Eva Sheie (00:03):
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. 

Dr. Dibelius (00:44):
Thanks for having me. 

Eva Sheie (00:46):
So it sometimes has to go a little bit in reverse, like here you are, we just described your, 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? 

Dr. Dibelius (01:10):
Sure. That's a great question. So I'm trained in ENT, ear, nose, and throat, which is one pathway into, uh, specifically facial plastic surgery. And as the name implies, you know, that's just a face. But it's pretty amazing that even within just one, you know, small area, you can pick one thing and 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, you know, from the simplest to the most complex. And so I was exposed to it in residency and then I spent a, my facial plastics fellowship basically focusing on rhinoplasty primarily. So, you know, it made sense to continue that training, go out in the world and uh, do my own practice with rhinoplasty. 

Eva Sheie (02:04):
So you did a fellowship that was entirely rhinoplasty focused? 

Dr. Dibelius (02:08):
Not entirely. I mean, we did cover the breadth of facial plastic surgery, but there was like 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 like a very front row seat to some of the most advanced stuff out there. 

Eva Sheie (02:29):
I'm picturing a nose in the front row. <laugh> Where was this?

Dr. Dibelius (02:33):
Yeah, so that was in Chicago, which is actually a city sort of famous for its, uh, history with nasal surgery. 

Eva Sheie (02:41):
Tell me more about that. 

Dr. Dibelius (02:42):
Uh, well, yeah, just a lot of the, the biggest names in sort of ear, nose and throat facial plastic surgery. You know, 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 (02:56):
And what school was this? Northwestern?

Dr. Dibelius (02:58):
This was the, at the time University of Illinois, Chicago. 

Eva Sheie (03:02):
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. 

Dr. Dibelius (03:10):
I was quite busy, but it is hard to not notice living in Chicago in the winter when you know there's a chill in your bones and uh, there's nothing you can do about it. 

Eva Sheie (03:20):
I'm from Minneapolis and I hear that it's colder in Chicago. 

Dr. Dibelius (03:24):
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. Voluntary, voluntarily. 

Eva Sheie (03:34):
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? 

Dr. Dibelius (03:46):
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, uh, 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, in sort of a field that interests them. 

Eva Sheie (04:16):
So if you were to do a residency in ENT, you would be focused for that entire time on the things that encompass ENT? Yeah. But then you specialized further after. 

Dr. Dibelius (04:25):
Exactly. 

Eva Sheie (04:26):
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? 

Dr. Dibelius (04:38):
Yeah. It is a confusing process and certain terms are thrown about there and like interns, you know, what's the difference between an intern and a resident and etc. And then it's further confused by popular television shows and things like that that really blur those lines. So, you know, it's, but it's all pretty straightforward. The intern year is just the first year of your residency and uh, then, you know, you finish the entire program, you finish your residency and then most people seek like, uh, 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, you know, a lot of us who do this pathway, we're technically double board certified surgeons. 

Eva Sheie (05:30):
I have a really important question from what you just said. 

Dr. Dibelius (05:33):
<laugh>. Yeah. 

Eva Sheie (05:34):
Can you watch medical TV shows or are they too terrible? 

Dr. Dibelius (05:39):
You know, I, I, I do find a lot of 'em to be kind of terrible, but <laugh>, I think it has nothing to do with the medicine, but I don't know, maybe it's just my taste in, in television. I mean the medicine is usually kind of bad, but to me that's not really the most critical factor. <laugh>. 

Eva Sheie (05:54):
Well then, okay, what is? 

Dr. Dibelius (05:56):
Oh, just, you know, 

Eva Sheie (05:57):
The acting, 

Dr. Dibelius (05:58):
It's, if it's good drama, if it's good comedy, good story, whatever it is, that's the most important. It has to be watchable. 

Eva Sheie (06:03):
Do you have a favorite? 

Dr. Dibelius (06:05):
I mean, yeah, I'd say Scrubs was probably. 

Eva Sheie (06:08):
Okay. 

Dr. Dibelius (06:09):
The best one. And, and in reality it's one of the more accurate ones out there. 

Eva Sheie (06:14):
I'm getting a sense for your sense of humor here. It's, I'm encouraged by this, by this choice. Scrubs. And also I know roughly what generation you're in based on that answer as well. 

Dr. Dibelius (06:28):
It's on of those Buzzfeed quizzes there, they guess my age. 

Eva Sheie (06:31):
So which Scrubs doctor are you, if you had to be one? 

Dr. Dibelius (06:33):
Oh, I don't know. I guess I would want to go with, uh, Turk, cuz he's a surgeon <laugh>. Um, but I don't, I'm not sure. I have to think about that. 

Eva Sheie (06:45):
First answer is the one that counts. 

