Evolution of Preoperative Rhinoplasty Consult by Computer Imaging

The preoperative consultation in rhinoplasty involves a multitude of actions that are mandatory for the decision-making process: history taking with attention to the symptoms and specific requests of the patient, clinical evaluation of the aesthetics, the functional status of the nose and the patients' motivation for surgery, and acquisition of standardized preoperative photographs. During the last decade, computer imaging or morphing of the preoperative pictures of the nose has become much more common. This part of the consultation allows the surgeon and patient to reach a mutually agreeable set of expectations by demonstrating the planned outcome of rhinoplasty and describing the objectives of surgery. The evolving literature on computer imaging supports that the benefits for both the patients and surgeons seem to outweigh the risks. Indeed, morphing enables the surgeon to precisely explain to the patients the goal of surgery, and to postpone or even cancel surgery in the group of patients that do not appear satisfied with the proposed changes. In addition, patients may feel more prepared for surgery and have a more realistic view of the outcome of the intervention. Presently, computer imaging is progressing from 2D to 3D models, optimizing the surgeons' capacity to perform morphing in the most advantageous manner for both parties. The current review provides a state-of-the art analysis on morphing in rhinoplasty, putting morphing into a historic and relevant perspective in clinical practice.