ENT OR PLASTIC SURGEON FOR RHINOPLASTY: WHICH ONE IS BETTER?

Are you considering undergoing nose surgery but can’t decide whether to choose an ENT or plastic surgeon for rhinoplasty? We are here to help you out of this dilemma. 

Since the result of nose surgery can have a massive impact on the patient’s physical and mental health, the doctor who carries out the surgery must have the dexterity needed for this field, and an in-depth understanding of human anatomy and surgery. So who is eligible? An ENT or plastic surgeon for rhinoplasty?

According to the American Board of Medical Specialty, the Subspecialty of Plastic Surgery within the Head and Neck is related to the cosmetic enhancement of the facial structures, as well as replacing, repairing, or reconstructing deformities (1). Medical doctors specializing in one of the ENT and Plastic Surgery specialties can choose this subspecialty. 

We will go through these two different specialties. After reading this article you will know more about:

  • Who is an ENT surgeon?
  • Who is a plastic surgeon?
  • Similarities and differences in the practice

We will be talking about the details to answer all your questions. Make sure you read until the end of the article so you won’t miss a point. Shall we begin?

Who is an ENT surgeon?

ENT stands for ear, nose, and throat. An ENT surgeon also called an Otolaryngologist or an Otorhinolaryngologist is a specialized doctor who treats diseases and disorders of the ear, the nose, the throat, and the related organs within these areas, as well as head and neck cancer. Just to remind you, Otolaryngology is the oldest medical specialty in the United States.

Facial plastic surgeons should have certain qualities and traits. Good listening and communication skills are essential for an ENT specialist. An ENT surgeon must have a teamwork spirit as they mostly work in a multidisciplinary team.

Due to extensive training in facial plastic surgery and comprehensive knowledge of anatomy, ENT surgeons are among the best doctors to perform nose job surgery. As otolaryngology is mostly related to the head and neck structures, facial plastic and reconstructive surgeon is strongly familiar with facial features and how to perform complicated procedures on them.

Who is a plastic surgeon?

A plastic surgeon is a specialized doctor who repairs, reconstructs, or restores the form, shape, and functions of damaged body parts caused by accidents, traumas, cancer, or congenital problems through complex surgical procedures.

The work of a plastic surgeon can be mainly divided into two categories: Reconstruction and Cosmetic procedures. In many cases, these two come together in practice to enhance both function and appearance.

A plastic surgeon must have some particular qualities such as good communication skills, teamwork, and motor skills to be able to meet a patient’s request and handle working in a multidisciplinary environment.

 Rhinoplasty procedures are one of the most commonly performed aesthetic surgeries done by a plastic surgeon. Being well-trained during residency and fellowship, up-to-date techniques and methods, and a wide range of knowledge of the human body enable them to perfectly carry out the procedure.

ent vs plastic surgeon for rhinoplasty

Similarities and Differences in the practice

So far we explained how surgeons from both specialties are highly qualified to perform nasal surgeries whether cosmetic or functional rhinoplasty.  Now let’s compare them regardless of specific similarities and differences.

Medical Education

The journey to becoming a physician is the same for both specialists. To become a physician one must get a degree in a 4-year biology or science program. Then they can enter a medical program for 4 years. After graduation, to legally practice medicine they must obtain a license. One must pass the USMLE to see how well they apply their knowledge of theoretical and practical sciences.

Residency

  • In order to become an ENT specialist, a physician must take a 5-year residency program in Otolaryngology. The details are as follows:
  1. 3 years of otolaryngology special training
  2. 1 year of general surgery training
  3. 1 year of additional training as a chief resident in an institution
  • Becoming a plastic surgeon requires a minimum duration of 6 years. Plastic surgery residency consists of two main programs: A 3-year general surgery training followed by a 3-year plastic surgery training

Both specialties train surgeons capable of carrying out complex procedures and meeting the cosmetic goals of patients.

Fellowship

  • ENT doctors can pursue higher educational levels by attending a fellowship program for 1-2 years in the subspecialties. These subspecialties are:
  1. Facial plastic and Reconstructive surgery: the field in which rhinoplasty is categorized.
  2. Otology, the branch related to the ear disease
  3. Skull base surgery
  4. Sleep disorders
  5. Rhinology, the branch related to the nose diseases
  6. Laryngology, the branch related to the throat disease
  7. Head and Neck surgery
  8. Pediatrics
  • For plastic surgeons, 1-year Fellowship programs in several subspecialties are available. These subspecialties are:
  1. Aesthetic surgery: cosmetic rhinoplasty is placed in this branch
  2. General reconstructive surgery
  3. Craniomaxillofacial surgery
  4. Burn surgery
  5. Hand and upper limb surgery
  6. Microsurgery

Board Certification

  • Board certification is an additional accreditation that shows a person is greatly skilled in their area of expertise. American Board of Otolaryngology-Head and Neck surgery offers this certification.
  • Board certification offered by the American Board of Plastic Surgery is an option for surgeons who want to take further steps in their academic and practical skills.

