Q1 | I had a noselift about 3 years ago and I was very pleased with the results, however I have gained a lot of weight and my face is now rounder and chubbier than before. I want a new shape for my nose to go together with the changes on my face. Is this possible? Can my case be considered a back job? Should the doctor charge me again?
Answer: | When I perform my noselifts I do it in such away that my patients can see the final outcome so they get the changes that they want done. We stop the surgery when the patient says ‘Doc I am very happy with this nose because this is exactly what I want.’ This is possible because the patient is awake during the surgery and the local anesthetic technique use makes the whole procedure quite comfortable for the patient. In this way I have reduced the number of cases of secondary surgery or redo’s. However there is about a 10% to 15% of these patients who like you, change their minds and want revisions on their nose. I believe this is a patient’s prerogative and since I want my patients to be happy with the results, I would follow what they want and perform the repeat operation.
For practicality, I consider all repeat operations as a ‘back job’. Strictly speaking though most plastic surgeons would consider complications only that would qualify for a back job while any alterations just because the patient changed their minds are considered new surgery. This is important because this relates to the issue of whether new payment is made or not. Most doctors may charge again although at a discounted rate.
In my practice, in cases of repeat surgery where the last surgery was done by me whether this is due to a complication or not, I don’t charge additional professional fees. I just ask the patients to settle operating room and medicine expenses. This has been my policy not only for rhinoplasty but also for all the other types of cosmetic procedures.
Q2 | I am planning to have a noselift and I have saved money for this from my meager income. I just want to be sure that I get the best value for my hard earned money. How can I be sure I am getting my money’s worth?
Answer: | Countless patients have been duped by quack doctors claiming to be plastic surgeons. Most of these counterfeit plastic surgeons packaged their charges much lower than what is considered standard fees to entice patients who are shopping for bargains. These patients later on realized that instead of making some savings they actually have squandered their money for naught and they end up spending more because of complications or results that are not acceptable. Complications are more difficult to operate on because the best results are more difficult to achieve and several operations might be needed to correct the problem, making the whole procedure more expensive. My advice is to really do a good checking of the credentials of your surgeon. Aside from the proper credentials which can be checked with the Philippine College Of Surgeons (tel: 9292297, 9292359, 9281083), your surgeon should guarantee that you will be happy with the results, which means he should be willing to correct any problems with minimal additional expense. When unavoidable complications arise your surgeon should be able to handle them properly and not refer everything to another doctor. The dictum in surgery is ‘a safe surgeon should not do a particular operation if he cannot recognize and manage its complications’.