a Master Surgeon in a fellowship.
(Read more about cosmetic surgical fellowships.)
But too often, they learn on their patients. And statistics show the results; one professional organization of cosmetic plastic surgeons estimated that 15 to 25 percent of first rhinoplasties are botched and require a revision rhinoplasty.
And so how are patients are supposed to make sure they are in capable hands?
On consultations, with plastic surgeons, ask about training and:
- Years experience plastic surgeons have in the procedure you want
- If there was a fellowship
- How many times weekly he/she does it
- His/her before and after pictures
Ideally, there should be hundreds of before & after pictures of the procedure you want.
Also ask if plastic surgeons are super-specialists (a medical, not advertising, term.) That means the surgeon is highly trained and much more likely to provide the results you seek.
