Each physician you see will have their own style of communication. I prefer to identify what particular features of the nose bother my patient most. Since everyone’s idea of the perfect nose varies widely, I like to hear what my patient would change about their nose. This gives me an idea as whether their expectation is realistic, and what features I would need to address. Most alterations are possible, but a patient’s nose must fit their face. If I believe a patient’s desires may leave them with a nose that does not fit their face I will explain this to the patient, and emphasize what I think would be an appropriate course of action. The patient is then evaluated for airflow problems, general medical problems, and undergoes a physical examination of the nose and associated structures. I explain the revision rhinoplasty surgery plan, all of the possible risks and complications, and also talk about what I think the outcome would be. If there are adjunctive procedures that would improve the patient’s appearance I discuss such measures.