Why Modern Rhinoplasty Is About More Than Vanity

追加: 2026-05-26

[00:00:05]Hello everyone. Today we have Dr. Philip Solomon who's a plastic surgeon from Toronto. How are you? Thank you for coming on the show.

[00:00:15]>> I'm great. Thanks for having me.

[00:00:18]>> So, I met Dr. Solomon randomly on Halloween. We're both dressed in our Halloween costumes and quickly realized that he was a plastic surgeon. I went to his Instagram immediately. His work was amazing and I asked him to be a guest on the show.

[00:00:35]>> It was meant to be >> so random. And actually looking at your Instagram, the rhinoplasties that I saw were absolutely amazing. So I thought that would be a good um topic to talk about today.

[00:00:48]Super talented. And so how long have you been doing plastic surgery?

[00:00:54]Um so I've been in practice I graduated medical school in 1994 long time ago and then I did my specialty training first in ottoarangology head neck surgery and I graduated that in 1999 and then I did facial plastic surgery additional training which I started practicing in about 2000 2001 so 25 years I think roughly I've been in actual practice and uh all in Toronto Canada.

[00:01:24]>> And what's your favorite surgery?

[00:01:27]>> Well, my practice is very limited now. I used to do a broader range, but it's all face and I do a lot of noses.

[00:01:34]>> Um, so I'd say that's probably definitely one of my top favorite procedures.

[00:01:38]>> Um, and I do a lot of aging face like faceelifts and then some patients we do both procedures on them. So facial rejuvenation and rhinoplasty are probably the two biggest parts of my practice. So I we really would like to talk about the nose because what happens to the nose like as we age >> well our entire there's a lot to it that the and it varies amongst person to person but in general people talk about the nose getting bigger or longer and it's not necessarily growing. What's happening is some of the other aspects of your face are changing. Mostly your facial skeleton is shrinking. So as your skull shrinks and the bones that your nose sits on become smaller, you get changes in the facial anatomy and the nasal anatomy where the base of the nose may become closer or sunken in a little bit and the tip ligament supports may weaken so the nose can start to droop and look longer. And then there's some skin changes that also happen. Some people develop some thickening of the skin. Some people actually have a condition called rosacea or um rhopya where their nose becomes thicker with time as well. So a lot of those things can play into the aging process. And on top of that you get the normal aging of the skin of the nose just like you do on the rest of the face. You can get sun damage and wrinkles and fine lines and changes in the pores. So all of those are things that happen with the aging process with the nose. But people typically think, oh wow, your nose just gets bigger. Doesn't just get bigger.

[00:03:05]There's a lot. That's what I thought.

[00:03:06]>> So, I actually, this is interesting. So, I have never wanted to mess with my face. Like, it's always just kind of been my money maker. Um, not to be vain, but like I really like I liked my face and I didn't want an overly perfect face. Like, I think that there's something pretty about not being overly perfect. So, that said, my nose never bothered me. It was never perfect. It had like a little lump where, you know, a plastic surgeon could tell me to shave it, but I liked my nose. Here's my issue. It's not getting bigger. And I really try to sleep on my back, but I think I'm a side sleeper in the middle of the night and I think my nose is shifting and my face is crooked. Can that happen? Can your nose get crooked over time?

[00:03:47]>> You know, some people do believe that their nose may change a little bit with time in terms of alignment. And I would say it's not it's not super common, but some people may have had some minor impact or trauma to their nose at a younger age and say a childhood trauma and then the nose may have some intrinsic weakness to it similar to like a piece of wood that has a crack in it and therefore you know it theoretically could warp a little bit as you go through your lifetime.

[00:04:13]>> Yeah, I'm convinced it used to be like here and now it's here.

[00:04:17]>> Can you analyze her nose right now? Can you tell from here? Like is my nose cro?

[00:04:21]Like I feel like my face used to be perfectly symmetrical and at some point in the last year I lost that symmetry and I'm convinced it's my nose. Like when I press on it this way it feels one way and then when I press on it this way it feels a different way.

