Three-dimensional Morphing and Its Added Value in the Rhinoplasty Consult

Lekakis G, Hens G, Claes P, Hellings PW.

PubMed 30859032 Publisher (DOI)Free full text (PMC)

What this paper says

Among 172 rhinoplasty candidates, 95 percent considered 3D simulation an improvement over 2D, while the two surgeons found it added value in 66 and 74 percent of patients.

Overview

3D surface imaging is becoming the preferred simulation method in hospitals, but no study had shown it beats standard 2D simulation during consultation. This study gave consecutive rhinoplasty candidates a 2D simulation, then a 3D one, and asked both patients and surgeons whether the 3D version added anything.

Sections of note

172 consecutive patients requesting rhinoplasty were included.
Patients answered a questionnaire after 2D simulation and then experienced 3D morphing, answering a single question on its added value; surgeons answered the same question.
Satisfaction with 2D morphing reached 61 percent.
95 percent of that same group considered 3D simulation an added value over 2D.
84 percent of revision rhinoplasty patients said 3D simulation helped them understand the aims of surgery, versus 61 percent of primary patients.
Among patients unsatisfied with their 2D simulation, 67 percent were reassured by the 3D version enough to proceed with surgery, versus 48 percent of those already satisfied with 2D.
Women were reassured by 3D imaging more often than men, 63 versus 42 percent. The two surgeons found 3D an added value in 66 and 74 percent of patients.

What it means for a patient

Nearly all patients preferred the 3D simulation, but surgeons saw it as useful in only about two thirds of cases.
Revision patients, who are hardest to counsel, benefited most in understanding the goals.
The groups most helped were those unconvinced by the flat simulation, revision patients, and women.
Limits: single question asked, one center, no comparison of how accurately either simulation predicted the actual result.

Why this paper matters

Simulation shapes what patients expect, and mismatched expectations are the main source of dissatisfaction. This documents a clear patient preference and a more measured surgeon view. Neither method's predictive accuracy against real outcomes is tested here.

Terms

Morphing: Digitally altering an image to show a predicted surgical result.
2D simulation: A predicted result shown on a flat photograph.
3D surface imaging: Capturing and displaying the face as a three-dimensional model.
Primary patients: Those who have not had previous nose surgery.
Revision patients: Those who have had previous nose surgery.

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

Abstract

Background: The evolving literature on 3D surface imaging demonstrates that this technology is becoming the preferred simulation technique in hospitals and research centers. However, no study has demonstrated before the superiority of this facility over standard 2D simulation during preoperative evaluation in rhinoplasty.

Methods: One hundred seventy-two consecutive patients requesting rhinoplasty were included. Patients answered a questionnaire following a 2D simulation and subsequently experienced 3D morphing. A single question was answered regarding the added value of the latter by patients and surgeons, respectively.

Results: In our survey, satisfaction with 2D morphing reached 61%. Ninety-five percentage of the same group considered 3D simulation an added value over 2D. Additionally, 84% of patients requesting revision rhinoplasty admitted that 3D computer simulation has helped them understand the aims of surgery, in contrast to 61% of patients from the primary group. Furthermore, patients unsatisfied with their 2D simulation got reassured following 3D simulation to undergo surgery at a higher percentage (67%), compared with the group initially satisfied with 2D (48%). Women appeared reassured by 3D imaging in higher percentage (63%) compared with men (42%). The 2 surgeons, however, found 3D simulations to be an added value in 66% and 74% of all patients.

Conclusions: The overwhelming majority of our patients considered 3D simulation an added value over 2D. Patients initially unsatisfied with 2D morphing, revision rhinoplasty patients, and women seemed to be the groups that appreciated more 3D than 2D computer simulation. In contrast, surgeons considered the facility of 3D an added value in two-thirds of the patients.

Abstract as indexed by PubMed; the article is open access (PubMed Central).