Q: Dr. Eppley, I had chin and cheek computer imaging done to show me what the effects of this surgery would be on my face. I notice in looking at the images that there is some asymmetry with one side being different than the other. Is this what I can expect from the outcome of the surgery?
A: There are some basic concepts of computer imaging in plastic surgery that are important for every patient who undergoes it for any procedure to understand. First, the quality of computer imaging is only as good as that of the original pictures. In your case, you provided the pictures which were not of great quality. (slightly blurry and out of focus) When these pictures are magnified for imaging, the quality is not good enough to create very good detail. Second, computer imaging is designed to serve as a method of communication so the patient and the surgeon can see if they are on the same page, it is not intended to be an exact replica or a guarantee of the result. Contrary to popular perception, there is no computer that does the imaging. It may be done on the computer but ultimately it is the hand of the operator (often using Photoshop) that is creating what he/she thinks the effects will be from the surgery. That is the reason it is called ‘computer prediction imaging’…it is a prediction not an assured result. Third and most important, Plastic Surgery is not Photoshop. The body does not respond to trauma and healing like pixels do on a computer screen.
Dr. Barry Eppley
Q: Hello there… I was curious on whether you dabble in computer imaging for let’s say a jaw enhancement procedure. Thanks.
A: When considering structural facial alterations, as opposed to age-related changes, it is extremely important for the patient to have a reasonable idea as to what their face may look like. For this reason in my Indianapolis plastic surgery practice, I never do such facial surgery without computer imaging before surgery.
Several points about computer imaging, however, are important for patients to understand. First, facial computer imaging is a prediction but not a guarantee of results. It is the plastic surgeon’s best estimate of what he or she thinks may happen. But plastic surgery is not like Photoshop. How the body heals and responds to surgical manipulation of its tissues is not precisely predictable. Think of computer imaging as a communication tool primarily. It helps ensure that what the patient finds acceptable is surgically possible.
Secondly, the most predictable facial features to image are those that can be done in profile. With a contrast between flesh-colored skin and a solid color background, it is much easier to change the feature in a more precise manner. Therefore, procedures that change the brow (brow bone reduction), nose (rhinoplasty), chin (chin augmentation/reduction), and neck (liposuction, facelift, tracheal reduction) can be imaged with reasonable realistic accuracy. Certain frontal (face forward) structures can also be done, such as the ears and lips, but most of the face is this view do not have good color contrast between adjacent parts.
Last, if you can not get computer imaging for these types of facial plastic surgery procedures…go find another plastic surgeon.
Dr. Barry Eppley