Dr Andrew Frankel – USA Rhinoplasty Expert

The AAFPS Masters Symposium was held in October 2015. The event was a collaboration between the AAFPS (Australasian Academy of Facial Plastic Surgery) and the ASPS (Australian Society of Plastic Surgeons) and the focus was on Functional and Aesthetic Rhinoplasty. We were lucky enough to get some pre-event interviews with some of the keynote speakers and share the first one with renowned Beverly Hills surgeon Dr Andrew Frankel.

Dr Andrew Frankel

Dr Andrew Frankel has been practicing at the Lasky Clinic in Los Angeles since 1994. He completed medical school and a five year residency in Otolaryngology-Head and Neck Surgery in Chicago before moving to Los Angeles in order to complete an additional year of specialty training in Facial Plastic and Reconstructive Surgery. The great majority of Dr Frankel’s practice involves facial rejuvenation (such as facelifts, brow lifts and blepharoplasty) and Rhinoplasty, however Dr Frankel also performs reconstructive facial surgery such as for skin cancer or trauma and a great deal of revision nasal surgery to help improve breathing as well as to restore form.

Dr Frankel is a member of the National Domestic Violence Project, where he performs pro bono surgery on victims of domestic abuse. Dr Frankel has been an investigator for clinical trials and has remained actively involved in clinical research as well as serving as a consultant to several medical corporations in this regard. He serves as a consultant for a Hollywood special effects company where he advises on making actors look better, younger, or occasionally older in a more realistic fashion. He has contributed to such films as “The Curious Case of Benjamin Button” “X-Men 3” and “The Departed”.


PSH: Computer Imaging is fast becoming a popular tool in the plastic surgery process. How closely can you duplicate the results seen on the computer with the real life outcome and do you think patient expectations are matched with what they see on the screen? Also, do you think there will come an age where computers do the surgery for us?

Dr Frankel: Computer imaging can be a very powerful tool, particularly for rhinoplasty. Its effectiveness depends solely on how it is utilised. In order for it to be worthwhile the surgeon him or herself should be the one doing the morphing with the patient. The changes should be done with regard to the patient’s desires but within a realistic range and take into account an honest assessment of that surgeon’s limitations. In this scenario the surgical results can come close to duplicating the computer generated ones. I have published a paper on this very topic and will refer to it during my presentation.

The question of whether I feel that computers will ever do the surgery for us is interesting, as there are already advances heading in that direction which I will mention. In terms of ‘doing the cutting’ it is feasible, however I believe that a live surgeon will always need to be in control to take into account variables such as the firmness of the cartilage, skin thickness etc. which play into decision making. It is important to note that the final result of a rhinoplasty is not as we leave it on the table; but occurs over time with wound contracture and this requires some experience and judgment and perhaps a sense of ‘touch’ that computers have yet to develop.

PSH: You are based in Beverly Hills. This location certainly has a reputation attached to it with regards to the popularity and extremities with which that society undergoes plastic surgery. What are some of the differences do you think with regards to the “rest of the world” when it comes to aesthetic appearance enhancing in Beverly Hills?

Dr Andrew Frankel: It is incredibly interesting to practice in Beverly Hills. One misnomer is that the patients are all actually local. In fact, a large percentage of my patients trek to Beverly Hills from all over the globe for surgery because of its allure: the glamour, celebrities, and ‘beautiful people’ are there so the surgeons must be good (right?). People come seeking out ‘The World’s Best Surgeon’ for this, or ‘The surgeon who did (place your favorite celebrity’s name here)’s work’ etc., and as you can imagine this attracts an array of very challenging patients. I intend to speak on the nature of these patients and highlight how practicing in this environment is an ‘acquired taste’.

PSH: Do you think there is a higher percentage of Body Dysmorphic Disorder (BDD) in Los Angeles and does this concern you when you are discussing procedures with a potential patient? How do you deal with this concern?

Dr Frankel: Although I have seen no data on this matter, I do see a significant number of patients with BDD each year but as I’ve mentioned already, they are not necessarily all from Los Angeles. I cannot deny that LA is a breeding ground for BDD due to its emphasis on beauty and fitness and the fact that many people are chasing their dreams and hanging their hopes on things that they have little control over (modeling contracts, acting roles etc.) where competition is fierce. When the hair on the back of my neck stands up during a consultation with one of these patients, I begin exploring and asking very direct questions about their motivation for surgery. I also tell the patient directly what my concerns are and why I suspect they might have an issue. I tell these people that I am uncomfortable operating on them and think surgery might be detrimental since they might never be satisfied regardless of the outcome. I request that they see a therapist who can determine how well equipped they might be to handle surgery and the possibility of imperfection or complication. Only after I’ve spoken with the therapist will I consider operating on these patients. This is when it gets tough because such patients don’t truly hear me and want the surgery even more so once I say no.

PSH: What is the most commonly asked for body features from your patients, ie. Angelina Jolie lips, etc.?

Dr Andrew Frankel: Of late I hear many requests for Blake Lively’s, Natalie Portman and Kim Kardashian’s noses, Jane Fonda’s face (most recent version ;-)), and yes, Angelina Jolie’s lips still rank high. Other celebs frequently mentioned include Megan Fox and, of course, Caitlyn Jenner.

With regard to your prior question about how celebrity and media influence plastic surgery I think the short answer is “significantly”. Celebrities may become famous for something other than their appearances, but once they are well known, people believe they are flawless. It is in the media’s best interest as well as the celebrity’s to promote the idea that they are genetically superior. Highly enhanced glossy movie posters and ads, photographs of glamorous locations with flattering lighting and sophisticated make-up help to perpetuate this myth. And nowadays social media allows for editing of every single image that is posted, giving the celebrity even greater control over how they are portrayed; making them seem even more likable and attractive. People aspire to look as good as these celebrities and often, if there is any resemblance, they will even request procedures to bring them closer in line with what their particular celeb appears to look like. I use the word ‘appears’ because none of these celebrities look in person as they are projected by the media. I know this first hand as their surgeon and its creating a problem where people (particularly younger females) are reaching for something that doesn’t truly exist. It sets unrealistic expectations and can lead to repetitive surgeries.

We’d like to thank Dr Andrew Frankel for taking the time to answer our questions; he’s at AAFPS Annual Conference and Masters Symposiumery

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