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

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