Safe Candidacy for Rhinoplasty Surgery: Munish Shandilya

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The Nose has a unique place in determination of Self-Image.
Why does the Nasal Appearance matter so much to some … more than others ?

In my experience if a new patient is not an ideal candidate for Rhinoplasty … it is often difficult to dissuade that person from undergoing cosmetic Nasal Surgery … it is however possible to discuss the safety and predictability issues if enough time is spent discussing these with the person seeking Rhinoplasty. I never shy away from requesting professional opinion regarding safe candidacy of a patient to safeguard my patients interests. Over the last ten years my patient-counselling has increasingly included a close relationship with the Adult and Child Psychiatrists. Although it adds an extra expense to the evaluation process, most patients recognise its value and respect our ethos of keeping the patient interest above every other consideration.

Morphing of Digital Images is a very useful tool that has a central position in my consultation process. It is only used to establish goals while making sure that the images are not considered to be the promised result.

It helps establishing realistic goals and allows great communication with the patient.

Rhinoplasty is a surgery I take very seriously. It is often said that most patients benefit from the surgery. It is generally true but then how many dissatisfied patients are acceptable ? In my view … None !

Is that possible?
Every Rhinoplasty Specialist must strive for that goal … Honest and clear evaluation of results and sharing these with my patients … at every stage is vital for me. A revision surgery rate of about 4 % in my practice suggests to me that our ongoing appraisal by me and my patients over the years … has helped us in knowing exactly where we stand.

How long should one follow the Rhinoplasty patient? The lesson I learnt From Bobby Simon in 1996, Mount Sinai Manhattan NY Workshop was … For Ever !!! Only then the surgeon will know that he has performed a surgery with long-term good results.

Is your patient happy and engaged enough in the process to keep returning over years ?
They do if they trust you and appreciate your ongoing efforts … and if the reviews are free 🙂

 

The Nose Clinic : Rhinoplasty in Ireland: 4 years today ! Munish Shandilya

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I started my Blog “The Nose Clinic” exactly four years back on the 1st of January 2011.

I am delighted with the achievements … because the ground covered in these four years is far beyond what I had proposed and hoped for … in my opening post.

So we had realistic goals ! and … that is how it should be !!

The Blog has been visited by 92,750 international visitors in these last years and has helped me spread the message that there is an Ethical, Carefully structured Caring journey available in Ireland for anyone interested in Rhinoplasty. There is Guidance available to those where the candidature may be in doubt. There is an Ear available to listen to those … who have been traumatised with or without past surgical experiences.

The role as Irelands National Delegate to the European Academy of Facial Plastic Surgery (EAFPS) has increased my interaction with similar minded teachers from Europe and beyond. This is the most important development of 2014 and has allowed me to grow as a Rhinoplasty Specialist at an exponential rate.

I have so far confirmed my attendance at Rhinoplasty Meetings in Milan, Prague, Chicago & Cannes in 2015. I will be attending the European meetings as an Invited Speaker. These are valuable fora to communicate and improve our skills and forever move towards safe and satisfactory outcomes in Rhinoplasty Surgery.

We plan to start our own Irish Rhinoplasty Meeting under the umbrella of the Royal College of Surgeons (RCSI).

 

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Extracorporeal Septoplasty : 5 years after an In-situ “Extracorporeal Septoplasty” as part of a Septorhinoplasty

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These pictures have been produced here with the kind consent of this young patient for teaching purposes
Extracorporeal Septoplasty is an advanced form of Septoplasty where the septal components are removed outside the body and replaced back after making the desired corrections. Although increasingly finding acceptance, I feel in my hands I rarely need to take out these components out completely. I perform what I call an “in-situ Extracorporeal”Septoplasty … preserving as much of the good septum possible and build around it.
This is a five year result with very satisfactory Functional & Cosmetic results.

Morphing in Rhinoplasty : Computer Simulation in Rhinoplasty: Digital Manipulation of Clinical Photographs in Rhinoplasty

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The picture used here to describe the concept of morphing pictures is not a true patient but a web image. The technique shown here is using  a popular digital picture manipulation software.

Morphing in Rhinoplasty refers to a technique of manipulating digital photographs of a patient aspiring for a Rhinoplasty surgery.

While most patients have a clear idea of what they are trying to achieve it can be difficult to accurately convey this to their surgeon. In other patients the ultimate rhinoplasty goal is less clear cut when they first arrive for their consultation. These patients know something is not quite right but they are relying on the Surgeons expertise to achieve a satisfactory result. For the surgeon, on the other hand, it is vital that the patients likes, dislikes and goals are fully understood.
Specialist Rhinoplasty surgeons use many tools to achieve that precise understanding of goals with their patients. Communication between the patient and the surgeon is a critical component to successful rhinoplasty surgery. Digital Morphing is a very powerful tool to arrive at the common ground.
What is required

 

1. TIME. Your surgeon should have the time and inclination to perform this himself because only your surgeon knows if he can achieve the result they are displaying.

 

2. COMPUTER AND PHOTOGRAPHY EXPERTISE. The Surgeon must have the expertise to convert their knowledge of Rhinoplasty surgery and its outcomes onto the screen with reasonable precision.

 

3. REALISTIC DEPICTION. The changes must be kept conservative to give an idea that is reproducible in most cases.

 

4. PATIENT UNDERSTANDING. It must be explained very clearly that the modified pictures are used as a guide and are not a promise of the outcome.

 

In our clinic the surgeon Mr Shandilya performs clinical photography and Digital Morphing himself in every single case. Consistency and experience of photographically recording the right angles every time and achieving consistent results in surgery makes the whole process very valuable.

 

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8TH International Biennale Milano Masterclass

It is my pleasure to introduce Professor Pietro Palma, The President of EAFPS (European Academy of Facial Plastic Surgery) who is a Rhinologist I would travel to listen to and learn from.

Professor Pietro Palma is a Rhinoplasty Surgeon who is respected across the Rhinology world for his innovative techniques and teachings. He is a master of the closed technique of Rhinoplasty and in my opinion one of the best when it comes to Profileplasty.

Mark these dates in your diary …

8th INTERNATIONAL “BIENNALE MILANO MASTERCLASS”
March 20 – 24, 2015
Milan, Italy
1. Sinonasal, Skull Base & Orbit Endoscopic Surgery
2. Rhinoplasty: The Matrix Reloaded
Directors: Paolo Castelnuovo & Pietro Palma

Email: [email protected]
Website: www.milanomasterclass.it

 

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