[00:04:36]>> Well most people think their face is symmetrical but very rare is a face sy truly symmetrical. And >> I mean you haven't seen me in real life.

[00:04:46]They've done studies where people like take mapping of half their face and it looks strange almost having perfect symmetry. So having some subtle asymmetry in the face is almost a a natural phenomenon and seen as beauty to the naked eye to not look almost artificial or or something's up with it like a mannequin. So I' looking at you just you know on video here I don't see anything naturally wrong with your nose.

[00:05:11]So it looks pretty good from here.

[00:05:12]>> Now I can sleep better tonight. and I won't freak out if I end up on my side in the middle of the night.

[00:05:18]>> So, do you get a lot of patients that prefer like a non-surgical technique like using filler or is it mostly >> We do both. I mean, I do way more surgery than non non-surgical filler nose jobs, but we do have patients that sometimes are very anxious to proceed with surgery.

[00:05:34]>> In the old day, like when I first started practice, injectable fillers were not really used for nose jobs. It became more popular probably in the last 15 years. And we do have patients because of social media become aware of it. It is a procedure we offer and some people are good candidates. Most people who are good candidates are sort of two category or three categories I guess.

[00:05:54]One is um postsurgical patients who have subtle imperfections of the nose from the rhinoplasty but don't necessarily want to go under the knife again.

[00:06:02]Sometimes you can use filler just to camouflage some super subtle imperfections. Um, and most surgeons will use that as sort of one of their tools in their toolbox if need be. Um, second category would be African-American or Asian patients who have a flat bridge who typically would we would offer an augmentation rhinoplasty building up often with rib cartilage to make their bridge taller.

[00:06:25]And those patients can sometimes get a nice result with filler and it also may be an opportunity for them just to get a sense of whether they like it built up.

[00:06:33]And so we we do a lot of those. Um, most of the fillers are temporary in nature, so they could try it out and see how it goes for a year roughly. Um, and the third category is someone who sort of typically would be a surgical candidate with a bump on their nose. And it's usually someone who has a relatively shallow part of the nose called the radex, the upper third of the nose. Then the middle parts a little higher with a bump and the tip may be a little bit down. So the middle part's higher than the upper and the lower thirds of the nose. And in those cases, you can add a little filler at the very top and a little bit of filler at the very bottom and it can often really provide nice results, even better than sometimes I used to expect. The trouble is is that many patients come in who've had filler now. So the surgeons are often not sure what they're looking at. So patients will hopefully volunteer that they had filler and then we have to take that into context when we're planning their surgical procedure. So we would bring them back for dissolving agents a few weeks before. We would take photos after the dissolving agents kicked in.

[00:07:31]Sometimes it's hard to even dissolve it.

[00:07:33]It can be quite stubborn and they need dissolving a few times because otherwise it's hard for us to really see their true anatomy.

[00:07:40]>> Can you stretch the skin if you get too much filler in your nose and then when the filler goes away, do you end up with like, you know, like how on other parts of your face you can have balloon face and then you have the deflation? Can that happen on your nose?

[00:07:56]It probably does happen to some extent, but it's usually probably so minor that it's not typical because you're not using a lot of filler.

[00:08:04]>> It's not a ton. Yeah. But I but I know what you're saying and it's a good question. Um the only time I've ever seen skin be stretched out in rhinoplasty that's become an actual surgical consideration is I've operated on some older patients who are doing faceelifts and they want to do their nose.

[00:08:21]usually someone who says, "I always wanted to do my nose and I'm having my face done. Can you please do my nose?"

[00:08:27]And those patients if they're in their say 70s and if they have a big reduction, they want a small nose and they've had a really big nose their whole life for 70 years, sometimes they do get a bit of wrinkles on their nose after and then we have to go do we do laser resurfacing like CO2 on their nose to contract it and improve the skin quality. And that's that's the only time that the skin in my practice is is an issue.

