Why won't my surgeon do a morph for a revision?

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.

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

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

 

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.
 

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