An Interview with Dr. Afshin Parhiscar: How to Choose a Rhinoplasty Surgeon
What is the first thing a patient should consider when choosing a rhinoplasty surgeon?
The first thing is training. Rhinoplasty is not simply a cosmetic procedure. It requires an understanding of nasal appearance, facial proportion, the septum, nasal valves, cartilage support, and breathing.
I am double board-certified in Plastic Surgery and Otolaryngology-Head and Neck Surgery. This gives me training in both the aesthetic and functional aspects of nasal surgery. A successful rhinoplasty should create a nose that looks natural and balanced, but it should also be structurally sound and breathe well.
How important is experience specifically in rhinoplasty?
It is extremely important. Every nose is different. Patients may have thick or thin skin, asymmetry, a dorsal hump, a drooping tip, prior injury, a deviated septum, weak nasal valves, or previous surgery. The surgical plan must be tailored to those individual factors.
After more than 20 years of experience, I have learned that there is no single technique or “signature nose” that works for everyone. The best rhinoplasty is one that fits the patient’s own facial proportions and preserves what makes them recognizable.
What should patients look for when reviewing before-and-after photographs?
Patients should look for naturalness and consistency. They should look beyond the most dramatic results and ask whether the noses still fit each patient’s face. A beautiful rhinoplasty should not look operated on. It should look harmonious from the front, profile, and three-quarter views.
For every rhinoplasty consultation, I perform individualized before-and-after imaging. This is an important part of communication. It allows us to discuss what the patient likes, what concerns them, and what may be realistically achievable. Imaging is not a guarantee, because healing is individual, but it helps us develop a thoughtful and shared surgical plan.
Can rhinoplasty improve breathing as well as appearance?
Yes. In many patients, the cosmetic and functional issues are closely related. A deviated septum, prior trauma, weak sidewalls, narrowed nasal valves, or previous surgery can all affect airflow.
I evaluate both the internal and external structure of the nose. When appropriate, I may combine aesthetic refinement with septal correction, nasal valve support, cartilage grafting, or spreader grafts. The goal is not just to improve a photograph. It is to create a nose that is stable, functional, and attractive over time.
What should a patient expect during a rhinoplasty consultation?
A good consultation should feel educational and personal, not rushed. I want to understand what bothers the patient, how they breathe, what they hope to change, and how the nose relates to their overall facial balance.
I explain what can be improved, what should be preserved, the alternatives, recovery, and the limitations of surgery. I tailor each rhinoplasty not only to a patient’s anatomy and appearance, but also to their personality and how they want to present themselves to the world.
Some patients want a subtle refinement that remains almost imperceptible. Others want a more defined change. The goal is always a nose that feels authentic to the individual—not a copy of someone else’s result.
The best rhinoplasty outcomes come from a careful partnership between patient and surgeon: thoughtful planning, realistic expectations, technical precision, and a shared understanding of what makes a result both beautiful and natural.