[00:08:50]>> So, do you actually do a lot of revisions where >> Yeah, probably 15 probably 15% of our practice, 15 20%. I wouldn't say it's like a a super high percentage. I mean, to be honest with you, we used to do more. Um but the there's specific challenges not just surgical challenge but managing patients and stuff who've gone into the category of not being happy to start with their original surgeon. It sometimes can become um stressful for everyone involved. So I I sort of am sort of a bit more selective on who I'll do revisions on. We typically want to see the previous surgeon's notes, where the patient started at, whether we think that we can help them um plan a a sort of a relatively safe route for another revision. Some people have had three, four revisions, >> bounced around between different doctors.

[00:09:42]>> And then some of them are very realistic and understanding that nose jobs can be sort of complex and unpredictable even with good surgery. Some people can be very difficult and feel like it's more of a guaranteed thing and they're spending money and they want a result.

[00:09:57]So, we try to figure out who we want to operate on a little bit more than I did probably a decade ago. Um, >> both mostly for just I'm very busy with the other stuff in my practice. I'm trying to be a little bit as I'm getting older, more selective on who we're going to take on. But some of those cases are uh very satisfying to do um the revisions if we feel that they're cases that we feel that we can predictably make the patient somewhat better.

[00:10:23]>> So in going with cases you're willing to take. To me, I very much think if you want a nose job, you should get it. And I especially think with like younger girls, if it really bothers them, by all means, go fix it, right? I don't think that's something you should wait a long time for. At what age do you think what age do you start taking patients for the nose job? Like when does the nose stop growing?

[00:10:50]>> So physiologically it's safe to do a nose job on females roughly at age of 15 and up. Okay.

[00:10:55]>> And then but then there's emotional maturity sort of has to be considered.

[00:11:00]So we do get patients who are young and they may not seem mature enough to do it or take on the full you know emotional >> sort of um challenges that come with cosmetic surgery that we may delay it.

[00:11:12]Um but a lot of the younger patients are the ones who are being teased or bullied or bothered by it.

[00:11:16]>> Yeah. I mean to me I think it's like if my daughter came to me and it really bothered her and like you have to look at it every single day I would gladly do it for her. like if it really genuinely bothered her get out.

[00:11:30]>> I would too. So when you do revisions, do you take the cartilage from the rib or behind the ear or does it just depend on the case?

[00:11:40]>> Yeah. So it really depends on what's required. So some patients who have are undergoing a revision may have undergone a primary rhinoplasty by a surgeon who maybe doesn't do that many nose jobs and may do mostly say for instance body work and they just do the odd easy nose job and they may have like some subtle imperfections of their nose and they may need some cartilage added to their nose.

[00:12:03]Some of those patients still have a very um usable septum. They haven't had the septum even touched. Um, and that really just depends on, you know, what type of surgeon did their primary surgeon. Some surgeons don't do a lot of nose jobs.

[00:12:17]They sort of has as a secondary procedure in their practice. So, I often find that patients who have say come for revision from a surgeon who doesn't do a lot of noses often are easier to improve upon because they've had relatively conservative surgery done to them and there'll be cartilage to work with from the septum. If they're coming for multiple revisions or they've had trauma, then we may require cartilage grafting and then it comes from either the ear.

[00:12:42]>> Um, if there's no septum available, then we would go to ear. Yeah, I usually only use ear cartilage when I'm using it for the nasal tip reconstruction. So, adding to the soft part of the nose. So, the ear cartilage is relatively soft. I don't like ear cartilage for reconstructing the stronger parts of the nose, the mid third of the nose or the tip support mechanism nose. I like to have things that are straight and strong and straight and strong we can get from rib. And then rib there's two types of rib grafts. There's your own rib >> which is often preferred. And then there's something called caver cartilage grafting which comes from a tissue bank which in the old days wasn't great. I found that the ribs we got had been processed a lot. But now the rib cartilage graft thing that most surgeons are getting from tissue banks in the United States are really good and um in some cases they're better quality ribs than from the patient themselves. Right?

