Eva Sheie  0:03 

The purpose of this podcast is simple, we want you to get to know your doctor before meeting them in person because you’re making a life-changing decision and time is scarce. The more you can learn about who your doctor is before you meet them, the better that first meeting will be. There’s no substitute for an in-person appointment, but we hope this comes close. I’m your host, Eva Sheie, and you’re listening to ‘Meet The Doctor.’ Welcome back to ‘Meet The Doctor,’ my guest today is Dr. Gregory Dibelius, and he’s a facial plastic surgeon in New York City who specializes almost entirely in rhinoplasty. Welcome to the podcast.

Gregory Dibelius  0:44 

Thanks for having me.

Eva Sheie  0:46 

So, sometimes it has to go a little bit in reverse, like, here you are, we just described your work life, at least, in a nutshell. And I understand that you do mostly rhinoplasty, but how did we get here? So, let’s maybe go a little bit backwards. Today you’re doing all rhinoplasty, how did you decide that that’s what you wanted to do? How did you end up here?

Gregory Dibelius  1:10 

Sure. That’s a great question. So, I’m trained in ENT; ear, nose, and throat, which is one pathway into, specifically, facial plastic surgery. And, as the name implies, that’s just the face. But it’s pretty amazing that even within just one small area, you can pick one thing and dedicate your whole life to it. I find the nose to be very challenging and rewarding. It’s actually sort of much more complicated than you might think if you just think about it briefly. There are thousands of techniques that are needed to deal with nose surgery, from the simplest to the most complex. And so, I was exposed to it in residency, and then, I spent my facial plastics fellowship, basically, focusing on rhinoplasty primarily. So, it made sense to continue that training, go out in the world and do my own practice with rhinoplasty.

Eva Sheie  2:04 

So, you did a fellowship that was entirely rhinoplasty focused?

Gregory Dibelius  2:07 

Not entirely. We did cover the breadth of facial plastic surgery, but there was a very distinct focus. And we did some of the most advanced techniques with rhinoplasty. Everything else was treated more sort of in the standard fashion, but rhinoplasty was given a very front-row seat to some of the most advanced stuff out there.

Eva Sheie  2:29 

I’m picturing a nose in the front row. Where was this?

Gregory Dibelius  2:32 

Yeah, so that was in Chicago, which is actually a city sort of famous for its history with nasal surgery.

Eva Sheie  2:40 

Tell me more about that.

Gregory Dibelius  2:43 

Well, just a lot of the biggest names in ear, nose, and throat, facial plastic surgery, many of the instruments are named after these guys. So there’s quite a legacy there, and I was happy to be part of that.

Eva Sheie  2:55 

What school was this, Northwestern?

Gregory Dibelius  2:59 

This was the, at the time, University of Illinois, Chicago.

Eva Sheie  3:02 

Okay. And how did you feel about living in Chicago? Did you even notice you were in Chicago? I think you were probably really busy at this time.

Gregory Dibelius  3:10 

I was quite busy, but it is hard to not notice living in Chicago in the winter when there’s a chill in your bones and there’s nothing you can do about it.

Eva Sheie  3:20 

I’m from Minneapolis, and I hear that it’s colder in Chicago.

Gregory Dibelius  3:23 

I have nothing to compare to except for New York, and there’s nothing like Chicago. So, it was a great year, but I would probably never go back in the winter voluntarily.

Eva Sheie  3:34 

I’m with you. So, you did this fellowship, and, I think, for patients who are listening, can you briefly explain why fellowship is so important?

Gregory Dibelius  3:46 

So, fellowship just means sort of another training program. So, everyone’s familiar sort of with medical school, that’s always followed by a residency where you specialize in whatever you’re doing. But increasingly, I would say, residency-trained physicians are seeking fellowship training to further specialize. I think that as medicine expands, in general, it’s compelling to trainees to really get expertise in sort of a field that interests them.

Eva Sheie  4:16 

So, if you were to do a residency in ENT, you would be focused for that entire time on the things that encompass ENT, but then, you specialized further after.

Gregory Dibelius  4:25

Exactly.

Eva Sheie  4:26

Got it. I think a lot of us just… I’ve listened to it many times now and even I still get confused, but it’s after medical school we all sort of go, then what did you do?

Gregory Dibelius  4:37 

Yeah, it is a confusing process, and certain terms are thrown out there like interns, what’s the difference between an intern and a resident, etc. And then, it’s further confused by popular television shows, and things like that, that really blurred those lines. But it’s all pretty straightforward. The intern year is just the first year of your residence. And then, you finish the entire program, you finish your residency. And then, most people seek board certification, whatever specialty that was. And then, the fellowship would be additional training in a certain field. Some of those also allow you to take your own subspecialty boards, which is the case with facial plastic surgery. So, a lot of us who do this pathway, we’re technically double-board-certified surgeons.

