Abstract
Despite the recognized value of morphing in the literature, this preoperative tool
has never been studied in the context of selection process in rhinoplasty. The main
purpose of this article is to identify the use of morphing as a filter for unsuitable
patients, the attrition rate from the initial consultation to surgery, and whether
patients' appreciation on morphing influence their decision-making process. Three-hundred
thirty-four consecutive patients, seeking rhinoplasty, underwent two-dimensional computer
imaging and completed a 14-question survey about their opinion on morphing. Based
on the presence or absence of patient/physician consensus on the expected outcomes
during simulation, patients were divided into accepted or rejected candidates for
surgery. Accepted candidates were scheduled for rhinoplasty and subdivided into those
who underwent surgery, those who postponed their surgery (static), and those who cancelled
their procedure. Their responses to the survey were compared between different patients'
categories. Forty-four patients (13.2%) were rejected for rhinoplasty since consensus
was not achieved during morphing. From 290 accepted patients, 178 underwent their
operation (53.3%), 74 patients (22.1%) postponed their rhinoplasty, and 38 (11.4%)
cancelled their surgery. Fifty-seven percent of rejected patients and 42% of the static
group were not satisfied with the proposed results of morphing, in contrast with 16%
of the operated group. Sixty-four percent of rejected patients, and 47% of the static
group were not reassured after morphing, compared with 26% of the operated group.
Presence or absence of consensus during morphing can guide the surgeon regarding a
given patients' suitability for surgery. Patient satisfaction and reassurance with
the morphed images can be a good predictor of patients who will proceed to surgery,
calling attention to the value of morphing as a selection tool for surgeons and patients
alike.
Keywords
computer imaging - morphing - patient selection - rhinoplasty consult - computer simulation
