Dr. Anil Shah analyzes how his book Maneuver It helps both patients and surgeons improve communication, establish realistic objectives and reduce the risk of review rhinoplasty.Review rhinoplasty rates are increasing, but many of the cases could be avoided with better patient education and clearer communication of surgeons. In ManeuverThe facial plastic surgeon based in Chicago Anil R. Shah, MD, FACS, aims to close that gap with a practical guide and oriented to the patient designed to help people choose the right surgeon and administer their expectations. While it is written for patients, the book also offers valuable lessons for younger surgeons who browse the challenges of building a rhinoplasty practice. In this interview, Shah shares ideas about patient education, review risk management and why honest collaboration consultations are key to long -term success.
Practice of plastic surgery: your book Maneuver It presents rhinoplasty as a deeply individualized procedure. What prompted you to write a patient oriented guide and how also see it for younger surgeons?
Anil R. Shah, MD, FACS: I have many many cases of review in which the patient if the patient had asked only some key questions duration of the initial consultation, he would probably choose a different surgeon, he avoided surgery completely. The goal of Maneuver It is to educate patients, to give them the tools to identify a qualified rhinoplasty surgeon who aligns with their aesthetic objectives. This book is not about generating more patients for me; It’s about helping patients find the right surgeon for them.
For younger surgeons, carrying food is honesty. Be clear about their own skills and understand which patients can help genuinely. There is hunger for more cases from the beginning, but it is essential to select patients whose goals can realistically achieve. Clear communication and self -awareness are key.
PSP: AAFPRS data show an increase in review rhinoplasty. What are the most common reasons for reviews and how can surgeons better manage the expectations of the main procedures?
CHA: There are many reasons why review cases occur, but the most common is simply that original surgery was performed by some that was not of complete quality. Rinoplasty is one of the most complex procedures in plastic surgery, and only in expert hands, reviews may be necessary. But the success rate dramatically improves when the primary surgeon is experienced and expert.
Another problem is the lack of communication. Many patients I see for review never showed images or images before surgery: their surgeon simply assumed what they would do. The digital image is a powerful tool to align expectations and make sure that both the surgeon and the patient are on the same page aesthetically.
PSP: emphasizes that a nose must complement the entire face, instead of following fleeting trends. How guides patients towards this special understanding in a world driven by social networks?
CHA: Social networks are a double -edged sword. On the one hand, it can help patients identify aesthetic preferences and potential research surgeons. In ManeuverI describe how to critically evaluate a surgeon’s social networks: if everything you see are intraoperative shots and filtered selfies, it is a red flag. But if you see detailed content, including videos, different stages of cure and a wide variety of noses, you may have found a surgeon worth consulting.
The disadvantage is the little reista expectations that social networks can create. Some patients think that a non -surgical rhinoplasty will make their nose closer, or that they will look perfect for a week after review surgery. Others come to look completely to someone else. In consultations, I focus on their unique strengths and helped them visualize an improved version of themselves, not a copy of another person.
PSP: The book presents tools and metrics for patients to evaluate their own noses. Is this empowerment, or can you complicate consultations with self -diagnosis?
CHA: I firmly believe in patient empowerment. The more patients understand their nose, such as their structure and limitations, the better they can evaluate whether a surgeon is really equipped to help them. For example, if a patient mentions the retraction of the nostrils, and the surgeon has no idea how to treat it, that is a sign. A qualified surgeon should be able to explain his approach, show examples and walk the patient through his plan.
I share consultations of surgical videos to explain my thought process. If a patient connects with my reason, it is usually a great coincidence. If not, it’s fine. My goal is to find some whose philosophy aligns with yours.
PSP: It also addresses the relationship between nasal function and appearance. How often do you breathe part of the conversation, even when patients focus on aesthetics?
CHA: All the time. If a surgeon does not even examine his nasal airway with a speculation, as I mentioned in the book, it is possible that it is better likely to play the lottery than to obtain a successful result.
Many patients do not realize that their breathing is not optimal until we begin to discussion. The benefits of good nasal air flow are huge: humidification, better oxygen exchange, less snoring, more nitric oxide production. There is a reason called the book Maneuver. In Ayurvedic medicine, breathing is life, and good breath begins with a functional nose.
PSP: You mention that achieving true facial harmony sometimes implies complementary procedures such as increased chin or fillings. How do you present these ideas to patients focused only on the nose?
Shah: I aboil it gently and without judging. When some come to want to change a facial feature, they are or feel vulnerable. Instead of overvaluing them, I let them interact with their images duration of the consultation. When patients can visualize possible changes themselves, they often begin to point out areas that they would like to adjust. It becomes a collaboration process, and that makes a difference.
PSP: What is a beginning? Maneuver You think that you should emphasize more in rhinoplasty training, special given the high revision and demand rates of today?
CHA: Listen to your patients. There is a great disconnection between what surgeons are taught and what patients really because. I have many cases in which surgeons insist on projecting or expanding the nose on behalf of “natural aesthetics”, when the opposite of what the patient wants.
The truth is that most patients, because narrower and more refined noses. And that is not just anecdotal-is compatible with algorithmic data on the safer faces on social platforms. As surgeons, we have to evolve. It is not about imposing our preferences, but to help patients achieve their beauty vision, in a safe, ethical and ingenious way. PSP