Eva Sheie  5:30 

I have a really important question from what you just said. Can you watch medical TV shows, or are they too terrible?

Gregory Dibelius  5:39 

I do find a lot of them to be kind of terrible, but I think it has nothing to do with the medicine. But, I don’t know, maybe it’s just my taste in television. The medicine is usually kind of bad, but, to me, that’s not really the most critical factor.

Eva Sheie  5:54 

Well, then, okay, what is?

Gregory Dibelius  5:56

No just, you know…

Eva Sheie  5:57

The acting?

Gregory Dibelius  5:58 

If it’s good drama, if it’s good comedy, whatever it is, that’s the most important. It has to be watchable.

Eva Sheie  6:03 

Do you have a favorite?

Gregory Dibelius  6:05 

Yeah, I’d say Scrubs was probably the best one. And, in reality, it’s one of the more accurate ones out there.

Eva Sheie  6:14 

I’m getting a sense for your sense of humor here. I’m encouraged by this choice; Scrubs. And also, I know roughly what generation you’re in based on the answer as well.

Gregory Dibelius  6:28 

Buzzfeed quizzes there, they guess my age.

Eva Sheie  6:30 

So, which scrubs doctor are you if you had to be one?

Gregory Dibelius  6:33 

Oh, I don’t know. I guess I would want to go with Turk because he’s a surgeon. But I’m not sure, I have to think about that.

Eva Sheie  6:45 

First answer is the one that counts. Okay, so I’m trying to make the topic of training more lighthearted, I guess, because it’s important, it’s very important, actually, when we’re trying to choose a doctor for something as important as rhinoplasty. We do need to understand it. And I wonder if you have any thoughts you can share with us on other ways that you could tell if you’re choosing the right surgeon besides training and credentials.

Gregory Dibelius  7:19 

Besides training and credentials, okay. Well, I would just make a plug for training and credentials, they’re very, very important. And there are different types out there. So, the most prominent and the most important things you’re looking for, number one are, essentially, you want to be board certified in either plastic surgery or facial plastic surgery. I think those are sort of the highest level of training in those fields. But, after that, I think it makes sense, especially in a place like New York, to look for somebody who primarily does whatever. So, in my case, nose surgery, because there’s a lot of surgeons, it just makes sense that if they tend to favor something they specialize in, that’s all they do, they’re going to just be more on top of the issues with those kinds of surgeries, they’re going to give it the most attention it deserves. I kind of view myself as a super-specialist in nasal surgery because I really think it is important to focus. And that’s one aspect of something that patients can get a sense of when they meet a doctor. And the other one is also critical and very important, which is just sort of the rapport that you have. You want to make sure that doctor isn’t sort of just bringing you in, spends two minutes with you saying, “Oh, yeah, I can do that,” and then, doing something… Even if things turn out well, that’s still not an ideal situation. You want a doctor that’s going to spend time with you to answer your questions, set the expectations, answer whatever detailed thoughts you have on any particular issue. And then, importantly, afterwards, guide you through the healing process because it’s not as straightforward as you might think. Healing, there’s a lot of sort of anxiety that people come into the healing process with, and you do want someone knowledgeable and experienced to guide you through that. And I do think you can get a sense of who’s going to do that and who’s not going to do that initially when you meet them in a consultation.

Eva Sheie  9:18 

I did several years of surveying work with plastic surgery patients, and one of the things we learned was that when people were dissatisfied, it was not because of their results. The number one thing that made them dissatisfied was that they were not prepared for recovery. And with rhinoplasty, the recovery is actually quite long. And so, how do you talk with your patients about being prepared for that?

Gregory Dibelius  9:43 

Well, there’s sort of a general overview that I give which is a summary of the timeline of swelling reduction, and how you’re going to be able to return to work. For example, if your case is likely to result in bruising around the eye, for example, that’s one of the early issues that patients deal with when they are… Especially if they work in a client-facing, public-facing job, you have to prepare them for that or they’ll be very disappointed and surprised. But the big thing is swelling of the nose, that takes many months, over a year sometimes to go down. It’s different in different cases, like, in revisions, it’s very different. It also fluctuates greatly depending on sort of environmental factors like diet, and temperature, things like that. So, a good summary of all that, I think, helps people understand what they’re getting into. And I just think the other thing is that people come in with their own questions and thoughts, and you have to be willing to sit there, and hear them out, and try to address those because you may not know what their anxiety is going to be about.

Eva Sheie  10:52 

When you’re consulting with people about changing their nose, do you use any special tools or anything that helps visualize what they’re going to look like later?

