| A computer imaging system for use in plastic surgery consists, basically, of a device to capture a digital photo of a patient and then input it into a computer where it can be electronically altered. It is not at all uncommon to see plastic surgery yellow page ads proclaiming the likes of "Preview Your New Face -- Free Computer Imaging". Such services are also available on-line for a fee. One company will even come out to your house.
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And so the question becomes: Is computer imaging a useful communications tool or just another marketing gimmick?
Any eyelid surgeon who has been around long enough has run into the following scenario: You're half way through a consultation with a patient whose anatomy makes him or her a challenging and less than ideal candidate for surgery. You're doing your best to explain the limitations and risks of a particular procedure. Suddenly, the patient stops you, reaches into a briefcase, and proudly presents a printout of a digitized image of his or her face with perfect "new" eyelids befitting a twenty-year-old. You discover that the preview comes compliments of a competitor down the street, a plastic surgeon whose primary experience is with breast surgery. You take a look at the picture and aren't sure whether to laugh or get mad.
Why? Because any eyelid surgeon worth his salt can tell that getting from Point A (the patient sitting in front of you) to Point B (the patient in the computer-generated picture) will only be accomplished through divine intervention.
In case you've never experienced the joy of playing around with advanced image-manipulation software, you need to understand that such products are extremely powerful. It is not at all difficult to take the body of Mickey Mouse and turn it into Donald Duck in just a few minutes. Erasing all wrinkles, eliminating all bags, and creating a perfect upper eyelid crease is, quite literally, child's play to this technology.
And so the question is -- is there any true medical value in computer imaging? The answer can be "yes" if the technology is used conservatively and responsibly, and even more of a "yes" when the process is applied to parts of the body other than the eyelids. For instance, in nasal surgery, exploring several different nasal shapes via computer imaging may facilitate doctor-patient communication and lessen the chance of unrealistic expectations or surprise outcomes. Back to the eyelids, though, the big limitation is that's it's just too easy to create after-images that cannot realistically be attained with actual surgery.
For patients interested in trying to visualize what eyelid surgery can do for them, most are probably better served viewing a series of actual before-and-after photos of actual patients. That way you'll get a real-life example of what can be accomplished. Another useful technique is to bring in a photo and have your doctor sketch his ideas directly onto it.
There is another benefit that comes with viewing real before-and-after photos: it gives you at least some indication of your doctor's level of proficiency in eyelid surgery as opposed to computer graphics.
So keep this in mind: Computer imaging is a marvelous marketing tool. Once you see your own body minus its love handles or paunch, it's much harder to say no to liposuction. When it comes to cosmetic eyelid surgery, though, the hypothetical is purely that and nothing more, while your actual final result is what you're going to have to live with whether or not it matches what the computer screen predicted.
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