For benefit of those surgeons what I mention before, who have yet not garnered much experience such as I to be expert of rhinoplasty, here are key principals which remain constant no matter the situation!;
1. Always smaller is better. Noone ever request larger nose for surgery; always better to over-resect nose than have complaint from patient that nose too big. Always you must aim for the smallest size nose possible!
2. No-one likes round, bulbous ugly nose. Always you must endeavour for most sculpted, pointed tip. This shows quality of craftmanship of nose, thin nose and sharp tip are indicators of great surgeron!
3. If patient request "conservative" rhinoplasty, then better it is to preserve some inherent traits than aim for perfection! For example, if patient nose is crooked, aim to have nose just as crooked after surgery, or even more crooked, this make sure others will have disbelief at nose being result of "nose job". Or if naturally then hanging columella exist then make sure columella still hang after surgery, to preserve patient unique "look".
4. If irregularities (dent or pinch) appear on surface of nose after surgery, is not the fault of surgeon! Never accept responsibility for poor healing of patient! Whenever collapse or irregularity appear is always fault of patient for inability of body to heal nose properly after surgery. Never it is fault of surgeon; can even happen to expert of surgery! I should know! Happen with me all the time!
5. Never tell patient before surgery of that what is to be done to them. It is no business of patient what you shall do to them during procedure! There is not even any need for surgeon to have prepared that which he will do for surgery before operation, if surgeon have any experience !
Follow this steps and you shall have always glorious practice of making aesthetic nose!
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