Rhinoplasty Research: Festina Lente

While researching for Rhinoplasty surgery it is quite natural to try and find out

Who are the good Rhinoplasty surgeons in your geographical area?

What are their areas of specialisation?

What are their Reviews? Are these Reviews for Rhinoplasty??

What is the Waiting Period?

What is the Recovery time or Down-time?

What are the Follow-up routines? Is the surgeon interested in your long-term results.

What is their Revision Rate?

Do they perform Digital Morphing in every case?

Are they Resident in Ireland?

What body of Rhinoplasty work and Annual numbers do they have?

Do they demonstrate a special interest by writing articles. Book chapters. giving invited lectures on Rhinoplasty.


And Finally the Cost involved and whether you would like to spend a particular price and this is obviously a very important factor for decision making.

I suggest the last consideration should be separated from all above … Go and meet the best surgeons who can give you a lot of insight and information and direct you towards a safer way to approach your aspiration for Rhinoplasty. A specialist Rhinoplasty surgeon spending an hour or more with you for a fee is invaluable … use this information. A consultation with a good surgeon does not bind you with their price or protocol … There is no obligation for surgery and that is why a fee is charged for their time as would be ethical.


Now is the time to find out what the costs are and would you prefer travelling, waiting or considering Finance plans etc.

We get many enquiries a day about Rhinoplasty that start by asking the cost of surgery …

It is not a good starting point in my opinion and it would be my advice that gathering information and taking good professional advice from a few surgeons should be on the top of your list …

Festina Lente (make haste slowly)

Revision Rhinoplasty: Dorsal Augmentation Options in a young growing mid-face.


These pictures of our patient have been posted here with their consent to educate other aspirants of Rhinoplasty Surgery.
Patient Satisfaction at seven month mark 9/10.
Augmentation Options in a Primary or Secondary surgery in case of a “Saddle Nose Deformity” … in a young person where Mid-Facial Growth Spurt is still underway … has to be considered carefully.
Conchal Cartilage Graft from the Ear was used in the above case to improve both Functional and Cosmetic results.

Finesse Rhinoplasty : Advantages of Endoscopic Rhinoplasty : Follow-up in Rhinoplasty : Swelling in Rhinoplasty

These pictures of our patient have been posted here with their consent to educate other aspirants of Rhinoplasty Surgery.
Patient Satisfaction at seven month mark 9/10.
PREOPERATIVE : Before Surgery
MORPHED: Computer generated and Digitally Modified picture Before Surgery
POST-OPERATIVE: The middle two pictures represent the evolving result at 3 & 7 months respectively
This was the gist of my lecture recently.
The nuances of Finesse and all Rhinoplasty can be understood by a surgeon who follows, documents and Audits their results indefinitely.
This practice also ensures that the results are long-term and survive the vagaries of healing and the effects of age & thickness of skin.

Psychiatric Evaluation of Cosmetic Rhinoplasty Aspirants : Munish Shandilya

Rhinoplasty is a difficult surgery.
To me there is just one aim : My patient should be happier after the surgery and for that objective I spend a lot of my time with my patients both before and after the surgery.
Psychological aspects and their influence on outcomes is a well known fact. What can a surgeon do to minimise these ?
Have you heard of Body Dysmorphic Disorder (BDD) ?
Do you know that BDD is quite common amongst persons seeking Cosmetic Rhinoplasty ?
Those with moderate to severe BDD perform poorly and have low satisfaction rates and surgery is considered contraindicated in this group. These are generally speaking easily diagnosed by your surgeon and surgery here can be a poor option.
Some of those with mild and sub-clinical BDD may benefit from surgery. This group is difficult to diagnose and it is difficult to ascertain its severity.
Current Protocols for safe assessment of our Cosmetic Rhinoplasty patients include assessment by your surgeon and a formal Psychiatric Evaluation.
This is by no means a reflection on a particular persons personality.
Despite vast experience, your surgeon has missed persons with mild BDD even after spending approximately two hours during interviews. This was also the experience of 285 American Plastic Surgeons who regularly missed the diagnosis of BDD according to one study.
In the absence of any clear guidelines, your surgeon prefers the route of a formal psychiatric evaluation on all patients seeking a cosmetic rhinoplasty. He has given several invited lectures on this very important topic to International audience of Rhinoplasty Surgeons in Cannes, Rio De Janeiro & London
Your surgeon sends referrals for Psychiatric Evaluation to one Adult and one Paediatric Psychiatrist to maintain uniformity and to take advantage of their ever-building experience in this small area. If a patient insists on an evaluation by a different Psychiatrist it can be accepted if your surgeon feels it is in your best interest.
You will be reassured to know that only persons considered good and safe candidates for Rhinoplasty by your surgeon are referred for PE. This is to identify subclinical mild form of BDD who are carefully advised again and so far all these patients (they are less than 1% of patients screened by Mr Shandilya) could be offered surgery with satisfactory results.
So, if you are referred for a Psychiatric Evaluation … I am already happy with your safe candidature … you are being asked to spend money for a further consultation … to ensure that you are not one of the less than 1% who may need further discussion.
Unfortunately there is a possibility that I may have to decline surgery after your PE but this is rare and has not happened yet. 
Mr Munish Shandilya formally declares that these decisions are his own and taken in the best interest of his patients. He has no financial interest in these referrals.


Septoplasty in Ireland: FAQs

Q: What is Septoplasty?
A : Plastic repair of Nasal septum that is typically performed for a crooked septum causing a blocked nose.

Q: What is SMR?
A: Sub Mucous Resection of nasal cartilage which has been largely replaced by Septoplasty which is less likely to cause cartilage depletion and complications like a saddle nose.

Q: Who Does Septoplasty
A: Septoplasty is one of the common procedures learned during training by every trainee ENT surgeon and performed by all ENT surgeons throughout their careers.

Read more […] “Septoplasty in Ireland: FAQs”