[00:13:32]>> And you may say why would that be? And it's usually age dependent. So >> most of those ribs that we get that are grafting material are from younger patients who likely have undergone an accident, a motor vehicle accident or something and their bodies have been donated and their ribs have been then processed and made into grafting. body parts are probably used for other donor stuff. Um, and those patients have high quality cartilage for utilization and revision rhinoplasty. Probably making many surgeons who never did rip cartilage in their practice able to do better surgery with them because they didn't necessarily feel comfortable harvesting a rib. Um, when I trained, we harvested ribs all the time. So, I used rib cartilage of my own patients for uh many, many years. But now I give the patient the option if they want to use their own rib or if I'm going to purchase a rib. Mostly it depends on their age. So patients over 45 I'll usually prefer to buy the rib. Younger patients I'll give them the choice. But I kind of find they're relatively comparable in in their utility. Now >> I think I'd buy the >> How do you take the rip? Like what how does that work?

[00:14:41]>> Like if you surgically go in >> Yeah, it's usually an incision made underneath a patient's breast. and we through the soft tissue um underneath the breast. If someone's got a breast implant, obviously we have to stay away from that. Yeah.

[00:14:55]>> And then we through these intercostal muscles, we spread through them and then we go directly down onto the ribs.

[00:15:02]>> And then we're exposing the rib and the segment that we want to use. It's usually a, you know, it could be a few inches. Um and uh then we're basically >> I think it's painful. Well, there there's a part there's a partial and then there's a full segment taken out.

[00:15:18]So, when a full segment's taken out, sometimes the patients usually it could be a floating rib, >> but sometimes when you're taking a full segment, it can hurt a bit more because the nerve neurovvascular bundle runs at the bottom of the rib. So, we try to dissect that all free to stay away from it. So, it shouldn't be as uncomfortable as you may expect it to be.

[00:15:36]>> So, it's better to buy the >> I just rather >> we would rather buy the rib >> when you're prepping for rhinoplasty. Is there I know like some surgeons have a certain diet, they like supplements. Is there anything you suggest somebody do leading up to the surgery?

[00:15:53]>> Uh we we often have patients taking arnica. Uh we do get patients an oral dose of traexmic acid which is to cut down on bleeding which came about in the last decade or so. Um some doctors inject tramic acid included in their local anesthetic. I don't do that. But they feel that it reduces bleeding and cuts down on bruising.

[00:16:16]>> Um, diet-wise, I just say healthy diet and it's more certain things to avoid because we don't want you to bleed a lot. So, fish oils, garlic, um, things, medications that could potentially make you bleed like not non-steroid steroidal anti-inflammatories to avoid. Like every other surgery, we just want you to avoid things that can make you excessively bruised or bleeding. Dietwise, I'm not I'm not super fixated on the diet.

[00:16:42]>> Do you find the techniques have changed a lot from when you first started until now? Yeah. So, rhinoplasty is an interesting operation because the techniques kind of go through these changes every sort of 10 to 15 years.

[00:16:54]And because I've been in practice 25 years or more, um I've seen a few sort of trends and uh so when I trained most of the procedures were called reductive rhinoplasty and um that was just making the nose smaller and the procedures may have been a little bit more aggressive. Then there then there was a movement towards sort of more conservative techniques as preservation and and not to remove too much tissue. And um then there became structural grafting techniques where open rhinoplasty was employed which is an operation where the incision is made across the base of the nose and and the whole nose is exposed subcutaneously. So you sort of see all the anatomy whereas when I trained a lot of the operations were from the inside of the nose. You didn't see a lot. You're working through holes. I do I still do both of these techniques closed and open. And then there's a third type of rhinoplasty that came about um called preservation rhinoplasty which was popularized in Europe and it's made its way over to North America. And there's certain surgeons who were very big on structural rhinoplasty, meaning adding cartilage grafts and things like that to make your nose strong so it didn't bend or warp over time and had integrity and strength to it to not violating the nose completely. So an example would be like a building. So if you picture an eight-story building, conventional rhinoplasty, we're taking off the eighth story and making it a sevenstory building said. But with this preservation rhinoplasty, what we're doing is we're taking out the sixth story and we're actually pushing the eighth and seventh story down. And it's called a drop down technique or preservation technique. And you may say, why do that? And the reason, the concept behind it is that if the bridge of the nose is naturally beautiful, like God made your nose beautiful on top, but you just feel like it's high and you're shaving it off from the top and then breaking bones to make it triangular or parameal in shape. That's a lot going on that could potentially not go perfectly.

