Just a handful of years ago, it was unheard of to get online to check out your plastic surgeon before making an appointment. That detail was reserved for coffee klatches or girls night out and even that was affected by regional influences, says Jeffrey R. Raval, M.D., F.A.C.S., triple board certified American Board in head/neck surgery, otolaryngology and facial plastic surgery.

That’s changing today as patients rely on the internet for volumes of information about every subject of interest to them, says Dr. Raval. Google.com or msn.com searches aren’t uncommon as a prospective patient begins to sort out the volumes of information about plastic surgery and other minimally invasive treatments they’ve heard about but not experienced yet.

“We get many hundreds of visitors to our website daily,” says Dr. Raval, who sees patients Monday through Friday and sometimes on Saturdays. “We know from the reports we get monthly that the inquiries are about specific products and treatments. People are searching for these topics by name, sometimes highly specific product names. They may have read about a treatment in a national magazine and then want to find a doctor locally that performs the treatments they’re interested in.”

The New York Times reported in April that roughly 5,700 plastic surgeons are certified with the American Board of Plastic Surgery and that roughly 113 million Americans have used the internet to get healthcare information, according to the 2006 Pew Internet & American Life Project.

Then again patients are very likely to go to the website to review it after they’ve heard from a friend or co-worker that they have been treated in Dr. Raval’s office. “They hear a personal testimonial, look our office up on the internet and then call to make an appointment. Or sometimes they hear a personal testimonial, call information for our phone number and after they’ve made their first appointment will cruise through the website to learn more about us before actually coming in for treatment,” Dr. Raval adds.

To that end, the design of one’s website is significant. Dr. Raval has chosen to run streaming videos of his frequent appearances on local TV channels during which he demonstrates a specific procedure. “Because I watched a video of Dr. Raval online on his website, it was almost as if I had met him previously when I went into his office for the first time,” reports one patient. Videos, especially, give viewers a better perspective of the doctor’s personality and presentation—qualities that are important to assess when selecting a doctor.

Obviously, one of the most motivating experiences to prompt calls for appointments is a personal endorsement. Says Dr. Raval’s receptionist: “We often hear from first-time callers that they are ‘friends with so-and-so’ or that ‘so-and-so referred them.’”

While many patients are talkative about their procedures and the outcome, some patients keep mum and want others to think they’ve got great DNA or luck. Patients in Miami, Florida or Los Angeles, California have historically been far more likely to open up about their plastic surgery and/or non-invasive treatments like BOTOX or Restylane injections, says Dr. Raval. In fact, it’s not unusual for the conversation between complete strangers to revolve around these topics in those areas of the country. In a curious way, you could almost overlay the regions of the country where patients are more inclined to discuss their physical surgical improvements with a weather map. The warmer the weather and the skimpier the clothing, the more patients are likely to reveal that they’ve been “improved.”

Another factor that impacts openness about the topic of plastic surgery (or any topic, for that matter) is cultural. Folks living in the bread-basket of America are known to be conservative and not likely to make fast friends. And sometimes it’s religious. And, of course, income levels have an especially profound impact on the decision to proceed with cosmetic surgery. Since most cosmetic surgery is elective and most insurance carriers won’t pay out on elective treatments, it means that the patient has to have the money to pay for the treatment. Considering that a syringe of the injectable Perlane is about $800, the limits on the credit cards these patients pull out to fund treatment generally are five-figures or six.

Dr. Raval practices in Cherry Creek North, the upscale neighborhood known for its fine spas and high end retail boutiques. It’s not unusual for a patient to pull up to Dr. Raval’s practice in a $60,000 car, wearing a $2500 suit showing off a glowing tan from an $8,000 vacation the week prior. By the same token, Dr. Raval has patients who prioritize their limited funds, making a choice between one luxury or another in order to have plastic surgery.

The tendency to prefer a lot of smaller, less-invasive treatments that don’t require down-time or at the very least require minimal down-time, is an increasing phenomenon, says Dr. Raval who has observed that the bulk of his patients lead highly active lives—with families and high powered jobs. That kind of thinking is directly in line with Dr. Raval’s preference for recommending and performing more frequent, less invasive treatments that allow the patient to enjoy immediate results and satisfaction while not keeping them from being productive otherwise.

The fact is, says Dr. Raval, that it’s the patients who are currently undergoing a treatment or say a series of treatments as in Sciton Laser microdermabrasion who are more inclined to talk up their treatment—in part because they’re so happy with the immediacy of the results, the return to looking younger that they can witness overnight. In some instances, says Dr. Raval, patients share their experience with friends and co-workers because they themselves are so amazed at how far medical technology has come in the last decade. Plus, they enjoy the compliments which typically include mention of them looking rested or young.  “Upon hearing that they look happy or rejuvenated, they’ll often jump in and offer the information about a simple procedure they’ve just had,” Dr. Raval says of the feedback he regularly hears from patients.

