Visualizing Cosmetic Post-op Results

The first thing most prospective patients do when they are deciding which plastic surgeon to approach for their treatment is to look at the physician’s pre- and postoperative photos, either on the Web or during a consultation appointment.

These before-and-after shots can help prospective patients visualize the results of a specific procedure and often reassure them that it will meet their specific physical goals. That said, the photos are 2-dimensional and we live in a 3-dimensional world.

A picture may be worth 1,000 words, but as we all know, beauty is in the eye of the beholder. That is why techniques like standardization of photos and the use of the same makeup and backgrounds in the before-and-after images are always good ways to help make the photos appear more relevant and real to our patients.

Still, no single series of pictures can truly show the difference between the pre-op situation and the post-op result. Because of this, some plastic surgeons have chosen to use videos rather than photos, but I have found that this is impractical in most circumstances.

Even among those who try to evaluate the results of a particular technique or technology — especially with the recent explosion of non-invasive skin-surface treatments — conventional photos and digital imaging are not enough for our patients to make an informed judgment. So, how do we help our prospective patients better understand what their results will look like?

Seeing a previous patient in person is something I recommend frequently in the initial consultation appointment. I am fortunate in that many of my patients have volunteered to speak with and meet prospective patients. Aside from providing a realistic view of what is achieved, direct contact from someone who has undergone the procedure in question is always incredibly valuable.

In addition, there are computer programs that do a wonderful job of morphing the preoperative photo and offering a theoretical postoperative result. Of course, a computer can do many things to a 2-dimensional image that I can’t achieve with a 3-dimensional patient, so I have shied away from a heavy reliance on such tools.

But that may be changing. My team at New York-Presbyterian Hospital has increasing experience with a new generation of 3D cameras and software for research purposes. These tools allow us to accurately document the volume changes after facial and breast surgery. The net effect is that we can take the image generated and convert it into data that can be analyzed objectively, without the inherent bias that comes from variables like changes in lighting and patient movements.

Eventually, with a large enough database of documented pre-and post-op results, we will be able to translate these outcomes to prospective patients, as well as produce better representations of what can be achieved by their desired procedure.

Improving the way we educate our clients before they agree to undergo a procedure means happier and more satisfied patients afterwards, which should be our ultimate professional goal.

Robert T. Grant, MD, MSc, FACS, is Chief of the combined Divisions of Plastic Surgery at New York-Presbyterian Hospital-Columbia University Medical Center and New York-Presbyterian Hospital-Weill Cornell Medical Center. He is also Associate Clinical Professor of Surgery in the College of Physicians and Surgeons at Columbia University and Adjunct Associate Professor of Clinical Surgery at Weill Cornell Medical College. For more information about Dr. Grant or to contact him, visit his website at www.robertgrantmd.com.