Preoperative Simulation in Planning Rhinoplasty: Evaluation from Patients' and Surgeons' Perspectives

Aksakal İA, Keles MK, Engin MS, Aydoğdu İO, Küçüker İ.

What this paper says

An online survey of surgeons and prospective patients found that experienced surgeons were significantly more confident using computer simulations, while less experienced ones feared being held to a visual contract.

Overview

Computer simulation lets a patient see a predicted result before surgery. The authors surveyed both plastic surgeons who perform rhinoplasty and people considering it, asking what they think of the practice and asking them to tell simulated images apart from actual postoperative photographs.

Sections of note

Online questionnaire survey of rhinoplasty surgeons and individuals considering rhinoplasty; the abstract gives no participant counts.
Respondents were asked their opinion of simulation and to distinguish simulated from actual postoperative results.
Analysis used SPSS software.
Major factors in patients' decision making: availability of preoperative simulation, being shown appealing results of the surgeon's previous work, and a personal reference from a patient with an appealing result.
Experienced surgeons were significantly more confident about using simulations than inexperienced ones, p below 0.05.
Whether to withhold the simulation or give the patient a copy did not differ by experience level, p above 0.05.
The authors conclude that patients' awareness of simulation is growing faster than surgeons' confidence in it. Level of evidence V.

What it means for a patient

Seeing a simulation is one of the main things that influences whether people choose a surgeon.
A simulation is a prediction, not a promise, and surgeons differ on whether to hand out a copy.
Personal referral from a past patient carried similar weight to the imaging.
Limits: survey based, level V evidence, no participant numbers reported, and opinions rather than measured outcomes.

Why this paper matters

Simulation has moved from novelty to a standard part of the rhinoplasty consultation, and this documents the gap between patient expectation and surgeon comfort. That gap is where disputes about unmet expectations arise. The study does not test whether simulation improves satisfaction after surgery.

Terms

Preoperative simulation: A computer-altered image showing a predicted surgical result.
Visual contract: The concern that a shown image will be treated as a promised outcome.
Level of evidence V: The lowest ranking, covering expert opinion and survey work.
Rapport: The working relationship and trust between surgeon and patient.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Among aesthetic surgery procedures, rhinoplasty is one of the most common. Preoperative simulations have become increasingly commonplace through the recent years along with a controversy regarding their use. Although capable of building a solid rapport between the surgeon and the patient by visualizing the end result,…”

Excerpt; the full abstract is on PubMed.