How Accurate is Digital Imagery when Considering Rhinoplasty?

Question

How accurate is digital imagery when considering Rhinoplasty? Also, is digital imagery available in the UK, or is it rather rare to find a clinic offering this service? Thank you.

Frank P. Fechner, MD · Answer

Imaging can be educational in communicating possible rhinoplasty results. I found it most helpful when discussing profile changes including nasal size reductions, removal of a bump or changes in tip rotation. In addition, it is a wonderful tool to demonstrate benefits of chin enhancement and liposuction under the chin.
BUT, it is only a computer tool, not more and not less. At the end, most patients don't want to see how gifted the surgeon is in manipulating digital photos with a computer program but rather get an idea about the possible rhinoplasty outcome. And of course, it is not real until the plastic surgeon was able to reproduce a comparable nose with rhinoplasty...
Unfortunately, I cannot comment on the availability of imaging in the UK.

C. Spencer Cochran, MD · Answer

Computer imaging for rhinoplasty is a valuable tool for communication  and for setting goals for surgery.  But, it is only as accurate as the surgeon who performs it.  It is very easy to make a computer image look good. The real challenge is being able to achieve that desired result with surgery. 
I recommend that patients visit with several rhinoplasty surgeons before deciding to undergo surgery. While the computer imaging that is done for the patient is important to set goals for surgery, the key thing for patients to look at, are the actual before and after results. 
Recently, 3D rhinoplasty imaging has become available. This is helping patients visualize how making a change from one viewpoint can impact the appearance of the nose from another angle.

Toby Mayer, MD · Answer

My son can make you the greatest nose you ever saw on a computer. Unfortunately, he knows nothing about doing surgery on real people! Look at the surgeons real work on patients, either photos or better yet real live patients. What you are buying is his proven skill over many years, not a computer drawing.

David C. Pearson, MD · Answer

As to the question of accuracy, remember that digital imaging is merely a drawing tool, not a simulation in the truest sense. I could, for example, morph a nose to look like Pinocchio, but that doesn't mean that it can actually be built in the operating room. So in that sense, imaging is only as "accurate" as the surgeon doing the morphing.
I routinely use imaging with my rhinoplasty patients. It helps me plan the surgery, but it also helps me make sure that the patient and I are on the same wavelength and share the same vision of what the goal is. Revising pixels is a lot easier than revising tissue! I take great pains not to morph the nose into simply the most perfect shape, but rather to morph the nose into what I think is nice looking and reasonably possible.
I would emphasize, too, that imaging is not to be thought of as ordering from a catalog. The final surgical result will be different, but ideally it should be close and should address the same issues.
All the best,
--DCP

Steven J. Pearlman, MD, FACS · Answer

I have found that computer imaging is very helpful when discussing rhinoplasty. The images are not an exact representation of results, but usually pretty close. Imaging is an excellent discussion tool with patients. We can explore making certain parts of the nose higher or lower to come to a mutual agreement on what we are striving for. I have found that patients like the interaction and ability to share in the procedure planning.
In the US, imaging is offered by many surge ions.

William Portuese, MD · Answer

Digital imaging is a communication tool. It allows the surgeon to communicate what is attainable for the patient and permits the patient to express what their needs are. Most computer simulations in our office come very close to the actual final result after the procedure is over.

D.J. Verret, MD · Answer

Unfortunately digitial imaging is a computer technology so the old saying - 'Garbage in and garbage out' holds true. The image you see is dependent on the physician who is performing the imaging. Ensure that it is the physician who is imaging your results and not an assistant or consultant. Most surgeons who utilize digital imaging can get a very close result. Always remember though that imaging is a simulation and that your actual results will likely vary.

Theodore Katz, MD, FACS (retired) · Answer

When you discuss with a surgeon what you are unhappy with about your nose and what you would like to see improved, he/she then discusses with you whether these goals are realistic and how close he can come. Digital imagery only gives you the best possible scenario and you must realize that your surgeon will try to get close to that but cannot guarantee it and if they do, run away quickly! It is nice to have goals, but once surgery is begun there are many variables that the surgeon must deal with. Digital imagery does not take into account the type of skin you have, deformities, depressions, angulations of cartilages, and it certainly can't predict the unpredictable, which is what can happen when the surgeon actually is "inside" and must deal with variables. See a board certified plastic or facial plastic surgeon, express you desires and goals, listen to what they say about how close they can get (with or without digital imagery), and certainly discuss the potential risks and complications and what he/she will do if these arise.

How Accurate is Digital Imagery when Considering Rhinoplasty?

Answers (8)

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