[00:18:55]>> But if you're doing it from the inside and taking that that floor out and everything's dropping down, your same bridge is still there. It feels perfectly smooth. It's just the bump has fallen into your nose. The downside of it is that it can sometimes be not totally predictable. You can have it fall too much or too little. Whereas when you're shaving it from top, you can kind of go millimeter to millimeter. So some surgeons who've kind of made it their new best thing, this preservation are saying that they're they only do that operation, they become super adept at being able to know exactly how much to take out to drop the bridge down. And there's some pros and cons each. So I do preservation rhinoplasty as well. I've learned that operation while in practice, but I wouldn't say I use it routinely. I use it in very specific circumstances. I like to use it if I'm already taking septum out a lot. So if someone's got a terrible septum to start with, I don't want to start taking off the top and I've taken out from the septum. Then you're left with very little tissue to work with. So there basically I'm preserving the bridge and I'm already taking out septum for breathing. Then those are ideal to convert to a preservation technique.

[00:20:04]>> So that's kind of how >> do you ever have patients asked to have their noses like pointed upward?

[00:20:11]>> Yeah. Well, that's like that's the new trend. So then even though we moved towards these conservative trends, there were some patients traveling abroad to Turkey and Iran and we have a big Persian community. So some of some of those patients were um requesting more dramatic operations.

[00:20:28]>> So I'm Persian and it's like a right of passage. Like I think it's rare that I don't have a nose job >> to have it upward. No, but the nose job like and they like more dramatic nose jobs. Like I think if you go back to Iran and get your nose done, it's going to be a lot more dramatic than if you do it here.

[00:20:45]>> Yeah. I mean, if you went back to Iran without a nose job, you wouldn't have to wear a hijab because they would assume you're not Persian.

[00:21:00]>> That's so funny.

[00:21:01]>> You can cut that out if you want. I could not.

[00:21:03]>> No, no, we love it. But the reason why I was asking my friend went to Colombia and she's not Colombian but she went to Colombia because she wants to look Colombian. So she asked them the surgeon to do like her nose is pointed straight up in the air like uh Dr. Seuss character from Yeah. Like the Newville characters. It's literally straight up in the air. And she's like it'll be fine. It's going to drop. It's been three months and it hasn't dropped.

[00:21:28]>> And the doctor told her it would drop in two years but it doesn't look like it's going to drop. It's literally sticking straight up in the air.

[00:21:35]>> You have a good nose, >> right?

[00:21:36]>> I'm looking at your site profile. It's a very good nose.

[00:21:40]>> Have you done it?

[00:21:41]>> Yeah. Three times.

[00:21:42]>> How many times?

[00:21:42]>> Three. But but it but in all fairness, the the second time somebody hit me in the face with a football, so I I had to do the second time. Yeah, I've had three. But mine's fine. It's most >> It doesn't look like it's like goes up, but not like in a little bit. Like an acute way.

[00:22:00]>> Yes. So the doctor put her nose straight up in the air and the same with her breast. So she asked for her breasts to be removed. Those are sticking straight up in the air and the nose is up in the air.

[00:22:09]>> And the same doctor did the boob and the boob.

[00:22:11]>> Yeah. And he's telling her it's going to drop in two years. And I don't see how it's going to drop.

