Simulated Nose Versus Real Nose?

Question

Does a good surgeon have the ability to achieve exactly the same nose look as that chosen on a rhinoplasty computer simulator? How reliable is a rhinoplasty simulator for surgery guidance?

C. Spencer Cochran, MD · Answer

Pre-operative rhinoplasty imaging, especially 3D imaging, is a valuable tool for both the patient and the doctor. For the patient, imaging can help patients understand the effect that changing the nose has on the overall appearance. For the surgeon, imaging is an important part of the preoperative analysis and planning.

	Patients and their surgeon should agree upon the goals for surgery, and imaging can help ensure that those goals and expectations are mutually understood. While imaging is useful technology, it is important to remember that it is just a simulation of a proposed result.

Ronald J. Edelson, MD · Answer

I personally do not use computer simulation when consulting with a potential patient. I find it more helpful to show them before and after photos of cases that are similar to theirs. Making a nose look good on a computer is easy. Actually achieving that same result is not. Select your rhinoplasty surgeons based on the quality of their work on previous patients. Make sure you see many examples and that you like the quality of work you see.

Gary M. Horndeski, MD · Answer

Great question. Although impressive and seemingly 'high tech', computer imaging is only a tool to communicate options available to you. It does not and cannot guarantee results. Best to see before and after pictures to best evaluate expertise of PS. Best wishes, Dr. H

Eric M. Joseph, MD · Answer

Computer-imaging is a routine part of nose job surgery consultations. It enables the patient to see what's attainable, and it also helps to assure the surgeon that the patient has realistic expectations. Computer imaging helps to set a realistic goal of what the surgeon thinks he may achieve, and to see if this would be a satisfying outcome for the patient. In my view, computer-imaging is an essential tool in the evaluation of my patients seeking cosmetic nasal surgery, and non-surgical rhinoplasty procedures.

	In fact, I do the computer-imaging and I routinely take imaged photos to the OR and may refer to them during Rhinoplasty Surgery. In general, if my computer-imaging is found to be attractive by my patients, I will typically exceed their expectations. I'm surprised to see that many RealSelf experts do not find this tool useful for predicting outcomes and ensuring patients' expectations are realistic.

	Hope this helps.

	Dr. Joseph

Stephen Prendiville, MD · Answer

Studies have shown that there is about a 50% correlation between preoperative computer imaging and postoperative results (according to patients). Therefore, although it can help explain what a Rhinoplasty procedure can do, the pictures you view may or may not be accurate. I personally feel imaging conveys an implied result, despite disclaimers and advice to the contrary. Based on this lack of accuracy, I do not use it in my practice.

Kris M. Reddy, MD, FACS · Answer

The reliability of the simulation is as good as the software, and while the software has improved considerably over the years it still needs additional refinement before it can consistently provide reliable rhinoplasty simulation. Neither from the perspective of the surgeon nor the patient do you want to create false expectations from flawed software.

Steven Wallach, MD · Answer

One of the reasons I do not use computer imaging is that it is almost impossible to achieve the same results as a computer because there are many variable that a compiter can not take into account for as what is seen and achieved in surgery.

Michael Suzman, MD · Answer

Imaging simulation is a very important and helpful tool. It provides another avenue for patients and surgeon to increase understanding and communication.
	
		Even if the results differ from the simulation, the process of simulation on the screen helps the patient understand what changes may be possible, and it helps the surgeon understands what changes the patient really wants ( and its often difficult to fully describe theses changes without imaging). 
	
		The simulation, along with thorough discussion, physical examination, and review of prior patient photos, all help the preoperative planning process so you can get the nose you want!

Darryl J. Blinski, MD · Answer

Computer imaging is a tool to HELP the patient understand the "possible" outcomes of the surgery. It is NOT the way you will look! Just a limited future view. Computers do not heal or preform any biologic action. Healing is 3 dimensional, while computers give you an image they can not predict the degree, amounts, effects of healing. Best to see before and afters of other patients the see if the surgeon can offer you an acceptable non computer generated result.

Michael L. Schwartz, MD · Answer

Surgeons should show you images that are realistic and that they are comfortable they can deliver or come close to. Both on my website and during consultation I show patients a series of previous patients photos demonstrating the before, the imaged result and the actual surgical result. I find this helpful in reassuring them and putting the technology in perspective.

Simulated Nose Versus Real Nose?

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