Considering facial surgery can be an intimidating experience. This is particularly true when the changes are structural vs. age-related. Age-related facial surgery, such as facelifts, browlifts and blepharoplasty, are more psychologically certain. Trying to turn the clock back and look more youthful is more comforting as one is headed to an appearance of which one is familiar. Structural facial changes, however, are different. Procedures such as rhinoplasty, chin and jaw augmentation, and forehead reshaping, change the appearance of the face in a way in which one is not familiar. A new look with different facial proportions may be enticing but it is psychologically uncertain.

The value of facial computer imaging lies in helping make this potential surgical transition more comforting. Having an approximate idea of what the outcome may be can help one decide both if and what specific procedures may be most beneficial. While predicting surgical outcomes with computer imaging is not an exact science, and it most certainly is not a guarantee of any specific outcome, its approximations are nonetheless very useful.

There are now available numerous imaging programs, both online and as phone apps, that can enable one to upload a picture and do their own imaging predictions. These electronic tools are both fun and easy to use. Some will let you use changes predicted by a procedure while others will let you manipulate as you desire without a script. While this may be fun, such ‘predictions’ are little more than an exercise in ‘photoshop surgery’ rather than realistic estimations. Only experienced plastic surgeons who have done these procedures and have an appreciation of a realistic outcome can provide a more accurate prediction.

To help patients get improved access to realistic facial computer imaging, Predict My Face has been made available. This website page allows one to upload their face pictures, describe what changes they would like to see, and get a response back within a day or two. This is done at no cost to any patient. Not only does this imaging service have a rapid response but it is done based on the experience of a board-certified plastic surgeon with extensive facial surgery experience.

The key to getting good results from computer facial imaging is to have reasonable picture quality with which to manipulate. Pictures should have a crisp amount of detail such as is available on all digital cameras and many newer smartphones. If the picture looks a little fuzzy to you, that lack of sharp detail will be infinitely magnified when it is imaged and morphed. The angle at which the pictures are taken, the lighting and the background are also somewhat important. Only two facial angles are really needed, a front and a side view. Other views are only useful if they help to show some specific problem or concern that is better seen from an oblique view. When it comes to lighting, many patients submit photos that are little too dark. A clean or solid color background, such as a wall or a door, is better than any background that is patterned or too active.

Predict My Face offers a unique one-on-one experience with expertise that can help you find the facial changes that are best for you.

Dr. Barry Eppley

www.eppleyplasticsurgery.com

Indianapolis Indiana

Computer imaging continues to gain in popularity for both face and body plastic surgery procedures. While traditionally reserved as a patient communication tool inside a plastic surgeon’s office, it has become available to patients at home from numerous internet website providers. Such imaging tools have even become available on the iphone  as downloaded applications for face and breast self-imaging.

One of the newer online do-it-yourself patient simulation services is facetouchup. This system allows interested patients to see the potential outcomes of cosmetic procedures. Patients can upload their own images and perform  simulations of various facial procedures. Like many such systems, it is a facial manipulation site with best use for rhinoplasty and other facial profile changes. Its quality of imaging is pretty good. While some plastic surgeons may criticize the concept of allowing patients to make changes to their own face, which may be wildly unrealistic, I have no aversion to what used to be the exclusive territory of the plastic surgeon. Having patients simulate what they want is a great way for them to generate increased interest and enthusiasm  and may be enough to have them make an in-office consultation.

One of the interesting offering this company provides  is that plastic surgery practices can upload the software to their website and customize it for their unique offerings. This is evident on the homepage as there are separate areas for both surgeons and patients to enter. Its value is probably not that the plastic surgeon can actually use it for their own imaging but it is an attractive entry and retention point for patients who visit their website.

Where will computer imaging for the plastic surgery patient evolve next? More smart phone applications is a certainty, live doctor-patient simulations is undoubtably right around the corner.  

