Choosing a rhinoplasty surgeon is not simply a matter of finding a physician who performs nose surgery. Rhinoplasty changes the central feature of the face, can affect breathing, and must remain structurally stable for decades. A strong consultation should therefore feel less like a sales appointment and more like a careful analysis of anatomy, function, proportions and expectations.
At Okland Facial Plastic Surgery in Denver, Dr. Tyler Okland’s practice is devoted exclusively to the nose, face and neck. My training at Stanford and Vanderbilt placed me in high-volume environments where cosmetic, functional and reconstructive nasal surgery were treated as parts of the same discipline. That background shapes a central principle of his practice: a beautiful nose should also be a functional, durable nose.
This is obvious but understudied. We are biologically programmed to find a functioning organ beautiful. Therefore, a beautiful nose should breathe well. I am a double-board certified facial plastic and reconstructive surgeon, which means I have spent my entire career and training operating on the face – marrying beauty to function.
The 12 questions to ask before choosing a surgeon
1. Does the surgeon specialize in the face? Facial plastic surgeons train specifically in the anatomy of the head and neck. For rhinoplasty, the external shape of the nose, septum, internal nasal valves and the relationship between the nose and the rest of the face must be considered together.
2. How much of the surgeon’s practice is rhinoplasty? Ask how frequently the surgeon performs primary, functional and revision rhinoplasty—not simply whether the procedure appears on a long service list. In general, those surgeons who specialize in rhinoplasty are performing north of 200 per year (Dr. Okland performs ~250 rhinoplasties per year, 30-35% revision).
3. Does the surgeon plan to do a septoplasty? If your surgeon does not plan to do a septoplasty during your rhinoplasty, they are not a rhinoplasty specialist. Modern rhinoplasty requires a masterful command of the septum and the grafts it yields. Where the septum goes, goes the nose. If your surgeon isn’t competent enough in septoplasty to perform it in every rhinoplasty, they are simply not a rhinoplasty specialist.
4. Do you like the surgeon’s before and after photos? Do you find their aesthetic beautiful? Even in Dr. Okland’s practice, where each nose simulation is guided in painstaking detail by the patient, there are commonalities of shape, rotation, curves and ratios. The first step when selecting a rhinoplasty surgeon should be to look through their photos and saying ‘what they find beautiful I too find beautiful.’ If not, you should consult with a different surgeon whose beauty aesthetic matches yours. Review front, profile, oblique and base views. A flattering profile alone does not prove the frontal view, nostrils or airway were handled well.
5. Does the surgeon have results for patients with anatomy like yours? Thick skin, thin skin, trauma, a crooked nose and prior surgery present very different problems.
6. What does the surgeon mean by a natural result? A natural rhinoplasty preserves identity, avoids a pinched or over-rotated appearance, respects the frontal view and maintains structural support. It DOES NOT mean “I can barely tell a difference.”
7. How is digital imaging used? Imaging should be a communication tool, not a guarantee. It should help discuss bridge height, tip rotation, projection and facial balance.
8. If the surgeon requires extra materials, such as cartilage, what is the source? The only reasonable option for cartilage in a primary operation is septal cartilage, with rib (either donor or from the patient), being the second choice. Ear cartilage has no role in the nose. It is bendy, brittle, and weak.
9. What happens if cartilage support is limited? Primary cases may use septal cartilage; revision cases or primaries where the patient has a low bridge or suspected minimal/damaged septal cartilage may require rib cartilage.
10. What is the revision policy? Ask when a revision would be considered, how concerns are handled and which costs may remain. A surgeon should not be doing a procedure if they don’t feel comfortable being able to revise their own work.
11. Who provides postoperative care? Rhinoplasty care continues long after the cast is removed. Ask who answers questions and how long follow-up continues. How can you communicate with the surgeon, is there an answering service, do you have their contact information?
12. Do you feel heard—and appropriately challenged? A good surgeon should understand your goals but should not agree automatically with every requested change.
Red flags during consultation
Be cautious when a surgeon guarantees an exact simulation, focuses only on the profile, fails to examine breathing, applies the same aesthetic template to every patient or pressures you to schedule before you understand the plan.
- Avoiding discussion of risks, healing or revision
- Generic statements about being ‘natural’ without explaining what that means
- No discussion of your unique anatomy
- An unwillingness to explain limitations or say no
- Proposing to use ear cartilage
Dr. Okland’s perspective
Rhinoplasty is both an aesthetic operation and a structural operation. The goal is not simply to remove a bump or refine a tip; it is to create a nose that belongs on the patient’s face, breathes well and remains stable. That requires technical training, but it also requires judgment—the ability to know how much change is enough.
Frequently asked questions
Should I choose an ENT, plastic surgeon or facial plastic surgeon? The title alone does not determine quality. Focused training, current rhinoplasty volume, before and after photos, airway expertise and consistent results matter more.
How many consultations should I have? There is no required number. The goal is to find the surgeon whose analysis, photographs and communication make you feel confident and safe.
Is board certification enough? It is an important baseline, but it does not show procedure-specific experience or outcome quality.
Should I travel for rhinoplasty? Travel is reasonable when expertise and aesthetic fit justify it, provided postoperative logistics are clear. 50% of Dr. Okland’s patients come from out of state.