CHOOSING A COSMETIC SURGEON AND AN ANESTHESIOLOGIST

It is important that the surgeon performing a rhinoplasty procedure has performed thousands of them. Dr. Portuese is board certified in Otolaryngology Head and Neck Surgery (Ear, Nose, and Throat Surgery) and board certified in Facial Plastic and Reconstructive surgery. His expertise is extensive within the nose. Approximately 50% of his practice is related to some type of nose surgery, whether it is cosmetic, broken, breathing issues or sinus-related issues. The surgery center where the procedures are performed is named The Seattle Rhinoplasty Center and is a Medicare certified surgery center located at 1101 Madison Street, Suite 1280, adjacent to Swedish Medical Center. Medicare certification for an ambulatory surgery center is one of the highest quality accreditations available. The surgical team consists of four registered nurses who have been performing plastic and reconstructive surgery for 30+ years combined. The anesthesia that is used for this type of surgery is a general anesthesia performed by individually board certified physician anesthesiologists from Swedish Medical Center.

OUT OF TOWN PATIENTS

When patients are coming from out of town to have their rhinoplasty performed at the Seattle Rhinoplasty Center, there are four hotels located within two blocks of the office. Our office administrator can give patients assistance with hotel reservations. We do recommend that patients stay in town for at least one week for their postoperative care. The cast is removed approximately six days after the surgery, however all of the stitches on the inside of the nose are dissolvable and do not need to be removed.

The Baroness Hotel (206)624-0787	The Inn at Virginia Mason (206)583-6453
The Silver Cloud Hotel (206)325-1400	The Sorrento Hotel (206)353-6156

CONSULTATION

The consultation is important face-to-face time with Dr. Portuese. This is the opportunity for patients to ask questions and to discover what a nasal procedure can and cannot do for them. At the Seattle Rhinoplasty Center, there is a charge of $75 for a consultation. This consult will last approximately 30 minutes with Dr. Portuese and 30 minutes with the administrative staff. During the consultation patients will fill out medical history forms and undergo a physical examination of the nose by Dr. Portuese. Often, additional time will be spent with the office manager and patient coordinator discussing fees, scheduling and reviewing computer imaging. During the consultation, some of the topics that are discussed are as follows:

• Patient's medical history.
• Patient's physical examination.
• Patient's opportunity to express what they would like to change about their nose.
• Realistic expectations reviewed.
• The technique of rhinoplasty explained.
• General anesthesia.
• The Seattle Rhinoplasty Center.
• Pre- and postoperative instructions.
• Common risks, alternatives, and relative expectations.
• Follow-up visits, costs and scheduling.
• All previous operative notes, records, and/or CT scans of the sinuses (the scan and the report).
• Previous medical history that is pertinent from an anesthesia standpoint.
• Recent or past injuries to the nose.
• Current breathing problems.
• Allergies to any medications.
• Prescription medications, herbal supplements, and nasal spray usage.

In summary, the consultation is the patient's opportunity to sit down with Dr. Portuese and discuss mutual goals and aspirations with regards to changing the shape of the nose for better fit and balance with the face. Dr. Portuese will examine the nose during the consultation, both internally and externally. Computer imaging is also performed at the time of the rhinoplasty consultation. Dr. Portuese takes photographs of the profile and through computerized morphing software patients can see what their new nose will look like following a rhinoplasty. This computer imaging is not a guarantee of how patients will look, but it is a communication tool and gives an idea of what to expect. This is an excellent opportunity for patients to talk about what they expect from a rhinoplasty surgery and to make sure that there are reasonable expectations and that Dr. Portuese can deliver their reasonable goals. During the consultation, Dr. Portuese also reviews with patients an entire book of before and after rhinoplasties that he has personally performed on many different styles and shapes of noses. These are also available on our website,www.Seattle-Rhinoplasty.com.