Q: Dr. Eppley, I am pursing getting a rhinoplasty to make my nose look better. In fiddling with my own version of computer imaging, I have made some changes to my nose that I would like to get done. Are these type of nose changes possible? If so, Acne X Factor what type of rhinoplasty do I need? I know there are two types of nosejobs, a tip rhinoplasty and a full rhinoplasty. Which do you think is best for me?
A: I would not as a patient get concerned about the different types of rhinoplasties. The differences between a tip and a full rhinoplasty is somewhat artificial. The basic difference that separates the two rhinoplasties is that a more complete technique involves osteotomies or the narrowing of the nasal bones due to hump reduction or bridge modification. A tip rhinoplasty by classic description does not go past the lower tip cartilages. Regardless, many rhinoplasties incorporate techniques that borrow from each basic type of rhinoplasty making the surgical changes that each patient’s nose needs unique. Your attempt at rhinoplasty imaging is pretty good and I think that it is a fairly achieveable outcome. Hump reduction and tip narrowing and elevation are fairly standard changes that can make many noses look better. Your lack of thick nasal skin makes it also realistic that the alterations to the underlying cartilage and bone will be seen on the outside when the swelling goes down. You may call the type of rhinoplasty that you need a more complete one.
Dr. Barry Eppley
Q: Dr. Eppley, Can you tell me how close a surgical result will be compared to the computer imaging that has been shown to me? Since it is done on the computer I assume that it is fairly accurate and representative of the result. I am desiring to get a rhinoplasty and chin and jaw angle implants and want to see if the result wiould be worth the effort and the expense.
A: A very important consideration when looking at predictive computer imaging is to realize how it is done and that it is not an exact science. The only thing ‘computer’ about it is that it is done on a computer. The computer does not create the images nor portray them on some one-to-one basis from the nose or jaw implant to the patient. In other words, the computer does not take the dimensions of the implant(s) or the amount of nose structure that is removed and directly transfer that onto the patient so the changes will identically match. Rather, computer predictive imaging is done on Photoshop by the plastic surgeon with their best guess of what the changes may be. It is an art form not an exact science. Thus, computer imaging can easily overpredict or underpredict what the final result may be. Since patients view computer imaging as a more exact science than what it is, I always slightly underpredict what I think will happen. It is important for the plastic surgeon to not overpredict as this may easily overpromise or oversell the surgical procedure. This can lead to postoperative disappointment in the result if these expectations are not met.
The very valuable feature of computer imaging in rhinoplasty and jawline implants is that it can be a very good predictor compared to many other facial plastic surgery procedures. Because these are silhouette or profile facial structures, they are easy to morph and see the potential changes.
Dr. Barry Eppley