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We are going to be joined by Dr. John Hilinski, a Board Certified Facial Plastic and Reconstructive Surgeon. Today Dr. Hilinski will be here to discuss the importance of ethnic rhinoplasty and progress in that field of plastic surgery.

ALEX: Dr. Hilinski, some people think that patients who opt for rhinoplasty simply want a better looking nose. Can you dispel that notion for us and perhaps share a few considerations that people may have when seeking rhinoplasty?

DR. HILINSKI: I would say that in a good majority of cases, rhinoplasty patients are not seeking to have a nose created that is better looking. The real impetus behind their desire to have cosmetic nose reshaping is to simply get rid of certain features of their nose that bother them. For example, patients with a large hump or bulbous nasal tip are not necessarily seeking a more beautiful nose. They are really looking to just reduce the hump (or bump deformity) or make the tip less rounded so that these features are not as obvious.

The real goal of rhinoplasty is to reshape the nose in such a way that people look beyond it without getting hung up on a particularly distracting feature, and are simply looking at one’s eyes.

In other cases, rhinoplasty patients are seeking to restore their nose to a state that once previously existed. For instance, (often times) noses are broken as a result of a traumatic injury or accident. The nose was displaced or shifted to one side or the other. In many cases, this is accompanied by trouble breathing through the nose as well. So these patients are seeking to correct the traumatic injury by reshaping the nose to restore their prior look. If there is trouble breathing through the nose, this dysfunction can likely be corrected at the same time.

ALEX: Dr. Hilinski, you recently gave a lecture on ethnic rhinoplasty at the UCSD Medical Center in San Diego, California. Are there problems or issues with current rhinoplasty standards for patients of different ethnicities?

DR. HILINSKI: Yes, that was part of the message I was trying to spread regarding ethnic rhinoplasty. Unfortunately, there are still a good number of plastic surgeons who are trying to reshape ethnic rhinoplasty noses in an overly aggressive manner. This results in noses that are far from ethnically appropriate for those faces. These patients end up with noses that look to ‘westernized’ or appear more Caucasian than ethnic. The end result is a nose that has all the stigma of having been surgically altered.

This is not the look ethnic patients are seeking. Rather, they are looking to achieve a result that appears ethnically consistent with their surrounding facial features – a nose that looks like they could have been born with it. I am trying to convey to other plastic surgeons the need to avoid this if at all possible.

ALEX: Doctor, will you share with us a few of the highlights from your lecture?

DR. HILINSKI: Sure. One thing that I really emphasized to the audience of community plastic surgeons was how different the skin is when dealing with ethnic rhinoplasty patients. Why does this matter? Because thicker ethnic skin behaves entirely different than thinner Caucasian skin. For example, if one is trying to create more tip definition in an ethnic nose that is quite rounded in appearance, you cannot rely on standard surgical technique that you would use in a Caucasian nose. You need to make more definitive changes to the skeletal and cartilage framework in the ethnic nose to achieve the desired type of cosmetic change. This is really important when performing ethnic rhinoplasty surgery.

ALEX: Dr. Hilinski, do you feel it’s important that surgeons keep their finger on the pulse of industry standards?

DR. HILINSKI: I think this is very important to understand where the community standard is when it comes to achieving surgical results in the field of plastic surgery. In my opinion, you should always strive to achieve consistent surgical results that are much better than average. So understanding where the community standard lies is a prerequisite.

You have to be careful that you are not easily swayed as a surgeon by the ‘latest and greatest’ technology. There are so many new technologies that are introduced each year in the world of plastic surgery – with all of them purported to help us achieve better results. The reality is, though, almost all of these fall way short. No matter how good technology is out there, it still distills down to the technical skill of the plastic surgeon when it comes to achieving the best, consistent results – especially in the area of cosmetic nose reshaping.

ALEX: Lastly, doctor, what are a few important considerations someone must make in selecting a plastic surgeon?

DR. HILINSKI: One of the more important considerations is board certification. If one is seeking facial plastic surgery – including rhinoplasty, otoplasty, facelift, etc. – I would highly recommend you seek consultation with a surgeon board certified by the American Board of Facial Plastic and Reconstructive Surgery. This is the only certifying organization that oversees plastic surgeons with dedication to cosmetic facial surgery.

If you are seeking body reshaping – like breast augmentation – then find someone certified by the American Board of Plastic Surgery. When it comes to facial plastic surgery, you should really seek out a surgeon whose practice is focused on just the face.

It is really, really hard to be a so-called expert in facial plastic surgery when you do breast augmentation one day, a tummy tuck the next, then do a rhinoplasty at the end of the week. Splitting one’s time between these widely varied plastic surgery procedures should make patients think twice about who they are choosing to perform their facial procedure.

In addition, patients should look at a healthy number of photos from prior patients treated by that surgeon. In many cases, patients will ask to see photo examples of, for example, rhinoplasty. When a plastic surgeon says they don’t have any to show or only produce a handful of examples – prospective patients should be worried. It is a red flag if they don’t have a wide range of representative examples of rhinoplasty.

If any surgeon does this type of surgery on a regular basis, they will have a good number of great results to show. This holds true for any type of facial plastic surgery procedure whether you are considering cosmetic nose surgery or otoplasty.

ALEX: Thanks so much Dr. Hilinski for joining us today and sharing your knowledge and experience on this important subject.

DR. HILINSKI: My pleasure.

Dr. John M. Hilinski is “double board certified” in Facial Plastic and Reconstructive Surgery as well as Head and Neck Surgery. He is based in San Diego, California.

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