Reconstructive Surgery

  • An ENT specialist can pursue higher educational levels by attending a fellowship program in Facial plastic and reconstructive surgery. Within this subspecialty training, they learn facial reconstruction skills and how to rebuild damaged head, neck, and facial structures that are malformed due to accident, trauma, injury, congenital abnormalities, and head and neck cancer. Otolaryngologists are highly trained to restore the shape and function of a nose following injury or a bad primary rhinoplasty during what is called a revision rhinoplasty.
  • Plastic surgeons who graduated from the subspecialties of cosmetic surgery or craniomaxillofacial surgery have an in-depth understanding of repairing, restoring, and reconstructing deformed body parts caused by cancer, accident and traumas, and birth malformations. 

The work of an ENT surgeon is mostly focused on the face, head, and neck and they might be more experienced in reconstructing nasal structures, and thus an experienced ENT surgeon can be a better option for revision rhinoplasty. However, there are always exceptions.

Functional Rhinoplasty

  • The practice of ENT concentrates on the nose, throat, and related body parts within these regions. Undoubtedly an otolaryngologist is well-acquainted with the anatomy and physiology of the nose and can carry out surgeries to solve specific problems to improve the quality of life. To name a few we can mention Turbinate reduction, sinus surgery, and septoplasty.
  • While the plastic surgeon is capable of performing operations to improve functional complications in the nasal cavity, their work in the facial area mainly meets aesthetic goals.

For specific procedures such as sinus surgery, septoplasty, and turbinate reduction an ENT specialist might be the more appropriate choice. At the same time, we remind you that a plastic surgeon with years of experience and many cases in Functional rhinoplasty is definitely a more logical option rather than an ENT surgeon with a lesser number of successful cases.

Cartilage graft

  • In the need for a cartilage graft during a rhinoplasty procedure, an ENT tends to harvest the cartilage from the nasal septum. The amount of cartilage needed strongly relies on the type of rhinoplasty and the surgical methods.
  • Many plastic surgeons prefer to use rib cartilage for nose aesthetic surgery and in that regard, the duration of the surgery might vary.

No significant difference has been reported regarding the usage of ear cartilage in both specialties. Before the operation, your surgeon will discuss the treatment plan with you and inform you of their method if a graft is required.

Technique

  • Most facial plastic and reconstructive surgeons prefer to use the open rhinoplasty technique, as it gives them more access to the profound nasal structures, however, this approach can leave barely visible scars.
  • Plastic surgeons mostly perform a nose job via a closed rhinoplasty technique. This enables them to enhance the patient’s appearance without any visible scars, but they might not always have the best access.

Choosing the appropriate approach is highly based on the surgery type. Before the surgery ask your doctor about their approach and techniques to get your ideal result.

Final Verdict

Regardless of all similarities and differences, a rhinoplasty surgeon must have years of experience and high success rates to be considered a reliable surgeon.

We explained why we believe an ENT specialist is a preferable option for some certain nasal surgeries, while a plastic surgeon is the first choice for others. However, at the end of the day, it is your surgeon who decides what’s the best option for you based on your condition and requests.

 

 ENT specialistPlastic Surgeon
Becoming a physician

4 years of pre-med

4 years of medical school

Getting a license to practice medicine

4 years of pre-med

4 years of medical school

Getting a license to practice medicine

Specialty

A 5-year residency program including:

3 years of ENT special training

1 year of general surgery training

1 year of extra training as a chief resident in an approved institution

A 6-year residency program including:

3 years of general surgery practice

3 years of plastic surgery training

Fellowship1-2 years of fellowship offered in 8 subspecialties1 year of fellowship offered in 6 subspecialties

Board certification

Available. 

the American Board of otolaryngology- Head and Neck (2)

Available 

The American Board of plastic surgery (3)

Septoplasty

Skillful and well-trainedYears of experience required to perform

Sinus Surgery

ProfessionalYears of experience required to perform

Surgical approach

Mostly openMostly closed

Revision rhinoplasty

PreferableYears of experience required to perform

Ethnic rhinoplasty

Years of experience required to performPreferable

We made it to the end of this article together. Hopefully, you have found your answer to who is the better option for you: An ENT or a plastic surgeon for a rhinoplasty?

Still a bit confused to choose between the services offered by an ENT or a plastic surgeon for nose surgery? Don’t hesitate to contact us and discuss your concerns with one of our well-trained medical consultants. They will be happy to help you with the best option and the right decision for this subtle surgery.

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