Three-dimensional Morphing and Its Added Value in the Rhinoplasty Consult

Abstract

Background: The evolving literature on 3D surface imaging demonstrates that this technology is becoming the preferred simulation technique in hospitals and research centers. However, no study has demonstrated before the superiority of this facility over standard 2D simulation during preoperative evaluation in rhinoplasty. Methods: One hundred seventy-two consecutive patients requesting rhinoplasty were included. Patients answered a questionnaire following a 2D simulation and subsequently experienced 3D morphing. A single question was answered regarding the added value of the latter by patients and surgeons, respectively. Results: In our survey, satisfaction with 2D morphing reached 61%. Ninety-five percentage of the same group considered 3D simulation an added value over 2D. Additionally, 84% of patients requesting revision rhinoplasty admitted that 3D computer simulation has helped them understand the aims of surgery, in contrast to 61% of patients from the primary group. Furthermore, patients unsatisfied with their 2D simulation got reassured following 3D simulation to undergo surgery at a higher percentage (67%), compared with the group initially satisfied with 2D (48%). Women appeared reassured by 3D imaging in higher percentage (63%) compared with men (42%). The 2 surgeons, however, found 3D simulations to be an added value in 66% and 74% of all patients. Conclusions: The overwhelming majority of our patients considered 3D simulation an added value over 2D. Patients initially unsatisfied with 2D morphing, revision rhinoplasty patients, and women seemed to be the groups that appreciated more 3D than 2D computer simulation. In contrast, surgeons considered the facility of 3D an added value in two-thirds of the patients.

Three-Dimensional Technology in Rhinoplasty

“…Preoperative 3D models, both virtual and physical, have demonstrated utility in preoperative counselling, intraoperative reference, postoperative outcomes tracking, as well as in surgical simulation. [9][10][11][12][13]33,34 While still in benchtop studies, 3D printed tissue engineered scaffolds have shown promise in recreating nasal structures, opening new avenues for custom printed grafts and struts. 15,[24][25][26][27][28] While 3D preoperative morphing and printing capabilities currently require increased time and financial investment from the surgeon, such platforms are undergoing rapid development and market expansion, becoming increasingly cost effective.…”

“…9 10 Patients have shown preference of preoperative planning using 3D morphing over 2D imaging, particularly in the revision rhinoplasty population. 11 When coupled with conscientious counselling, careful documentation using 3D preoperative imaging may reduce surgeon's liability in the case of malpractice suits. 12 Surgeons additionally benefit from improved anatomical information captured in 3D imaging, allowing more detailed patient assessment and surgical planning.…”

Virtual Surgical Planning and Three-Dimensional Printing in Rhinoplasty

“…For decades, 2D computer imaging has been utilized as a means of improving communication during consultations for aesthetic surgery. 5 This is particularly relevant for rhinoplasty, which has many unique features such as relatively high patient expectations, increased patient stress, and a wide range of aesthetic "ideals" or goals. The use of 2D photographs during a consultation can be a useful aid to help align patient and surgeon goals.…”

Novel Selection Tools in Rhinoplasty Patients

“…39 We introduced the application of 3D computer imaging in the rhinoplasty consult and hypothesized its added value. 40 We tested the novel application of 3D printing as part of the preoperative assessment for rhinoplasty, and hypothesized its added value in patient selection and satisfaction. 41 Computer imaging enables the surgeon to precisely explain the goals of surgery, and to postpone or even cancel surgery in the group of patients who do not appear satisfied with the proposed changes.…”