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We're laying our cards on the table.


These questions are adapted from RealSelf's 20 Essential Questions to Ask at a Cosmetic Surgery Consultation.

1. Are you board-certified to perform this procedure?
      Dr. Waterman is board-certified by the American Board of Facial Plastic and Reconstructive Surgery, as well as the American Board of Otolaryngology.

2. Where will my surgery be performed?
      For procedures involving general anesthesia, we work with multiple surgical centers around Seattle, including Northwest Face and Body at Carillon Point and others. Procedures involving local anesthetic and oral sedation are performed at Dr. Waterman’s office.

3. How much does a Rhinoplasty cost? i.e. How much does a nose job cost?
      Our prices vary case-by-case, depending on what the plan for your procedure is, the surgery center where it is performed, and how long the procedure takes to complete. Our price quotes are comprehensive, including nearly all of costs directly associated with your surgery. Patients are responsible for acquiring prescription medications, and other incidental costs related to maintaining the surgical area clean such as cotton swabs, gentle cleansers, triple antibiotic ointment, etc. For Cosmetic Rhinoplasty requiring general anesthesia, our price starts at $9800, and rises with considerations like whether grafts or implants are required, the anticipated duration of the procedure, complexity and other factors. Revision rhinoplasty typically costs $10,400 but is evaluated case-by-case. Our price quotes are valid for 30 days.

4. Do you have hospital privileges for this procedure?
      Dr. Waterman is on active staff at UW Medicine/Valley Medical Center, located near our preferred surgery centers.

5. How many procedures like this do you personally perform each year? How many do you do in an
average day?

      Dr. Waterman performs nasal surgery regularly as part of his Otolaryngology (ENT) practice. In addition to regularly doing standard nasal and sinus procedures, Dr. Waterman performs approximately 50 rhinoplasty cases each year. To ensure the greatest care possible, Dr. Waterman does no more than two cosmetic Rhinoplasty procedures during a standard surgery day.

6. Can I see before and after photos of your previous patients for this procedure?
      We encourage our patients to take a peek at our before and after photographs. We have an array of Rhinoplasty before and after pictures (nose job before and after pictures). Beyond those included in our online gallery, we have a collection of photos of our previous patients that you can review during your office visit or consultation.

7. Am I a good candidate physically and emotionally for this procedure?
      During cosmetic consultations, we do everything we can to evaluate whether surgery is the best option for our patients. Before any plans or decisions are made, we thoroughly evaluate patients' mental and physical health. We do all we can to ensure that our patients have a healthy perspective and expectations regarding their day-to-day lives and all the possible outcomes of surgery. Patients' well-being is evaluated on case-by-case.

8. What will be expected of me before the procedure to ensure the best results?
      In addition to safe and healthy post-operative hygiene practices, like gently cleaning the skin with a mild cleanser and water, Dr. Waterman recommends drinking lots of water, staying active, and eating well. Always be cautious of bumping or bashing the nose against surfaces. Eat a balanced diet rich in greens and proteins. If you smoke cigarettes, you will heal better if you do not smoke leading up to, and following your surgery. Wear a sunscreen before going in sunlight for extended periods of time, as sunlight can affect the healing process.

9. What are the risks?
      There are risks associated with any procedure, especially those which involve general anesthesia, including loss of life and other serious complications. Risks that are unique to Rhinoplasty include nasal valve collapse during recovery, over-resection of tissues, or the need for further surgery.

10. What specific techniques would you recommend to achieve the look I want?
      There are several techniques that can be applied during Rhinoplasty. “Open-” and “closed-rhinoplasty” refer to the location of the incisions that are made during surgery. In an open Rhinoplasty, incisions are made around the nostrils and across the columella, whereas a closed Rhinoplasty involves incisions solely in the nostrils, out of plain sight. While closed techniques leave no external scarring, there are significant advantages to using an open technique, as it offers a greater range of space to work within. With open Rhinoplasty, the surgeon can remove and remodel without constraints or visual obstructions. Some Rhinoplasty procedures require reduction and resection, while others require constructive addition and grafting. Dr. Waterman reviews these possibilities with his patients during consultations.
In general, the details of your procedure are determined during or after your consultation as a physical exam is necessary to determine a course of action.

