Dr. Epstein: It's Dr. Epstein, with a patient who's going to have her nose done. We actually would do it in the next couple of days but I'm here today. We're here just go over the computer imaging. This is something I usually send to patients by email but she wanted to come in to go over it, and just to go over all the details of her surgery. She's schedule for a rhinoplasty in the next day or two. She's in her early twenties, great candidate. She's tall, thin, just has some features with her nose with which she's unhappy. She's sitting next to me but I'll show you the pictures first, because I also have her computer imaging. Can you see this Cindy? We're focused in?

Cindy: Um-hum.

Dr. Epstein: So basically obviously this is going to be nothing better than the real thing but, you can see that she's got a somewhat wide bridge, a little bit of a fullness more on the left side than the right of her nasal tip. That's really her only complaint in the frontal view. This is the computer imaging, and I went over these with her. And this is to show in front of you what I like but this is the better view. This is her profile. Like I said, she's quite pretty but she's mainly concerned about the bump that she feels takes away, draws attention away. We went over her computer imaging and I actually showed her two different versions of an after. This is why I find computer imaging to be so valuable. This is subtle differences, this is one version, this is the other version. You can see with this version, as opposed to what she had. Generally with my noses I like to create a nice straight profile, and we've done that here. But the difference is on this one we have a well-defined supra tip break. So this the tip, this is the supra tip region and there's a break, which means a slight indentation. Here it's smoother. Most patients I think generally look better with a slight supra tip break, it's a personal decision but it's something which I prefer usually. But in this case we decided, and I agree with her, that the lack of a supra tip break is actually going to work better for her and you can see how nice it is.

So here she is preoperative. She's smiling. Let's take a look at her, so basically let's talk about the nose. She's got a wide dorsum, a wide bridge rather, an over-projected dorsum. She's got a well defined tip when she smiles. Smile for me, doesn't really droop which is nice so she has nice cartilage. This is what's called, you can stop smiling if you want to. This is what's called a double break. It's where columella becomes the tip. It's got a really nice defined double break. Which is very difficult to achieve surgically, we can do it but she already has a natural one. But obviously this is her main area of concern is the bridge, which is over-projected. This is bone, this is cartilage, so it's a combination of bone and cartilage. We'll take that down and give her a nice straight look. Reset the bridge and do a little bit of refining of the tip. Just a little bit, she's got these really nice facets, these soft tissue triangles which are really pretty. We're just going to go ahead and do a little bit of refining. Make sense?

Cindy: Yes.

Dr. Epstein: And that's what we got.

Rhinoplasty Computer Imaging Consultation

Dr. Jeffrey Epstein consults with a patient pre-operatively to explain his plan for her upcoming rhinoplasty using computer imaging technology.