Gregory Dibelius  11:01 

Yeah. So, it’s pretty standard, I think, to do, number one; digital photography in a fairly standardized fashion. That’s actually one of the most non-negotiable parts of what I do. You need to do the photographs because, once something’s different, you never know what it started as. You can never reference the original, it doesn’t matter how many selfies you have on your iPhone, or in the cloud, it’s gone. So, we have a record, and that’s really critical. In terms of visualization, I do a couple of things. We have a review of sort of, like, previous patients and different outcomes. And because you get a realistic view of actual results, and that gives you the best sense of how does these techniques actually play out in the real world. And then, to individualize that, we do the photographs, and then we do, essentially, photoshopping. It’s really important that patients understand that’s not a perfect predictor, it’s not a guarantee of outcome, but it is a very important tool, number one; for communication between me and the patient to make sure we’re on the same page aesthetically. And number two; it actually does help the surgeon plan the surgery. What am I trying to get to at the end of my case, Photoshop and the digital photography, when you look at it, it actually gives you a sense of how much change is possible. So, I sit down at the computer, and although there’s a number of ways you can make the nose look, that’s not what you should do, you should do what you think is possible, present it to the patient and say, “I think this is somewhere we could get to around this look.” And then, look for feedback. If they say, “I think that looks really great, my aesthetic sensibility is in line with that,” then that, to me, is a good match. And that’s a good favorable situation to move forward from.

Eva Sheie  12:55 

Is there anything about your rhinoplasty approach that you think patients should know before they come to see you?

Gregory Dibelius  13:01 

Yeah. So, I think, number one, I would describe the way I approached the surgery is that I’m looking to get a natural outcome. So, I think there’s a distinction between that, which is gaining a lot of popularity these days, versus something that would be a little more cookie cutter, more stylized, cutesy, something that’s designed for Instagram rather than regular life. And I think that there are different types of patients. And, in general, some are looking for a more natural change, and others are looking for the more sort of aggressive and stylized things. Fortunately, there’s like an even older type of rhinoplasty that I think we’ve moved on from that was very unnatural. But I would say that it’s important to understand that I’m looking to do more natural results and not something that I feel is too aggressive and will lead to problems later in life, like breathing issues, etc.

Eva Sheie  13:59 

I’ve seen galleries and I’ve seen examples of other surgeons’ work where all the noses look the same, and I think what you’re saying is you’re the opposite of that.

Gregory Dibelius  14:09 

Yeah. I also think that it’s helpful to tailor, as much as you can, to the individual patient. I try to paint a picture for patients that rhinoplasty is, at once, very, very precise, and also, not as precise as you might think, in certain ways. So there’s a lot of things that I do that try to subtly preserve a certain feature that the patient wants, for example, but then sometimes they say, “Well, I want you to make sure that this little half-millimeter difference between this and that is corrected,” and what they don’t realize is that’s not something you can control necessarily, but you can still control getting an excellent outcome. But people, without knowing nasal aesthetics or a rhinoplasty, they maybe will focus on sort of the wrong thing, and part of the consultation is guiding them, “This is what is going to look good,” and you try to give them examples and the best visualization you can of that, and try to help them understand the process, which, by the way, is probably the number one goal of my consultation is just like an educational session. People come in with a lot of really good questions, and some of them are just, they’ve never even thought about it, and some people have thought about it extensively. Some people are like, essentially, nasal surgery experts in terms of maybe they don’t do the surgeries, but they know every concept, they know every technique, different types of graphs, when you would do certain types of maneuvers, when you would use rib drafts, they know a lot of things. And so, it’s actually really nice to sit down with people coming from different places and try to fill in the gaps for them and help them understand rhinoplasty.

Eva Sheie  15:51 

I have not heard this sentiment anywhere else, and I’ve heard it a couple of times today and I have to wonder if New York patients are just much much more involved in their research process.

Gregory Dibelius  16:03 

I don’t know, I don’t have a lot of comparisons.

Eva Sheie  16:06  

Do patients come from all over the world or just mostly from New York?

Gregory Dibelius  16:08 

Yeah, it’s an international place.

Eva Sheie  16:12 

I think maybe you’re a destination, and that’s part of that.

Gregory Dibelius  16:15 

Yeah. But I think it may also be a generational thing. With things like real self and other social media or internet-based things, Instagram communities, etc., people share information and some of it’s bad information, but a lot of it’s totally legit information. And I’ve interacted with a number of patients who have just sort of just come in very, very informed, and it’s really a pleasure.

Eva Sheie  16:43 

Sure, people who are prepared are definitely the best kinds of patients. Let’s switch gears a little bit, tell me about yourself outside of work. What do you like to do for fun?

Gregory Dibelius  16:56 

Well, I’m into music, I play the guitar. I recently picked up lessons again, I don’t know, since college or something. I studied a little bit of jazz, I started doing it again. Formerly sort of very active working out like marathons, endurance sports. Got a knee injury, though, which hampered that a bit, but I’ve been very into cycling since then. And I have a young baby now at home, so that takes up most of my time now.