11. What sort of anesthesia can I expect during my procedure?
      The type of anesthesia you can expect depends largely on the procedure you are seeking to have performed, how long the procedure takes, and your own history. For standard cosmetic Rhinoplasty, we work with anesthesiologists to provide general anesthesia, rendering patients completely unconscious during the procedure. There are some procedures that can be performed in the office under local anesthesia with oral sedation, including blepharoplasty and tip Rhinoplasty. You should ask Dr. Waterman during your consultation if you have questions about anesthesia.

12. Will anesthesia be administered by a board-certified anesthesiologist or nurse?
      We work with multiple board-certified anesthesiologists to ensure our patients’ safety during procedures that require general anesthesia. For in-office procedures, Dr. Waterman administers local anesthetics himself to be sure no region of the surgery site is overlooked, helping patients remain comfortable during their procedures.

13. Will you be performing my surgery?
      Dr. Waterman performs all procedures arranged through his office.

14. Who will be assisting you during my procedure? What are their qualifications and levels of experience?
      We work with multiple teams of highly-trained nurses and medical assistants at the surgery centers where we perform Rhinoplasty procedures. Minor procedures that are performed in-office are aided by medical assistants. All the teams we work with are trained for surgery, and are familiar with Dr. Waterman and his methods.

15. How often do you see complications for this procedure in your practice?
      For Rhinoplasty, the most common complications we see are discomfort and bleeding from the site during the days immediately after surgery. With cold compression and pain medication, this usually clears quickly. Patients may have trouble breathing through their nose until swelling subsides, and this can bring nausea for some individuals, but again this is generally easily managed, and temporary.

Occasionally, in cases with unexpected changes in recovery, minor procedures are necessary to further refine results. Complications are best avoided by strictly following recovery guidelines.

16. If a complication occurs during or after my surgery, how will it be handled?
      Dr. Waterman has admitting privileges through UW Medicine/Valley Medical Center, and is committed to ensuring the safety of all his patients during their procedures. Should an emergency arise during surgery, you will be transported to a local hospital and treated appropriately. If you experience extreme discomfort or any complication after your surgery, we insist you contact our office or patient liaison. Should we be unavailable by phone, please go to an urgent care center near you for treatment, let them know about your procedure, and ask them to contact Dr. Waterman.

17. Where will I recover immediately after my surgery? Will I receive continuous care by trained medical staff?
      Most of Dr. Waterman’s patients are discharged within hours of surgery, and are encouraged to recover in the comfort of their home during the next seven to ten days. You must have another person bring you home after surgery, as it is unsafe to operate vehicles after general anesthesia or oral sedation.

18. How long will my recovery be, and will I need help?
      There are three stages of recovery for Rhinoplasty. Immediately after surgery, you will require a ride home, where you should rest. You may continue to need assistance during the next couple days, depending on your response to pain and pain medication.
During the first week after surgery, swelling and bruising is greatest, and can be uncomfortable. You will probably not need assistance during this time. After week one, swelling begins to subside, discoloration fades, and you will be able to return to regular activity including work. Continue to avoid particularly strenuous activity during your recovery. If you are unsure whether your work is too strenuous, be sure to ask Dr. Waterman during your consultation, or call our office.
Once swelling has subsided (generally between 1 week and 1 month after surgery) your results will start to shine. Healing continues for about six months, so you may notice further refinement even as the weeks go by. During recovery, it is especially critical to avoid hard impacts with your nose, and to apply UV sunscreen when going in the sun.

19. Who will be handling follow-up care and visits?
      Dr. Waterman and his assistants provide follow-up care and visits after cosmetic surgery. For Rhinoplasty, we typically see our patients for 1-week, 1-month, 3-month, and 6-month follow-up appointments.

20. What will happen if I’m not satisfied with my results?
      If you are unsatisfied with the result of your surgery, we encourage you to let us know during your follow-up visits. Rhinoplasty results should not be evaluated until after healing is complete, generally after 6-months to a year following the procedure. Most of our patients are satisfied or very satisfied with their results, and many report improved breathing function following Rhinoplasty in addition to their cosmetic results. There are many factors beyond surgery that can affect your nose and the quality of your results. It is imperative to follow post-operative care instructions to get the best results. Most post-operative issues can be addressed during follow-up care and treated during recovery. Because our prices are established based on time, facilities, and other variables that are unrelated to patient satisfaction, all payments related to surgery prices are final once collected. We cannot issue refunds for unsatisfactory results, but we will work as diligently as we can to deliver you the best results possible.
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