Dr. Dibelius (06:47):
<laugh>. 

Eva Sheie (06:48):
Okay. So I'm trying to make the topic of training, you know, more lighthearted I guess because it's, 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 there are, if you have any thoughts you can share with us on other ways that you could tell if you're choosing the right surgeon mm-hmm. <affirmative> besides training and credentials? 

Dr. Dibelius (07:19):
Besides training and credentials. Okay. Well, I mean, I would just make a plug for training and credentials. They're very and very important and there are different types out there. So you know, the most prominent and the most important things you're looking for, number one, are essentially you wanna 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, you know, knows surgery because there's a lot of surgeons, you know, it just makes sense that if they tend to favor something, they specialize it. That's all they do. They're going to just be more on top of the issues with those kinds of surgeries. They're gonna give it the most attention it deserves. 

(08:10)
I, I kind of view myself as like a super specialist in nasal surgery because I really think is important to focus and that's, 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, the rapport that you have. You wanna make sure that doctor isn't like sort of just bringing you in, like spends two minutes with you saying, oh yeah, I can do that. And then doing something. And even if things turn out well, I mean that's, 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, you know, answer whatever detailed thoughts you have, you know, on any particular issue. And then importantly afterwards, you know, guide you through the healing process because it's, you know, it's not as straightforward as you might think. Um, 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. You know, initially when you meet them in a consultation. 

Eva Sheie (09:18):
I did, uh, 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? 

Dr. Dibelius (09:43):
Well, you know, there's sort of a general overview that I give, which is a summary of the timeline of swelling reduction and you know, when, how you're gonna be able to return to work. And like, for example, if your case is likely to result in bruising around the eye, for example, you know, that's one of the early, you know, issues that patients deal with when they are, you know, especially if they work in a client facing public facing, uh, job, you have to prepare them for that or they'll be very disappointed and surprised. But the big thing is, you know, 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, it's very different. It also fluctuates greatly depending on sort of, uh, environmental factors like diet and temperature, things like that. So, you know, a good summary of all that, um, 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, and you have to be willing to sit there and hear them out and, and try to address those cuz you may not know what their anxiety is gonna 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 gonna look like later? 

Dr. Dibelius (11:01):
Yeah, so, um, it's pretty standard I think to do number one, digital photography in a fairly standardized fashion. That's actually one of the most like, like, uh, non-negotiable parts of what I do. You need to do the photographs because once something's different, you, you know, you never know what it started as. You can never reference the original, doesn't matter how many selfies you have on your iPhone or in the cloud, it's gone. So, you know, we have a record and that's really critical. In terms of visualization, you know, I do a couple things. There's, um, we have a review of sort of like previous patients and uh, different outcomes and you know, because you get a realistic view of actual results and that gives you the best sense of how do these techniques actually play out in the real world. And then, you know, to individualize that we do the photographs and then we do Photoshopping, you know, it's really important that patients understand that's not 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. 

(12:08)
And number two, it actually does help the surgeon like, plan the surgery. You know, what did I, what am I trying to get to at the end of my case? You know, Photoshop, when you and the digital photography, when you look at it, it actually gives you a sense of how much change is possible. So, you know, I sit down with the, at the computer and although there's a number of ways you could 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, this look. And then, you know, look for feedback. If they say, you know, I think that looks really great, my aesthetic sensibility is in line with that, then that's, that to me is a good match and that's a good, uh, favorable situation to, 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? 

Dr. Dibelius (13:03):
Yes. I, I think, you know, number one, I would describe the way I approach the surgeries 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, you know, something that would be a little more cookie cutter, you know, more stylized, you know, cutesy, something that's designed for Instagram rather than regular life. And I think that there are different types of patients and, 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. So, you know, but I, I, 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, you know, lead to problems later in life, like breathing issues, et cetera. 

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. 

Dr. Dibelius (14:09):
Yeah, I, I think I also think that it's helpful to tailor as much as you can to the individual patient. And I try to paint a picture for patients that rhinoplasty is at once very, very precise and also, you know, not as precise as you can, as you might think in certain ways. So, you know, 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 like make sure that this little half millimeter difference between this and that is corrected. And you know what, what they don't realize is that's not something you can control necessarily, but you can still control getting an excellent outcome. But you know, people without knowing, you know, nasal aesthetics or rhinoplasty, they maybe will focus on sort of the wrong thing. 

(14:58)
And part of the consultation is guiding them, no, 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 with a lot of really good questions and um, 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 like, concept, they know every, you know, technique, different types of graphs, you know, when you would do certain types of maneuvers when you would use like, you know, rib graphs. They know a lot of things. And so it's actually really nice to, to sit down with, you know, people coming from different places and try to fill in the gaps for them and help them understand rhinoplasty. 