Eva Sheie  17:25 

Mm-hmm. Forget about your hobbies.

Gregory Dibelius  17:28 

Yeah. You forget about a lot of stuff.

Eva Sheie  17:31

Yeah, this is true. (Laughs)

Gregory Dibelius  17:32

But it’s been very fun, it has been very enjoyable but it’s kind of funny to think about what I do outside of work now. It’s pretty much that and the hobbies…

Eva Sheie  17:43

It’s going to be for a while.

Gregory Dibelius  17:44

Yeah, I’m going to work the hobbies back in because I formerly was… They were very important to me. But it’s okay, for now.

Eva Sheie  17:51 

What can patients expect when they come to see you for the first time?

Gregory Dibelius  17:56 

I try to have what I consider to be a unique consultation process. Probably one of the big differences, and I’ve gotten this feedback from patients, is that I really don’t book a lot of consultations on a given day, I put a lot of time into each one. Not everybody wants to use a lot of time, and that’s fine, but some people really need it and I don’t really cut it short. So, I would say, typically, it’s like 60 minutes to go over the case. And, again, not everybody needs that, especially if it’s pretty straightforward. But when I do revision consults, these are people who have a lot of anxiety about a bad outcome or something that happened to them in the past, and they just want to make sure that, this time around, they get their questions answered, they do as much education for themselves as they can. And that’s what my philosophy and my practice really is, is to do that. So, even if it’s not the right fit, or whatever, it’s hopefully a productive use of their time, and that they come away with something which is a better understanding of what the world of Plastic Surgery, rhinoplasty, or whatever it is.

Eva Sheie  19:07 

Surgeons don’t usually work alone. Everyone has a team, and I wonder if you can speak to who’s on your team and who we might expect to meet if we come to see you.

Gregory Dibelius  19:17 

Well, actually, I have a very small practice. You’ll interface pretty much with me, which is another unique aspect to my practice is it’s essentially like a boutique type of surgical practice. It’s nice because it does help keep costs down, and everything, and it’s something that’s more… It’s not a factory, you’re not coming to a factory, you’re not coming there with like 10 other people waiting for Botox, you’re not going to get three minutes with me, it’s not that kind of thing.

Eva Sheie  19:44 

So if we call the office you might actually pick up the phone?

Gregory Dibelius  19:47 

No…

Eva Sheie  19:48 

Not quite.

Gregory Dibelius  19:49 

Not quite, but pretty close. I have my own very small staff, but there’s different facilities we use because I operate at facilities, for the most part, rather than do the office surgery thing. A lot of great administrators, nursing anesthesiologists, etc., we work with. So yeah, it’s a small practice, but it’s the thing that allows me to do what I want to do very specifically.

Eva Sheie  20:17 

So, if someone is interested in coming for a consultation, where should they reach out to you?

Gregory Dibelius  20:22 

You can call the main number, email, all the standard stuff.

Eva Sheie  20:27

Do you have Instagram?

Gregory Dibelius  20:28

I have Instagram, yes. I wouldn’t recommend reaching out via Instagram…

Eva Sheie  20:34 

All right, scratch that.

Gregory Dibelus  20:34 

It’s a little work in progress, sort of, the Instagram, it’s not the best. Just the more traditional, like, phone, email, that kind of thing.

Eva Sheie  20:42 

Sure. So the best way to reach out is to go to your website and…

Gregory Dibelius  20:46 

Yeah, which is linked to the Instagram, but…

Eva Sheie  20:50 

Some people want to be communicated with on Instagram. So, that’s why I asked.

Gregory Dibelius  20:55 

Yeah. ?No, I get it. But, as I said, it’s a work in progress. And we’re building a platform to try to be a little more responsive on socials, and stuff like that.

Eva Sheie  21:07 

Well, I think you’ve got the important stuff down.

Gregory Dibelius  21:11 

Yeah.

Eva Sheie  21:12 

I really appreciate you taking the time to come tell us about yourself today, and I hope that we can have you back someday in the future.

Gregory Dibelius  21:19 

Yeah. Thanks for having me, it’s a really fun thing to do today.

Eva Sheie  21:24 

If you’re considering making an appointment or are on your way to meet this doctor, be sure to let them know you’ve heard them on the ‘Meet The Doctor’ podcast. Check the show notes for links including the doctor’s website and Instagram to learn more. Are you a doctor or do you know a doctor who’d like to be on the ‘Meet the Doctor’ podcast? Book your free recording session at meetthedoctorpodcast.com.  ‘Meet The Doctor’ is made with love in Austin, Texas, and is a production of Theaxis, T-H-E-A-X-I-S.io.