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Indianapolis, Indiana

Making changes to one’s face is always a big consideration that requires a good deal of thought from surgeon selection to the final choice of operation(s). While there are lots of facial procedures to consider, they can be divided into those operations that treat aging changes (skin and soft tissue sagging) and those that can change structural shape of the face. (bone and cartilage)

From a psychological standpoint, these two facial procedure categories are not the same. Reversing aging changes of the face is about making one look younger…turning back the clock so to speak. Facelifts, blepharoplasties, and browlifts, for example, aim to return one to something that is familiar…a younger you.  That is an easy decision to make for most. The desire to return to what once was is deep seated. The biggest fear in anti-aging surgery is that the operation may be overdone and look unnatural. (not like oneself)

Structural changes of the face, however, pose different psychological considerations. Rhinoplasty, facial implants, and any facial bone changes head one to something unfamiliar…a changed face and a new look. This can create much greater uncertainty because one doesn’t always know what to expect. While one may have a great desire to improve one’s appearance, there is always the trepidation that one won’t like it or it may not turn out well…and then forever be stuck with it. These concerns are magnified in that many of these procedures are often done in younger patients whose sense of self-image is less established and more fragile.

Structural facial changes are usually done in one or two areas at a time This is most commonly seen in rhinoplasty alone or rhinoplasty in combination with chin augmentation or other facial implants. Making a male’s face more masculine or defined often involves the trifecta of structural facial surgery… chin, cheek, and jaw angle implants. Derounding the face usually involves neck and buccal fat removal with a chin implant for women, men may get jaw angle implants as well.

In my Indianapolis plastic surgery practice, I have seen numerous patients over the years who have come to me because they were unhappy with the results of their structural facial surgery done elsewhere. In listening to their concerns, it has become clear that in some cases there was a fundamental misunderstanding or miscommunication about objectives. Sometimes it was the ‘wrong’ operation for their concerns. (e.g., treating submalar and lateral facial concavity with jaw angle implants) Other times, it was an operation that was over- or underdone. (e.g., too large a facial implant or a nose that didn’t have enough of a change) Most of the time, their operations were done well…but the patient’s aesthetic target was missed.

While no plastic surgery operation is an exact science, one’s objectives prior to surgery should be. The use of computer imaging is absolutely essential for structural facial surgery. This is a critical method of visual communication that often unravels the specifics of a patient’s objectives. Looking at combinations of procedures and amounts of changes can almost always avoid an unexpected outcome. While predictive computer imaging is not a guarantee of outcomes (I think of it as Photoshop plastic surgery), it does put the plastic surgeon and the patient at least on the same page.

When considering any form of facial structural surgery, it behooves the patient and the plastic surgeon to meet for several consultations. Computer imaging plays a vital role in setting the surgical plan and helping with postoperative expectations. The emotions and psychological implications that come with forever changing one’s facial appearance is a high stakes proposition that should not be taken lightly. This type of facial surgery is associated with much higher rates of patient dissatisfaction than with more commonly performed anti-aging procedures.    

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

The value of computer imaging in facial plastic surgery is significant. For procedures of the nose, chin, and neck, profile imaging is standard and fairly accurate. For frontal views around the forehead, eyes, nose and mouth, computer imaging is not as accurate but is, nonetheless, useful. While compter imaging was once only available in a plastic surgeon’s office, there are now online programs available that patients can try at home.

One such online program is LiftMagic. (http://www.liftmagic.com) This is a free online system in which anyone can upload a picture and see the results of various cosmetic procedures performed. Once can try various cosmetic procedures on their face via individual slider bars to adjust the degree of the outcome of the procedure from subtle to very significant. The individual’s picture is then morphed to reflect the selections, with the capability to flash back and forth between the before and after images. There are 13 procedure selections from forehead and cheek lifts to nose reduction and lip augmentation. There is even one option available for weight reduction. The program even includes an option to let the software optimize the patient’s image by selecting among all procedures and to the optimal degree.

