How accurate are the before and after morphs doctors create before Rhinoplasty? (photos)

Question

Scared for multiple reasons, not sure if im over thinking things? 1. I'm afraid of a botched job, how many rhinoplasty cases need revisions? 2. Im self conscious, I just want to look beautiful so that I don't worry when people look at me. Sometimes I think I look okay, then other times I feel like I'm not very pretty at all. But the worst is if I go through with it to get a refined face, how many friends and family will notice and judge for it? 3. My final question is, I know the doctors do before and after morp4hs. How accurate are they to the final outcome?

Donn R. Chatham, MD · Answer

Use of a computer program to change the shape (morph) of a nose or other facial feature can be very helpful. Keep in mind that it is not a prediction or crystal ball, but is fun & visual way for the surgeon & patient to communicate. Since it uses a picture and not just words, this can assist many patients in understanding what the surgeon is trying to communicate. You may or may not like what the surgeon has changed on your picture, so now is the time to speak up. The most important factors are the trust in your surgeon, and developing a thorough understanding of the pros & cons of your proposed surgery.

Sam Naficy, MD, FACS · Answer

Simulations are a great tool for communication between you and your surgeon and when done appropriately and performed by your surgeon (as opposed to someone who does not perform the procedure) can give you a good idea of the possible outcome

Thomas A. Lamperti, MD · Answer

The accuracy digital morphing varies depending on the surgeon. No one can guarantee results, but I find that my morphing normally comes very close to the simulations.

In experienced hands a botched rhinoplasty result is rare. I'd recommend you find a surgeon who you trust and who has long term (at least a year) before and after results that you like.

You can learn more about digital morphing simulations at my web reference link below.

Kenneth Hughes, MD · Answer

I would perform rhinoplasty in closed fashion without a visible scar.  The result would be a refined, natural nose.  The revision rate will be different for every surgeon.  I average about 5% each year.  I think that it is more helpful to look at dozens of before and after photos to gauge the typical result.Find a board certified plastic surgeon who performs hundreds  
of rhinoplasties and rhinoplasty revisions each year.  Then look at the 
 plastic surgeon's website before and after photo galleries to get a   
sense of who can deliver the results. 	Kenneth Hughes, MD Los Angeles, CA

Andrew S. Frankel, MD · Answer

I addressed this exact question and published a paper on it in 2010  "Accuracy of Preoperative Computer Imaging in Rhinoplasty" Archives of Facial Plastic Surgery/Vol 12 (NO.6) Nov/Dec 2010. If you would like a copy then please contact my office and we will get one to you.In an nutshell..If the surgeon does the imaging and they know their own skill levels and are honest it can be very accurate. At the very least the imaging allows the patient and the sugeon to be on the same page when it comes to establishing a goal to shoot for.While there are never any guarantees with rhinoplasty a "botched job" should not happen in competent hands. Try to define precisely what you would like altered or what bothers you most about your nose and then consult with several surgeons before making a determination. It should feel right before you get on that table. If you cannot get to a point where your excitement overwhelms your fear then you are not yet ready to proceed.

Michael R. Menachof, MD · Answer

It depends on the surgeon. Most try really hard to morph accurately because the last thing anyone of us wants is someone upset afterwards because he or she was promised something that was never going to happen. In our office the first thing we do after a patient returns for their 6 month post-op visit is to compare these photos to the imaged photos done before surgery  as a way to see how accurate our imaging was. We use this to continually improve our imaging ability in order to try and give as accurate an estimation of the results as possible. Remember- imaging is an estimation only. It is a communication tool, not a guarantee.Sometimes no matter how well the imaging was done, the results may turn out a bit different. As for the other questions- a well done rhinoplasty is something others won't notice. Revisions are uncommon (less than 10%) but are sometimes needed even if everything was done correctly and well. The key is doing your research, look for experience (rhinoplastys are hard!), look at before and after photos, use the imaging as a part of the decision, and trust your gut. If you are comfortable with your choice of a surgeon after all of this, you will very likely get the result you are looking for.Good luck.

William Portuese, MD · Answer

Computer imaging is  form of communication with patient's  for them to understand what the anticipated result will be.   It is important to seek out a very experienced rhinoplasty surgeon who has performed thousands of rhinoplasty surgeries in their career.  As a general rule in our office, our morphed photographs from computer imaging come very close to  matching the rhinoplasty results consistently. Even in experienced hands, expected 10-15%" touchup" rate for rhinoplasty. For many examples of rhinoplasty, please see the link below.

Barry L. Eppley, MD, DMD · Answer

You have a very good type of nose shape that will do favorably with a rhinoplasty, getting a slimmer shape with a slightly shorter and more upturned tip. While different types of noses carry with them different revision rates after a rhinoplasty, a good average number is 10% to 15%. These are often minor adjustment procedures. Computer imaging is not a guarantee or an absolute predictor of a rhinoplasty outcome. It is more of a communication tool so the surgeon has a good idea as ti what the patient wants fro their surgery.

Stephen Weber MD, FACS · Answer

Both the accuracy of video-imaging and revision rate are entirely surgeon dependent. It is possible to overpromise and under-deliver when performing video-imaging so it's important for your chosen surgeon to simulate natural, achievable results. I hope this information is helpful.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Douglas J. Kibblewhite, MD · Answer

I think it is appropriate to be concerned and to express those concerns to your surgeon.  If your surgeon seems glib and says things like "don't worry everything will be fine", I would be even more concerned.In response to your questions, revisions rates are 10% in the best of hands.  Noses do look different in different lighting and positions, good photographers take advantage of this.  A good rhinoplasty should not be noticed.  The morphing is a guide only - it is mostly a method of communication between patient and surgeon to see what the patient might wish, and what might be reasonably achievable.

How accurate are the before and after morphs doctors create before Rhinoplasty? (photos)

Answers (14)

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