Evolution of Preoperative Rhinoplasty Consult by Computer Imaging

Overview

The consultation includes history, aesthetic and functional examination, assessment of motivation, and standardised photographs. Over the preceding decade, morphing the preoperative photographs became common. The authors (including Hellings) review the literature on morphing and place it in historical and clinical context. No new data are presented.

Sections of note

• Morphing lets surgeon and patient reach "a mutually agreeable set of expectations" by showing the planned outcome.
• It allows the surgeon to postpone or cancel surgery in patients unhappy with the proposed changes.
• Patients may feel more prepared and hold more realistic expectations.
• Imaging is progressing from 2D to 3D models.
• The literature is described as supporting benefits over risks.

What it means for a patient

• A simulation is meant to test whether you and the surgeon want the same thing before anyone operates.
• If you dislike the simulated nose, that is useful information; surgery can be modified or declined.
• The simulation is a plan, not a promise; later studies show real results can differ in both directions.

Why this paper matters

It is a state-of-the-art review at the point when 3D imaging was arriving. Limits: review, no data.

Terms

• Computer imaging (morphing): digitally altering a photograph to show a proposed result.
• 2D versus 3D imaging: flat photographs versus surface-scanned models viewable from any angle.
• Standardised photographs: images taken with fixed angles, lighting and distance for comparison.
• Preoperative consultation: the assessment visit before surgery.