Sam P. Most M.D. Stanford C.A.: A Most Intriguing Option

Sam P. Most may not be the most famous plastic surgeon out there but he may be the most personable, amiable and considerate. After my primary rhinoplasty consult with Dr. Most today I couldn't find anything negative to say about his "bedside manner" or office staff. It is true that I have only consulted with three plastic surgeons so far, and so far Dr. Most is the "most" qualified, but he far outshone them in inspiring in me a sense of trust and belief. He was very frank about what could not be done: it would likely not be possible to fix the slight asymmetry in my nose, but the bulbous tip could be reduced and the bridge bump lessened to my specifications. He stressed that learning what my specifications are, communication, is very important to being satisfied with the result. He does computer imaging, but he is frank that slight deviations from the plan can result as is the nature of surgery and the healing process. I suppose it would be wise to say that one needs an understanding of a small range of what the result may look like and feel happy with to have realistic expectations. It seemed to me that while some doctors have a certain aesthetic that they aim for... as in Dr. Mang in Germany "the Mang Nose"... that Most may take more effort to make each nose individual. Some of those in his photobook, a bound edition of those photos he has permission to display, likely his best work, is available to peruse. It is not a thick book, rather the length of a childhood picture book, but covers a wide variety of noses and situations. I am assuming, and Dr. Most indicated this to be true for one patient, that many of his patients wished to keep elements of their ethnicity or heritage, as on some I found that there could have been more reduction for ideal aesthetics.

Dr. Most does the surgeries open and indicated that the scar may be a little visible but not an issue. He pointed out that on his photos it's not visible. He maintained that an open surgery will be more accurate, a mantra I have heard before. He said he performs about 200 rhinoplasty surgeries per year and of those 1-2% need revision. He was honest enough to state that it was likely if some of his patients were unhappy they wouldn't return to him and they would get the revision elsewhere. Yet even counting that unseen group the likely revision percentage was negligible. For revisions of his own work he said that generally only local anesthesia is needed and it seemed the procedure can be much simpler than the first ...probably for small aesthetic adjustments. 

Wait time for surgery may be 1-2 months, so it's wise to book ahead.

I appreciated that he was the one to take my photos in the photo room and then adjust those photos in front of me and that despite being behind schedule that day he took the time to address all my questions despite my having numerous moments when I found myself unsure of what questions to ask. He joked that I was likely referring to my list for Plastic Surgeons I had found online... which was spot on. He never caused me to feel rushed. He examined my nose carefully, something some doctors just don't do. (One reached across a table and squeezed my nose as if he expected it to honk.)

I ended up getting a botox treatment while with him, 20 units between the eyes. I liked that the office charged by the unit and not by the syringe which is something I have encountered elsewhere. If one doesn't want that much botox it's wiser to go this way. Having him inject it rather than an internist or nurse was also comforting as my last reaction to Botox had some complications.

One of the fellow Rhino seekers I have met on an online forum had surgery with Most recently and I am eager to hear how she is feeling and/or to speak to or meet a former patient.

So far Dr. Most: most intriguing!