For rhinoplasty, should the doctor provide you with a mock-up photo of what you will look like? Is it fine if they do not?

Question

Looking to confirm whether a doctor should provide you with a mock-up or not. I trust my doctor and he does not provide mock-ups, but I have anxiety with not having a "visual" . . . thoughts?

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for
your question.  I think before-and-after photographs are more telling, realistic, and predictive of your own outcome than virtual photographs. In my opinion, the keys of your
rhinoplasty consultation should be for your surgeon to address all your aesthetic goals
and concerns specifically, discuss the surgery details including the
position and size of the incisions used (with actual photographs and not just
digital animations), the risks and benefits of the procedure, recovery time,
and post-operative course.  Also, be sure to see plenty of
before-and-after pictures in patients who have a similar nose appearance to yours,
and preferably at different time frames (3 weeks out, 3 months out, etc) to
more accurately predict your own surgical outcome.  
After seeking out a
board-certified plastic surgeon who specializes in aesthetic plastic surgery, I
think the most important component of the consultation is to establish a good
connection with your plastic surgeon.  It’s the connection that allows you
to clearly define your desired nose outcome goals, the first step of this whole
process. If you don’t feel you have a good connection with your plastic surgeon
after your consultation, he/she may not be the best surgeon for you.
For more information on
rhinoplasty, please refer to the link below.
Good luck.
Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic
Plastic Surgeon

Steven M. Denenberg, MD · Answer

It's not good enough for the doctor to say I'll elevate your tip or I'll bring the tip back closer to your face, or I'll lower that bump, or I'll give you just a teeny-tiny scoop. The words are great, but you need to see the mock-up so you *know* what's in *his* mind when he says those words.
The mock-up can give you more reassurance that you and he have the same goals. If he draws something that's waaay too short, you have the opportunity to tell him it's too short, and to change his goal for the operation.
If he draws something and you say that's not nearly enough change and he says "Well more change than that isn't realistic," or "I can't make more change than that," then you know you better not have him do your surgery, because you won't get what you want.
And there are a million other things the morph can show you, like how the main change you want affects other parts of the nose, and what else then has to be done to the nose so it looks natural.

Suleyman Tas, MD, FEBOPRAS · Answer

Hello and thank you for a good question. Providing mock-up photos or not is a choice of each doctor. We provide simulation photos to show the patient what kind of changes he could probably come up but not the exact outcome. So the patient could easier adapt to his post op appearance.

Thuy-Van Tina Ho, MD · Answer

Dear franklin28,
Thank you for your question. While morphing imaging to show a possible anticipated rhinoplasty result is often help in setting realistic expectations for both the surgeon and patient, not all surgeons use this method in their consultation. Not having this modality available does not take away from the expertise of the surgeon. Surgeons who do use morphing imaging software also make sure to emphasize that the morphed images are not a guarantee of results. I recommend you seek an in-person consultation with a facial plastic surgeon or plastic surgeon who is an experienced rhinoplasty specialist who can perform a thorough evaluation and discuss with you the best surgical options to meet your goals.

Ronald J. Edelson, MD · Answer

I would not choose a surgeon on the basis of whether they do computer imaging.  I don’t do computer imaging but do something different which I feel is more helpful.  I take a profile of the person using my cell phone then have it printed off.  I then use a pencil to give the person an idea of what I plan to change.  Much simpler and easier to help the patient understand what I plan to achieve.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  3D imaging should never take the place of real before and after pictures in rhinoplasty.  It is far more important that you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. 
 
 Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Jeffrey H. Spiegel, MD · Answer

A virtual photo is a gimmick.  Speaking with the doctor is the key thing.  If they are busy and can show you many pictures you should be set.  You can always do it yourself to show the doctor.

Robert L. Kraft, MD, FACS · Answer

Imaging cannot provide a guarantee of results. I use it with that caveat.  It is easy to show the lateral view but there is a definite leap of faith in this procedure as to how the nose will look from a frontal perspective. A computer image can be tweaked to show anything but that does not make it realistically accomplishable. Best wishes.

Michael Elam, MD (retired) · Answer

Dear Franklin28, Not every surgeon provides digital imaging and they can still be expert rhinoplasty surgeons. I personally like to use digital imaging to help make sure the patient and I are on the same page with their desired results. When performing imaging its important that you take into consideration the patients skin thickness and nasal anatomy so that the morphed or imaged photograph is a realistic proposed result. I personally have an entire before and after book of imaging photographs, showing the patients before, proposed and final results. This gives patients a very good idea of how close in proximity the imaged and final results are. I would not say that its a red flag that your surgeon does not use imaging its a personal choice. For myself and my practice I find it a very helpful tool. See some examples of before and afters in the link below and see an example of the imaging process including the proposed and final results in the video below. Best regards, Michael V. Elam, M.D

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