Morph for Revision?

Can someone please tell me why my original surgeon doesn't want to do a morph of a revision of my nose that didn't turn out well to begin with? Other surgeons I consulted with had no problem doing morphs but my original one said he won't do them. He did a side profile morphs before my original surgery but never the front but the front is where my major issues are at. Should I take this as a red flag? I am very uncomfortable going into yet another surgery without seeing a morph first.

Doctor Answers (12)

Morphing planning for rhinoplasty

+3

You ask a good question.  Morphing is a communication tool, not a guarantee of a result.  The problem with front view morphing is that it just isn't very good yet, in terms of how the final result might look. It's great for profile however.

My suggestion is:  Talk with your surgeon and be as specific as possible about what you would like, at each level of the nose - upper, mid and lower / tip. Ensure your aims are realistic.  Discuss the proposed plan to achieve a realistic, reasonable and agreed aim for the revision surgery.

If you feel that the  communication and agreement between you and your surgeons is right - that is both of you feel that you are in agreement, and the proposed revision is realistic - then the morph is redundant and you will likely do very well.  Ergo, a morph but poor communication between you and your surgeon will not get you where you want to be.

Hope this helps.  The question to ask is really:  why not do a morph?  and if the answer is that a realistic impression of the new result cant be conveyed through that technology, then that is a reasonable answer.

All the very best.

Howard Webster

 


Melbourne Plastic Surgeon
5.0 out of 5 stars 64 reviews

Computer imaging can be helpful

+2

Computer imaging can be helpful, but it is important to understand that someone who is competent with the computer can draw anything.  They can draw a perfect result.  The experienced surgeon with computer imaging will only draw what can be realistically obtained with surgery.

Robert Mounsey, MD
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Morph for revision?

+2

In general, a computer morphed photo serves the following purposes:



1) To give the patient an idea of how the final result of surgery may appear


2) To serve as a goal for the surgeon to follow in the operating room



Every surgeon has their own individual protocol they follow. Some use computer morphing and others do not. Your surgeon may be perfectly capable of doing a great job, but may not want to use the morphing for whatever reason. This may be a red flag, but not the determining factor of your surgeon's capability. Did they explain to you what would be performed during a revision? Are you confident they will be able to fix your nose and this will be the final surgery? If not, a second opinion may not be a bad idea. I hope this helps, and I wish you the best of luck

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

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Morphing for revision rhinoplasty

+2

Morphing for rhinoplasty is a great tool for communication between plastic surgeons and patients, however, it has its limitations. Front view is somewhat difficult to morph and depends on the quality of photos taken in the office. Fine changes may be impossible to depict on the front view. Also, it is a personal choice of surgeons when to use morphing and is not necessarily the standard of care, although most colleagues i know do use it routinely. 

Grigoriy Mashkevich, MD

New York Facial Plastic Surgeon

 

Grigoriy Mashkevich, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Computer imaging and noses

+2

I do not use computer imaging for primary or secondary rhinoplasty. I think that sometimes patients feel that it will give them the exact result shown, but in reality the soft tissues do not respond exactly as shown in a computer image. 

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Computer imaging is a great communication tool but for revision it's not quite as precise

+2

In the past I used to never image and morph revision rhinoplasty. The frontal view is the hardest. However, I find now that imaging is great for revision surgery. A lot of what we do for revision surgery are set goals for what we are looking to achieve as well as discuss what can and can't be done; even more than primary surgery. I don't give out the photos though for revision surgery since it's a discussion tool and may be less accurate than morphing for primary surgery.
 

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 40 reviews

Computer imaging for revision rhinoplasty

+2

  Computer imaging is simply a communication for surgeons and patients to use to give an idea of what the nose might look like. Be very specific in your communications with  your surgeon to  make sure both have  a clear understanding of the limitations and expectations of revision rhinoplasty surgery, since it is quite difficult.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Morphing of nose

+2

I also agree with Dr. Webster.  Morphing the nose pre-operatively is used to present a simulation of the results post-operatively.  It is a tool used to verify the goals of patient and surgeon.  Morphing of the lateral (side) view, is much simpler to create than a frontal view.  That is probably the main reason the frontal view is not morphed.  I recommend an open discussion with your primary surgeon, before changing physicians.

Nana Mizuguchi, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 22 reviews

Morphing for Revision Rhinoplasty

+2

Using of technology is a personal choice for surgeons. Choosing to do it, or not is a personal decision. 

In my practice I use it a s a communication tool between patients and myself. I always do the morphing, as I believe it is important for visual communication about what the surgeon can achieve, and what the patient expects.

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.5 out of 5 stars 83 reviews

Rhinoplasty and Imaging Technology?

+2

Your plastic surgeon's response is not necessarily a "red flag”. Best to run your questions and concerns by your plastic surgeon; online consultants will only be able to speculate as to what his reasoning may be.

 Remember that imaging technology is not used as a “guarantee” of results but is simply a form of communication. Ultimately, you will need to feel comfortable that you and your plastic surgeon have  communicated sufficiently and that you are both on the same page as to what the goals and expectations are.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 781 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.