Eva Sheie (15:51):
I've not heard this sentiment anywhere else and I, I've heard it a couple times today and I have to wonder if New York patients are just much, much more involved in their research process. 

Dr. Dibelius (16:04):
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? 

Dr. Dibelius (16:09):
Yeah, yeah, yeah. It's an international place. 

Eva Sheie (16:12):
I think maybe you're at destination and that's part of that.  

Dr. Dibelius (16:15):
So, but I, I think it may also be a generational thing, like with things like RealSelf and other social media or internet based things, Instagram communities, et cetera. There's people share information and, you know, some of it's bad information, but a lot of it's like totally legit information. And I've interacted with a number of patients who, you know, have just sort of like, just come in, you know, very, very informed and it's really a pleasure. 

Eva Sheie (16:43):
I'm 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? 

Dr. Dibelius (16:56):
Well, I like to, and I'm into music and 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, you know, marathons, endurance sports, got a knee injury though, which uh, has hampered that a bit. But I've been very into cycling since then. And, uh, you know, I have a, a young baby now at home, so that takes up most of my time now. 

Eva Sheie (17:26):
Mm-hmmm. <affirmative> Forget about your hobbies. 

Dr. Dibelius (17:27):
Yeah, yeah. You forget about a lot of stuff. 

Eva Sheie (17:31):
Yeah. <laugh>, this is true. 

Dr. Dibelius (17:32):
So, but it's been, it's been very fun, been very enjoyable, but it's kind of funny to, to think about what I do outside of work now. It's pretty much that and uh, the hobbies. 

Eva Sheie (17:42):
It's gonna be for a while. 

Dr. Dibelius (17:43):
Yeah, I'm, I'm gonna work the hobbies back in because I formerly was, you know, 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? 

Dr. Dibelius (17:56):
I try to have what I consider to be a unique consultation process. The, 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. You know, I, 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 like 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, you know, a bad outcome or something that happened to them in the past and they just wanna make sure that this time around they get their questions answered. They do as much education for themselves as they can. And you know, that's what my, the philosophy of my practice really is, is to do that. So even if it's not the right fit or whatever, it's, you know, hopefully a productive use of their time and then they come away with something which is a better understanding of what the world of plastic surgery or 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? 

Dr. Dibelius (19:17):
Well, I actually, I have a very small practice. It's kind of, you know, you'll interface pretty much with me, which is another unique aspect to my practice. It's, it's essentially like a boutique type of surgical practice. It's nice cuz it does help keep costs down and everything. And it's a, 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 know, you're not gonna get three minutes with me. It's not that kind of thing. Um, 

Eva Sheie (19:44):
So if we call the office, you might actually pick up the phone? 

Dr. Dibelius (19:47):
No.

Eva Sheie (19:49):
Not quite. Not quite. 

Dr. Dibelius (19:49):
Not quite, but, okay. You know, pretty close. But you know, I have my own very small staff, but there's different facilities we use. Cause I operate at the facilities for the most part rather than do the office surgery thing. A lot of great administrators, nursing, anesthesiologists, et cetera, we work with. So yeah, it's a small practice, but it's, it's the thing that allows me to do what I wanna do. Like very specifically. 

Eva Sheie (20:17):
So if someone is interested in coming for a consultation, where should they reach out to you? 

Dr. Dibelius (20:22):
You can call the main number email, you know, all the standard stuff. 

Eva Sheie (20:27):
Do you have Instagram? 

Dr. Dibelius (20:29):
I have Instagram, yes. I wouldn't recommend reaching out via Instagram. 

Eva Sheie (20:33):
All right. Scratch that.

Dr. Dibelius (20:34):
It's a little, uh, work in progress, sort of the Instagram, it's not the best, just the more traditional like phone, email, you know, that kind of thing.

Eva Sheie (20:43):
Yeah. So the best way to reach out is to go to your website and 

Dr. Dibelius (20:46):
Yeah. Yeah. Which is linked to the Instagram, but you know. 

Eva Sheie (20:50):
Some people want to be communicated with on Instagram, so Yeah. That's why I ask. 

Dr. Dibelius (20:56):
Yeah, no, I get it. It's a, but as I said, it's a, yeah, work in progress and we will, you know, 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. 

Dr. Dibelius (21:10):
Yeah. <laugh>. So, yeah. 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.

Dr. Dibelius (21:19):
Yeah. Thanks for having me. It's a really fun thing to do today. 

Eva Sheie (21:25):
If you are considering making an appointment or are on your way to meet this doctor, be sure to let them know you 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 Meet the Doctor podcast.com. Meet the Doctor is Made with Love in Austin, Texas and is a production of The Axis, t h e a x i s.io.