Computer Imaging: Are These Reasonable Expectations for a Revision Rhinoplasty?

Personally, I do not think digital imaging is as constructive in a consultation as your impression of the Surgeon and examples of his/ her previous work.  Digital imaging, even if a disclaimer is given, inevitably produces an implied result in a prospective patient's mind.  Recent studies show that digital imaging has about a 40% correlation with the actual final result.  For these reasons, I do not use it in my practice.  I recommend that you discuss your expectations and concerns with your Surgeon.

With the limited photographic views and without examining your nose it's hard to say for certain what result is possible. Depending on your anatomy it may be hard to get as sharp a nasal tip as you've morphed, though.

A full facial analysis and examation would allow your potential surgeon to perform digital morphing to allow the two of you to come together about what level of changes you're interested in.

 

My only critique of this simulation is that the tip appears a bit too sharp and the alar base is a bit too narrow. The main issue seems to be the hanging columella. This tends to exaggerate the prominence of the nostrils, too. I do prefer computer imaging--if done in a realistic fashion--since it allows me to plan the case better and it improves the chances that the patient and I share the same vision for their nose. With any revision rhinoplasty, however, it's important to avoid making things worse, so surgery should be designed around improvement, not perfection, of course.

All the best,

--DCP

Hello,

We perform simulations routinely, but only for surgical planning.  I let my patients know that I can make their noses look however I want on the computer.  They understand that healing forces will ultimately shape the nose and not the computer.  As a male you have thicker, more oily nasal tip skin.  I would be surprised if any surgeon could make the tip look that sharp during a revision surgery (? possibly with aggressive tip grafting ?).  Make sure you have a clear, realistic understanding of the probabilities that your nose will not be as finessed as shown in the after simulation photo.

Good luck,

Dr. Shah

I read your concerns and reviewed your photos:

You appear to have an acceptable Rhinoplasty result 1.2 years post-op, so you should reserve surgery as a last resort.

Your nose is a bit long, and you appear to have a hanging columella and excessive nostril show. If you desire to improve the appearance of your nose, you should consult with several revision rhinoplasty experts to see what you might expect after revision surgery.

Your imaged photos appear reasonable, but you should show these to your surgeon during your consultation to get his input and tailor a plan specific for you.

I hope this is helpful.

Dr. Joseph

 

I think these results are a reasonable goal.  More important would be your surgeon's history and results as a revision specialist.  They should have plenty of recent before and after photos for you to see and past patients available for your to speak with about their experience.

It also depends on your prior rhinoplasty.  If it was endonasal (no external cut) with minimal dissection and cartilage work, then your goals are easier to obtain and the results more predictable.

Remember that the computer simulation is a guideline or blueprint.  You can get very close, maybe even exactly as it appears in the simulation, but you can be 100% sure in anyone's hands. 

Get at least 2 or 3 consults. 

Best of luck.

Dr. Chase Lay

IMHO, no computer imaging gives realistic results as the software manipulates, shrinks and rotates tissues in a manner unavailable during the surgery, in this case the Rhinoplasty.  One view shows the entire nasal base more narrow, which IMO is unrealistic.  See real before and after pictures of Rhinoplasty patients during the consultation and forget the computer analysis.

I would recommend you discuss your desires with an experienced surgeon. For me I cannot comment based on your photos alone.