I think this software program is a great tool for prospective facial patients to interact with and have fun. It helps answer the basic curiosity question of….what if I had this done? It provides some excellent insight into the patient’s needs and concerns before coming into a consultation with a plastic surgeon. While the program is not meant to be an accurate predictor of the outcome of any particular plastic surgery procedure, and most patients seem to understand that, it helps empower the patient more in the thought process and decision-making aspects of surgery. Patient involvement in any decision process is always valuable and probably does more in managing patient expectations than anything else I know. When patients get involved and start speaking in-depth about their desires, you often find out issues that might not otherwise have been apparent. An interactive software program, such as LIftMagic, does exactly that.

Modification and adjustment of computer imaging predictions (otherwise known as reality), however, must ultimately be done in conjunction with a plastic surgeon. Computer technology makes it possible to do a lot more than what can be predicted and done by modern-day surgical manipulations and the nuances of wound healing . Transitioning from ‘Photoshop’ plastic surgery’ to ‘Reality plastic surgery’ still requires human interaction. But LiftMagic provides a great first test drive.

Dr. Barry Eppley

http://www.eplpeyplasticsurgery.com

http://www.ologyspas.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis

I have previously blogged on the benefits of computerized digital imaging prior to surgery for select plastic surgery procedures. Historically, and due to the limits of software programs, predictive digital imaging was mainly used for facial procedures such as rhinoplasty, chin augmentation and other facial structures which can be easily morphed such as brows and lips. As technology has advanced, any body structure can now be manipulated such as breasts and other body contours. Programs now exist to do this in 3-D as well, providing a near unlimited amount of image manipulation.
While digital imaging is a great asset to patient communication and understanding, it is also fraught on the flip side to ‘misrepresenting’ what can be done surgically or to expect that the result on one’s face or body can closely match these predictions. I routinuely point out to patients that these tools are for predictions and will likely not precisely match the outcome. I am well aware, however, that such commentary often falls on deaf ears. And in today’s world with nearly everyone having access to a digital camera, one’s postoperatuve results can be jjust as easily critiqued by patients as what we do as plastic surgeons with our own photos.
Therefore, several points about predictive imaging bear repeating. First and foremost, predictive imaging is similar to actual surgery in one important aspect…the manipulations are done by the surgeon’s hand. The only computer component of it is the fact that it is done on a computer screen with software. The outcome of both is still dependent on the surgeon’s hands and eye. No software program can guess what a surgical procedure will actually do or how one’s face or body will respond to surgical intervention. Computer imaging is precisely predictable, actual surgery is not. Secondly, predictive imaging is not intended to act as a benchmark to determine how successful the surgical procedure was. It is an estimate of what may happen, not a guarantee of what will happen.There will always be some differences between the predictions and the actual result. Thirdly, the purpose of predictive imaging is to relay a general concept of what can be done, to estimate whether the discussed procedures can create the general effect that the patient wants. They are not meant to be measured and analysed at the millimeter level. ‘Putting a ruler to it’ so to speak is to misinterpret why predictive imaging is being done.
These comments I now send to every patient that receives predictive imaging after their initial consult.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Rhinoplasty (nose) surgery is not only one of the most frequently performed cosmetic facial procedures but is also the most demanding. Despite the fact that the nose is not altogether that large compared to the overall size of the entire face and skull, its prominence in the center of the face guarantees that even the smallest change will be seen. As few changes caused by rhrinoplastic surgery are reversible, it is of paramount importance that both patient and surgeon are on the same page as to both the surgical goals and what the final outcome could be.

Todays digital cameras, computer uploading, and imaging programs as common as PhotoShop have made it not only possible but very easy and quick to do surgical predictions of the nose. The nose in both profile and frontal views can be done within minutes. While one has to be careful about making computer predictions that can not be done surgically, I have found such imaging to be a both a great communication tool and a fairly estimate of potential outcomes.