[00:22:16]>> Yeah. Listen, it it's a weird operation that way and that you can predict a lot, but you can't predict 100%. So like when we do the surgery we make a surgical plan like every surgeon and then you implement it and then part of the process is monitoring everyone for about 12 months and then there is about >> it can drop up to 12 18 months even but some people do need revisions for stuff like that because what they're doing in a nose like that is we're actually adding a lot of cartilage. It's called the septalion graft to make it very >> strong at the base so that we're able to put it into >> That's exactly what he did. And he took the cartilage like you said for her rib and then he stuck it literally I've never seen a nose like that before. Like literally >> So at what point do you get into revision territory like say you do your nose and you're not happy with it, right? Like at what point is it safe to get a revision? How long do you have to wait? It varies amongst doctors, but I'd say we typically and probably relatively universally patients will be told to wait a year before doing a revision because >> two reasons. One is that the nose may change on its own.

[00:23:20]>> Like I've seen my own patients where I think I'm going to have to do a revision, they develop a bit of a callous in the middle and I'm think I'm have to file that down and the patient gets say pregnant and I don't see them for a year and a half and they come back and I'm like, I thought you had that little bump there. What happened? and they go, "Oh, yeah, it went away." Like, so stuff does sometimes settle down. If it's sort of an inflammatory callus that's healing, it can sometimes be temporary and then dissipate on its own.

[00:23:46]So, that's why we want to wait at least 12 months to sort of have a good sense of it. Um, but um we usually, yeah, roughly at around the one year mark, we'll look to see if there's any functional problems with nose, like breathing issues, or if there's any ongoing aesthetic concerns that we're able to hopefully improve for the patient. So that's sort of our process.

[00:24:07]Do the surgery, wait a year. It's a bit sometimes it's hard for patients. We've had some patients, you know, not like their nose in the middle of the one-year process and then at 12 months love it.

[00:24:18]So things do change. So you sort of have to hold the hands. I mean, most people it's predictable and they're pretty happy right away and things settle as expected, but there's always sort of some people that are outliers and we have to sort of see on how they're going to settle and heal. And I think most people are okay as long as you they have the reassurance that if there is an issue that you'll be there to help work them, you know, work through it. I mean, you know, some people are fully understanding of that like you you have three. I know you had trauma and stuff, but you you likely >> and stuff like you were you >> probably Yeah. But I think like part of part of your whole um you know your social media stuff is good to let people know that it's not unusual to sometimes require tweaking and touchups and additional work to get you to the point that you're satisfied. It's >> it's ideal if it's one and done, but sometimes there is the need for additional stuff to get people.

[00:25:15]>> Yeah. Sometimes it's not because I the first time I went to somebody and it was like he did the signature nose that I didn't like. The second time I was it was broken. And then the third time I actually went to the right person.

[00:25:26]>> I have a question and you guys can't laugh because it's probably a really dumb question. Are there fat cells in your nose? Like can your nose get fat?

[00:25:32]>> Fat cells?

[00:25:33]>> Yeah. Like are there fat cells in your nose? Like could you gain weight and get a bigger nose? Because the inflammation you said you >> the nose the nose does have a little bit of fibro fatty tissue underneath the skin.

[00:25:46]>> So you could your nose could get fat.

[00:25:49]There is a little there is a little bit of fibro fatty skin. So some people have big thick tips of their nose. Yeah, we're reshap we're reshaping their cartilages with sutures. We're trimming the cartilage. But in some of those cases, we're trimming a little bit of fibro fatty tissue out of this area here.

[00:26:04]>> So it could happen the nose.

[00:26:06]>> It could happen. You know, sometimes because when I was pregnant, this is why I asked this what made me start think I swear my nose got big when I was pregnant and then it went back down.

[00:26:14]Like I was so worried that my nose like was never going to come back to normal.

[00:26:20]And then like I would say like two months postpartum I was normal again.

[00:26:24]>> Yeah. Listen, it's it's hard to know but I mean people do there's all sorts of weird physiologic changes with pregnancy.

