ALLURE
Computer Imaging
To be sure, anyone with access to computer graphics can reshape a face to ideal proportions. “One patient did her own imaging,” says Gerald H. Pitman, attending plastic surgeon at Manhattan Eye, Ear & Throat Hospital in New York City. “She brought it in and said, ‘This is what I want to look like.’ But I told her I couldn’t give her what she wanted. For that reason, I think the surgeon’s the one who has to do the imaging, because he's the one who's going to be doing the surgery.”
Pitman is a recent convert to imaging. “I resisted getting a machine for a long time because I thought it was an unnecessary commercialization of the practice. But I’ve found it to be very useful for showing things to the patient visually that you can’t explain in words.” He uses it only for rhinoplasty (nose jobs), “because that procedure is so sculptural and involves having the patient understand the three-dimensional changes that occur in the nose. I’ll make the alternations I think are possible and aesthetically desirable. It’s useful to show before and after photographs of other patients, but it’s not quite the same as seeing your own nose on the screen.”
“Imaging is particularly helpful when I’m proposing to add to the nose,” he says. These patients are often veterans of “ski-jump nose” surgeries, in which too much bone was scooped out from the bridge. “Most of the time, if you tell a patient you’re adding to her nose, she’ll say, ‘What are you, nuts? Good-bye!’ But if you can show her how a small addition in one area will improve the overall proportion and actually make her nose look smaller and more harmonious with the rest of her face, it obviates all the talking.”
Before we had computer imaging, says Thomas Romo III, director of facial plastic and reconstructive surgery at Lenox Hill Hospital in New York City, doctors would place tracing paper over a photo of the patient and sketch the intended result. “Or I’d have her hold a mirror while I pinched the tip of her nose with my finger and pulled it up with my thumb and squeezed it on the side to show what it would look like,” says Romo. “It was ridiculous—all you could see were my fingers! But the computer lets the patient see for herself what can and cannot be done.” As long as imaging is used ethically, he thinks it’s a great communication device. “Old-school surgeons criticize it as a marketing tool,” says Romo.
“Well, you can say that about a lot of things. But marketing is not a negative process, unless it’s done dishonestly.”