All potential rhinoplasty patients today should have surgical predictive imaging done. I would not do any rhinoplasty surgery without it, because the patient needs to have a good understanding of what the rhinoplasty procedure can achieve. Predictive imaging also allows the patient to appreciate if other facial changes may be complementary to the rhinoplasty. Most likely, this would be chin augmentation which is a common companion procedure done with a rhinoplasty.

 
As I do an increasing number of ethnic rhinoplasties, of both Asian, Hispanic, and African-American origins, the importance of patient communication and an appreciation of what they want to achieve is of an-ever increasing concern. Most ethnic rhinoplasties, contrary to some beliefs, do not want to be ‘westernized.’ Rather, they seek better proportions of their nasal shape but not a radical change in most cases.

Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Rhinoplasty and Computer Imaging in Indianapolis with Dr Eppley

Rhinoplasty (nose) surgery is one of the most sought after procedures for cosmetic facial changes. The prominence of the nose in the center of the face guarantees that any change done to it will have an impact on overall facial appearance. Because of its facial importance, it is very helpful for a patient to have a good understanding of what can be achieved with rhinoplasty surgery.

The use of digital imaging through the computer has long made it possible to do surgical predictions. Such technology has been available for nearly 15 years and the initial use of it was for…..rhinoplasty surgery. The earliest software programs were best used for profile changes, which is still the most important predictions to see today. But the rapid development of imaging software, such as Adobe photoshop, have made changes in the frontal facial view very accurate as well. With today’s digital cameras and computer software, it is possible to have facial surgical predictions done within minutes.

All potential rhinoplasty patients today should have surgical predictive imaging done. I would not do any rhinoplasty surgery without it, because the patient needs to have a good understanding of what the rhinoplasty procedure can achieve. Predictive imaging also allows the patient to appreciate if other facial changes may be complementary to the rhinoplasty. Most likely, this would be chin augmentation which is a common companion procedure done with a rhinoplasty.

An important concept to understand about computer surgical predictions is……they are just predictions, not guarantees of rhinoplasty and facial outcomes. They are great methods of communication between a plastic surgeon and the patient to help both understand what may be possible.

Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

With the advent of the internet, digital cameras, and software morphing programs, many potential patients inquire about what their surgical results may look like. This is an understandable request and in my Indianapolis plastic surgery practice one I try to accomodate depending upon what type of procedure (s) is being considered. However, most patients do not understand the predictive imaging process and are under the misconception that it may actually simulate the surgical result. It is important, therefore, to understand the difference between reality and artistic interpretation.

Despite the tremendous technological advances in software programs, the most accurate predictive images still comes from profiles, such as manipulating the chin a9chin implant), neck (facelift), and nose (rhinoplasty). Changing the silhouette of a profile is usually very realistic, provided the surgeon does not overestimate what surgery can actually achieve. The same could be said for body profiles such as thighs, knees, and the abdomen as in liposuction or a tummy tuck. When it comes to frontal views of the face and body, however, predictive imaging is more art than reality. From this view it is no longer morphing a sihouette but, like a painter on a canvas, making an image that looks good but may not be able to be surgically attained. While you can take away lines and wrinkles on the face or lift a brow, it is easy to overestimate these type of manipulations. The most inaccurate type of predictive imaging, in my opinion, is in breast augmentation from the front. While you can image a breast that is bigger, it is not possible to really know what size implant can create that same effect.

The key concept that I discuss with patients is that predictive imaging is…..an estimate….an educated guess. It is not a guarantee of results. It is mainly a method of communication between the plastic surgeon and the patient…which does help in making sure both on the same page about outcomes. To reinforce this concept, every set of before and after images has the following written at the bottom…..This is not a guarantee of results.

Dr Barry Eppley
http://www.eppleyplasticsurgery.com/
http://www.ologyspa.com/
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis