Scars and Scar Revision After Plastic Surgery

For many plastic surgery procedures, it helps if the patient can get an idea of what they will look like after the procedure, as opposed to looking at photos of what other people look like after a similar procedure.  (See a recent story in Business Insider about plastic surgery photo morphing here). I’ve used photo morphing for years, both 2-dimensional (2D) and 3-dimensional (3D).  The 3D morphing has been more useful for breast augmentation patients, and I am going to limit this discussion to the 2D morphing which I mainly use for facial procedures, especially rhinoplasty.  (There will be some more things to discuss in the realm of 3D morphing in the near future and I’ll describe them in a future blog post.)

When I trained, morphing software was just beginning, but very few surgeons had it.  If they did anything to “morph” someone’s photo, it involved taking a physical, printed photograph (remember those?), and then, using a black marker (or a blue marker, if the background was blue), adjusting the contours of the person’s features.  This worked fine for bringing down a nasal hump, but beyond that was very limited.  Some surgeons would get creative with colored pens or paints to modify the photo, but this was very crude, messy, and couldn’t be easily changed.

The Mirror system by the Canfield company has long been the leader in digital clinical photo morphing and I have used their systems for over 13 years.  Although other systems were used, like Niamtu which got its start in the dental field, Mirror brought photo morphing to the plastic surgery mainstream.  Although I’m sure its software algorithms are similar to Photoshop, its proprietary morphing tools are targeted for the plastic surgeon’s needs.

I find morphing invaluable, especially for rhinoplasty.  It helps the patient and me to be on the same page regarding the goals of the surgery, and gives me an opportunity to show the patient what is (and isn’t) possible.  I also use it for other facial plastic surgeries such as faceliftbrowliftblepharoplasty, and neck liposuction or Precision Tx.  I find that photo morphing is less helpful for body contouring procedures, but I have occasionally used it at the patient’s request.

Douglas J. Mackenzie, MD

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