New Horizons in Imaging and Diagnosis in Rhinoplasty

Three-dimensional (3D) surface imaging has found its place in aesthetic surgery globally. The first attempt to use 3D surface imaging technique in clinic was in 1944 by Thalmaan, who used stereo photogrammetry to examine an adult with facial asymmetry and a baby with Pierre Robin syndrome. Three-dimensional photography is becoming more common allowing for a more dynamic facial evaluation, although it is associated with increased cost.

Key points

  • Maxillofacial 3D CT imaging allows precise skeletal evaluation for rhinoplasty.

  • Three-dimensional photography enhances appreciation of pre- and post-operative assessments.

  • Pre- and post-operative photo documentation remains the standard for any facial cosmetic surgery.

Three-dimensional imaging in rhinoplasty

Three-dimensional (3D) surface imaging has found its place in aesthetic surgery globally. The first attempt to use 3D surface imaging technique in clinic was in 1944 by Thalmaan, who used stereo photogrammetry to examine an adult with facial asymmetry and a baby with Pierre Robin syndrome.

Early studies involving 3D surface imaging systems were mainly completed by using stereo photogrammetry. Although the results were not precise enough and hard to be quantitative, it still showed that 3D surface imaging system did have great potentials and apparent superiority compared with 2D photography. Other techniques such as Moiré topography, , laser scanning, structured light, and so on have been developed and studied. As a result of the various studies of 3D imaging, it is apparent that the technology is best used to determine objective changes in volume such as in breast surgery and fat injections. The static 3D image capture provides accurate objective true surface dimensions, morphologic changes, and volumetric changes when comparing before and after results. Another very valuable use of the 3D technology is to be able to show prospective patients how they may look with various procedures and also to allow breast implant patients the ability to participate in the selection of breast implant sizes. In patients who desire a change in the appearance of the nose, the surgeon can use software-morphing tools to change the shape and contours of the nose, thus allowing each patient to understand the realistic goals of a rhinoplasty.

Using oVio360 dynamic imaging in nasal surgery allows the patient and surgeon to observe and document movement of the nasal tip with animation ( Figs. 1–3 ). Thus, when comparing the before and after dynamic images, the surgeon will be able to document correction of issues such as a plunging tip. Regardless of whether a static image or dynamic is captured, it is important to have a comprehensive digital record of the morphologic features of the nose so that operative planning can be completed and the ultimate result can be recorded and reviewed with each patient. The oVio360 images are used in all steps of the patient experience including the initial consultation, preoperative visit, intraoperative guidance, and postoperative follow-up and for presentation and publication. Being able to show actual before and after images gives each prospective patient the opportunity to understand the surgeon’s results and aesthetic ideal.

Fig. 1
CBCT analysis of of the cranio-maxillofacial region displaying the transverse (top left), sagittal (bottom right), and coronal (bottom left) views along with the 3D reconstruction (top right).

Fig. 2
Patient positioned in the CBCT device for a scan.

Fig. 3
Standard photography for rhinoplasty surgery.

Currently, most surgeons performing rhinoplasty procedures use 2D photography to evaluate new patients, to document results, and to plan a successful procedure. Two-dimensional photography lacks the ability to document the entire clinical picture. In today’s cosmetic medicine market, it is more important than ever before to document results from various procedures such as rhinoplasty.

Being able to illustrate a complete clinical condition with 360-degree dynamic imaging and/or 3D capture enables surgeons to communicate with patients more clearly and to also develop a surgical plan that will be successful. Evaluation of results is also much more comprehensive with a complete clinical picture of outcomes obtained with rhinoplasty. For a surgeon, the ability to go back and review a complete lifelike before image of the face and nose compared with the results provides such important lessons of learning. In addition, with today’s savvy consumers, it is more important than ever to be able to provide patients with state-of-the-art imaging that is better than the pictures that one can capture on any smart phone. Being able to sit down with each patient and review a high-quality 3D digital capture is an essential tool for today’s successful rhinoplasty surgeon. New technology that results in 360-degree motion capture with the oVio360 Dynamic Imaging System is also being introduced to the market. This new system allows perfectly standardized images to be captured before and after all procedures. Using the unique self-centering technology, images are easily obtained and always perfectly positioned and lighted for standardization. Regarding the face and nose, the workflow and capture of oVio360 images includes 5 views: (1) repose, (2) smile/animation, (3) chin up, (4) chin down, and (5) relaxation and flexion of the neck muscles ( Box 1 ). Each 360-degree view capture takes 12 seconds, and the resultant digital file provides a complete picture of the shape and form of the head and neck as well as nerve and muscle function. Being able to capture the face and body in motion provides the most lifelike capture of the face and body. Dynamic imaging allows the understanding of skin quality, muscle, and nerve function. Visualizing the nose and face in animation allows one to see themselves exactly as others view them. With this process, the provider and the patient have a comprehensive lifelike digital medical record that will capture all perspectives of each therapeutic intervention. With today’s advanced technology that addresses all aspects of the skin and underlying soft tissue, motion capture is the only imaging technology that captures the complete clinical picture.

Apr 19, 2021 | Posted by in Oral and Maxillofacial Surgery | Comments Off on New Horizons in Imaging and Diagnosis in Rhinoplasty
Premium Wordpress Themes by UFO Themes