“When I get a new car, I tend to notice all the other cars on the road that are the same make and model as mine,” Dr. Raval admits with a chuckle. “When I have just returned from a vacation in a tropical place, I’m more likely to talk about that trip to people I know versus months later. Let’s face it, one of the favorite subjects most people have is themselves, so they tend to talk about what they’re doing and what they’re up to. If I remodel a room in my house, I’m more inclined to talk about the progress while I’m in the middle of it—good or bad—than I am months later after the remodel is complete and my focus has turned to another subject.”

Reach Dr. Jeffrey Raval at 303-744-2300 or visit his website at www.ravalmd.com.

Google Jennifer Aniston and 18,900,000 results pop up in less than 19 seconds, among them teasing headlines like “Aniston and John Mayer caught kissing again” to a report by Fox News in 2007 that Aniston has had a second nose job by Indian plastic surgeon Raj Kanodia, the second one to correct a first surgery for a deviated septum done a dozen years ago. The surgeon is also reportedly the plastic surgery solution to Jessica Simpson and Cameron Diaz, the article by Catherine Donaldson-Evans on the FX website, owned by News Corp. the parent company to FOX News.

Repeat rhinoplasty or nose jobs aren’t uncommon, reports Dr. Jeffrey Raval of Denver, CO, who is known as “The Nose Guy” for his exceptional surgical capabilities in repeat nose jobs. “The issue with a repeat nose surgery is always the scar tissue,” says Dr. Raval, F.A.C.S. and triple board certified facial plastic surgeon with American Board certifications in head and neck surgery, otolaryngology and plastic surgery.

Patients frequently seek out Dr. Raval for their repeat nose job when they’re not happy with the surgery performed by another plastic surgeon. Sometimes these patients come from states away, says Dr. Raval who is not afraid to tell a potential patient who wants unreasonable surgery that they’re not a good candidate for cosmetic surgery.

“I make a point of taking the time to discuss with the patient their concept of what the surgery will do for them,” says Dr. Raval. “If they’re scheduling surgery to please someone else or expect their lives to become altogether different, new and improved because of a surgical procedure, they will not be pleased with the outcome, even when the surgery is flawless.”

No surgical procedure makes everything about one’s life perfect, Dr. Raval adds.

Take, for instance, Jennifer Aniston. Even though she had a first nose surgery, she still ended up divorced from her husband, Brad Pitt. And although she underwent a subsequent corrective nose job to trim the wideness of her nose, she still suffered heartbreak, falling in and out of love. She was incessantly  pursued by the paparazzi. Reports about Jennifer’s every move, whether it was true or not, were widely circulated, particularly when she was expected to be at the same event as her ex, Brad, and his new wife Angelina Jolie.

Nose jobs are done for many reasons, not the least of which is to simply correct the appearance of the nose. Other reasons for nose surgery include restoring breathing function in the case of a patient whose breathing is limited because the inside of the nose is crooked (called a deviated septum). Many patients have noses that are outsized like their parent or other family member, consistent with their DNA of origin. Surgeries to minimize the size of a nose or to correct a bump on the nose are often performed on teens in their mid-teen years.

“The outcome for a teen patient who has been ridiculed or teased because of the size or shape of their nose is almost always highly positive,” says Dr. Raval. “A good nose job eliminates the object of this ridicule and torment. Now if a teen has a big nose and a repulsive attitude or other offensive behavior, chances are nose surgery won’t do a thing to endear others to him/her or to make the teen feel better about him or herself.”

“That would be a case where I would suggest to a parent that the child be seen by a counselor who could help the teen work through his or her emotional issues to better understand what is causing issues in interaction in the first place,” Dr. Raval says.

In his years in practice, Dr. Raval has had many, many patients who’ve had nose jobs tell him that the surgery has improved their lives.

Sometimes patients combine surgery to correct a deviated septum along with surgery to correct the appearance of the nose. When Dr. Raval is minimizing a nose or removing a bump, his overriding concern is that the nose be consistent with the rest of the patient’s facial characteristics. “In the ‘60s patients who came in wanting a nose job might want theirs to be made into a small pixie nose. But those days thankfully ended when the objective of cosmetic surgery became more focused on making a patient look natural as well as beautiful, absent exaggerated change or an over-surgerized noses,” says Dr. Raval.

The decision to opt for a nose job is one that requires a patient to take appropriate time off rigorous activities to recover. Following rhinoplasty, the nose is packed with dressings that must remain in place for several days. Then for about a week to 10 days, the patient is advised to not sniff their nose or blow their nose. Instead they’re instructed to gently dab at any discharge with a tissue. Once the nose has begun to heal, the mucous plug, that at first functions as a sort of protective cover, will naturally dry up and release from the inside walls of the nostrils. Follow-up visits to the doctor will check to confirm that the healing process is going as is expected and the swelling and tenderness that occurs will minimize as the nose heals completely.

“Just because you like the noses the celebrity twins Mary-Kate and Ashley Olsen breathe out of, doesn’t make that same nose ideal for you,” cautions Dr. Raval. “By the same token, it can be tough on a child to have a nose that attracts attention for all the wrong reasons.”

Dr. Raval can be reached at 303-744-2300 or visit his website at www.ravalmd.com