[00:26:30]>> Very strange.

[00:26:31]>> Can you tell if somebody comes in and they're they drink a lot, they're an alcoholic. Can you tell that by their nose? Because I've seen that their nose is red >> and big. Mhm.

[00:26:42]>> I mean, rhopyma and rosacea used to be felt to be an alcoholic illness, but it's actually not. I mean, people who get that condition at like the red ruddy skin, it could be genetics. They can have Celtic background. They could just have some rosacea on their cheeks often, rosacea on their nose, ruddy looking skin. Um, and then their body sometimes develops an almost an inflammatory autoimmune reaction. Some people thinks it's almost like mites, microscopic mites in the skin and then they develop um hyperplasia of some of the um glands around the skin and the nose. But we do rhinopy surgery. I mean if you look at um our website I mean we have some rhinopus. Some of those patients have like giant pedunculated blobs on their nose and um those people we we remove all of it with laser and things like that and they can really improve but it's not a normal nose job like if someone comes in with a big nose like that a normal dose job's not going to help them. They need to it's more of a skin condition.

[00:27:43]>> Do you get a lot of people fly in from other places?

[00:27:47]>> Yeah. Surgery. Yeah.

[00:27:48]>> Yeah. I mean we used to limit our patients to Canadians only because of our insurance. Um and then we extended our insurance to cover. We had a lot of inquiries like international. I think right just the whole industry's become more open-minded to being international to South America, Korea, um Asia, you know, uh Turkey, um were sort of the big hubs. And then the Canadian surgeons always got some trickle over from Americans, often ex Cananadians living in the States. So we always had a lot of that.

[00:28:18]>> Um but we sort of went all the way across Canada from Victoria, British Columbia, all the way to Newfoundland.

[00:28:23]We'd have patients, but we would turn away Americans because our insurance for malpractice wouldn't cover it. But then we recently, we added it in just before COVID and then we were like really busy with Americans primarily for noses or facelifts probably partially, you know, it's close, it's easy access, and the Canadian dollar was weaker. So, and our fees may be different than the United States. So, it's in some jurisdictions for certain procedures more affordable.

[00:28:50]Um and then patients have like the security that a Canadian health care system while it's universal the private side of it like my practice is very similar to American style private practices. So um whereas if you go to other parts of the world you just don't know who your anesthetist is what their training is how good the surgery's going to be the afterare access how to get in touch with the person. So all of those things are like the same the same as if you were in the states and I feel like a lot of American patients are willing to fly stateto state. So they're definitely willing to fly.

[00:29:22]>> Right. So Toronto is not a big deal.

[00:29:24]>> How soon Toronto is like rhinoplasty.

[00:29:27]Can you fly?

[00:29:28]>> We have patients fly even a few days after rhinoplasty. Most people stick around Toronto for a week.

[00:29:34]>> Um but again you can fly in and out. We have the odd person who flies home three, four days later and and we let them just um do a virtual company.

[00:29:43]>> That would totally be you.

[00:29:44]>> That would be me.

[00:29:46]>> Sheila loves trying to posttop.

[00:29:49]>> But this has been great. So how can the viewers get in touch with you? What's the best way? Just to go to the Instagram or your website?

[00:29:56]>> Oh, to get in touch with us. Either of those is good. Website or insert. I mean, if you go on our website, there's a contact form patients can just click on and it sends you can send questions to us. Some people like communicating on our Instagram, too, or they it's a good um relatively good educational, I think, Instagram for patients to learn about procedures and see the type of work that we do.

[00:30:18]>> Yeah. Which is great. Your work is amazing. So, I'm so happy that you were able to come on to the show today and we'll put all that information in the show notes.

[00:30:27]>> Yeah. let us know and we'll put it on our Instagram, too.

[00:30:30]>> Okay, great. We will. Thank you. Thank you. Nice to see you.

[00:30:34]>> Yeah, nice to see you, too.