A rhinoplasty consultation is where you and your surgeon work out whether the changes you have in mind are realistic and suit your face. It tends to go smoothly when your goals are clear and conservative, when everyone in the room is on the same page, and when computer imaging is used to talk those goals through before anything is decided.
In this video, Dr. Thomas Buonassisi, MD, FRCSC, Specialist in Otolaryngology – Head and Neck Surgery, with a practice limited to facial plastic surgeries, describes a consultation with Holly, who came in with her mom, and why agreeing on the goals made such a difference. She agreed to share this video.
What happens at a rhinoplasty consultation?
At 8 West, the rhinoplasty consultation is a one-on-one appointment with Dr. Buonassisi, who has over 25 years of experience in facial plastic surgery and has performed over 2,500 rhinoplasties. It's a critical step, not a formality. It's where expectations are aligned, candidacy is assessed and you learn what is and isn't achievable for your nose.
In general, you'll talk about which features you'd like to change and why, and the surgeon will look at your nose and how it relates to the rest of your face. Computer imaging is used to talk through the changes being considered, and you'll hear about recovery: most people are socially presentable in about 1–2 weeks, and final results take about 12 months.
If you're wondering what happens at a rhinoplasty consultation beyond the medical side, a lot of it is simply conversation. It's a chance to ask questions, voice any worries and hear an honest view of what rhinoplasty could do for you. Surgeon consultations at 8 West have a fee.
What do realistic rhinoplasty expectations look like?
Dr. Buonassisi says the patient in this video came in with very specific, but also very realistic, expectations for her nose, and that he was impressed by that. She wanted to be conservative. There were a couple of particular things about her nose she didn't love, and she knew what they were.
The two features she pointed to were a tip that tilted down a little and a small dorsal hump. A tip that tilts down is sometimes called a ptotic tip, and it can make the nose look a bit longer. A dorsal hump is a little extra fullness or height along the bridge of the nose. Apart from those, Dr. Buonassisi thought many of her nasal features were quite good, and she felt the same way.
That's a helpful picture of realistic rhinoplasty expectations. In general, people who arrive knowing which specific features they'd like to soften, and who are happy with the rest of their nose, find it easier to have a clear conversation about what surgery can and can't do. You can read more in our video on setting realistic rhinoplasty expectations.
Why does it help when you and your surgeon agree?
Dr. Buonassisi explains that what made this consultation work well was that the features she wanted to change were the same ones he'd noticed. When the patient and the surgeon are both on the same page, he says, it really makes a big difference.
It's easy to see why. If you're hoping for one thing and your surgeon would recommend something quite different, there's more to work through before anyone can feel confident. When the goals line up from the start, the conversation can move on to the details: how much change, and how it will sit with the rest of your face.
Agreeing doesn't mean the surgeon simply says yes, though. It means you've both looked honestly at your nose and reached the same view of what would bring it into better balance.
How does computer imaging help in a consultation?
During this consultation, Dr. Buonassisi did computer imaging to show the changes he'd expect with surgery. He says her mom could see it too, and that it was nice for her mom to realize her daughter's ideas were good ones: reasonable, conservative changes that would make her nose a little less prominent on her face. She wasn't expecting changes that were particularly big.
That's the role computer imaging plays at 8 West. It gives everyone in the room the same picture to talk about, which can be easier than trying to describe a change in words. It's a guide to talk through goals, not a promise of how a nose will turn out. Our video on computer imaging in a consultation explains what it can and can't show.
Should a parent come to a rhinoplasty consultation?
Dr. Buonassisi says it was very important that she came with her mom. In his view, the consultation worked out well for everyone: she had her mom's support, her mom could see that the request was reasonable, and his own view of what would look good fit as well. Having everyone on the same page, he says, makes the whole process a lot less stressful.
He's just as clear about who comes first. The most important person in the whole conversation is the patient. If the patient has particular goals or particular changes in mind for their nose, he has to honour that. He can't make changes to a patient's nose based on what a parent wants.
For families, that's a useful balance to keep in mind. A parent can offer support and perspective at the consultation, while the decisions about the nose itself stay centred on the patient.
How is the approach chosen after a consultation?
Every rhinoplasty Dr. Buonassisi performs is bespoke. He recommends an approach tailored to your anatomy and objectives, using the full range of rhinoplasty techniques rather than favouring one method.
The aim is natural harmony: a nose that looks like you, just refined, with your identity kept intact. Looking natural and breathing well are treated as the same goal, so the recommendation takes both into account.
What should you bring to a rhinoplasty consultation?
If you're looking into rhinoplasty in Vancouver and North Vancouver, a little preparation helps you get the most from the appointment. A few things worth bringing:
- A short list of the specific features you'd like to change, and the ones you like
- Your questions about recovery, risks and the time between consultation and surgery
- A parent or support person, if you'd like one there
- An open mind about what the surgeon recommends for your anatomy
The free Essential Guide to Rhinoplasty has more questions to bring along, and you'll find more short videos in the Rhinoplasty Knowledge Hub.
Frequently asked questions
Can a parent come to my rhinoplasty consultation?
Yes. The patient in this video came to her consultation with her mom, and Dr. Buonassisi says that was very important. A parent can offer support and see the computer imaging and recommendations at the same time. The conversation still centres on the patient, though, because the patient's own goals for their nose are what matter most.
What if my parents want different changes to my nose than I do?
Dr. Buonassisi says the most important person in the conversation is the patient. If the patient has particular changes in mind, he has to honour that, and he can't make changes based on what a parent wants. A consultation, with computer imaging, can help everyone see what's reasonable and get on the same page.
How do I know if my rhinoplasty expectations are realistic?
In general, realistic expectations focus on specific features you'd like to soften rather than a completely different nose. The consultation is where you learn what is and isn't achievable for your anatomy, and computer imaging helps you see the direction and scale of a change. Being open to the surgeon's view is part of reaching a realistic goal.
Is there a fee for a rhinoplasty consultation at 8 West?
Yes. Surgeon consultations at 8 West have a fee. The consultation is a one-on-one appointment with Dr. Buonassisi and a critical step in the process, where expectations are aligned, candidacy is assessed and you learn what is and isn't achievable. Our team can tell you the current fee when you get in touch.
Does computer imaging show exactly how my nose will look?
No. Computer imaging is a guide to talk through goals, not a promise. It shows the kind of change being considered on your own face, which makes it easier for you, and anyone supporting you, to react to a picture rather than to words. Final results take about 12 months, and they depend on how your own tissues heal.