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Digital Imaging in Rhinoplasty

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Imaging in facial plastic surgery is becoming common. With the advances of digital imaging software, modifications of preoperative images for rhinoplasty patients can help to predict outcomes. The primary objective of this study was to determine whether preoperative digital image modification in rhinoplasty patients is useful in predicting postoperative outcomes.


Patients undergoing rhinoplasty were prospectively collected and underwent preoperative digital imaging modifications using computer software. Postoperative images were compared to the preoperative modified images. Rankings for similarity were performed by patients and surgeons. Wilcoxon ranked-pairs test was used to compare the groups with a predetermined P value of 0.05, and levels of agreement were assessed using weighted kappa scores.


One hundred twelve patients were collected and postoperative images were taken 11 months after surgery (range = 6–30 months). Frontal images were rated as poor, average, very close, or identical by patients 6.2, 52.7, 33.0, and 8.0%, and by surgeons 2.7, 61.6, 34.8, and 0.9%, respectively (Wilcoxon test, P = 0.23). Lateral images were rated as poor, average, very close, or identical by patients 1.8, 18.8, 48.2, and 31.3%, and by surgeons 0.9, 24.1, 59.8, and 15.2%, respectively (Wilcoxon test, P = 0.0024). Weighted kappa scores for agreement were 0.42 for frontal views of patients and surgeons and 0.65 for lateral views.


Ratings by patients and surgeons comparing preoperative manipulated images with postoperative outcomes are predictive in approximately 75% of the patients, and lateral images are more useful for this goal. Level of agreement between patient and surgeon scoring is good for lateral images and moderate for frontal.

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  1. Galdino GM, DaSilva D, Gunter JP (2002) Digital photography for rhinoplasty. Plast Reconstr Surg 109(4):1421–1434

    Article  PubMed  Google Scholar 

  2. Bronz G (1999) The role of the computer imaging system in modern aesthetic plastic surgery. Aesthetic Plast Surg 23(3):159–163

    Article  PubMed  CAS  Google Scholar 

  3. Vuyk HD, Stroomer J, Vinayak B (1998) The role of computer imaging in facial plastic surgery consultation: a clinical study. Clin Otolaryngol Allied Sci 23(3):235–243

    Article  PubMed  CAS  Google Scholar 

  4. Sharp HR, Tingay RS, Coman S, Mills V, Roberts DN (2002) Computer imaging and patient satisfaction in rhinoplasty surgery. J Laryngol Otol 116(12):1009–1013

    Article  PubMed  CAS  Google Scholar 

  5. Chavez AE, Dagum P, Koch RJ, Newman JP (1997) Legal issues of computer imaging in plastic surgery: a primer. Plast Reconstr Surg 100(6):1601–1608

    Article  PubMed  CAS  Google Scholar 

  6. Parodi PC, Moreschi C, Rampino E, Codarini M, De Biasio F, Riberti C (2003) Corrective rhinoplasty: medical and legal aspects. Acta Otorhinolaryngol Ital 23(5):356–361

    PubMed  CAS  Google Scholar 

  7. Muhlbauer W, Holm C (2005) Computer imaging and surgical reality in aesthetic rhinoplasty. Plast Reconstr Surg 115(7):2098–2104

    Article  PubMed  Google Scholar 

  8. Ewart CJ, Leonard CJ, Harper JG, Yu J (2006) A simple and inexpensive method of preoperative computer imaging for rhinoplasty. Ann Plast Surg 56(1):46–49

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Richard Rival.

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Punthakee, X., Rival, R. & Solomon, P. Digital Imaging in Rhinoplasty. Aesth Plast Surg 33, 635–638 (2009).

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