Just Picture This
Allure - May 1997
As more consumers demand to see what they will look like before undergoing cosmetic surgery, computer imaging enables patients to preview and commit to plastic surgery. A promising technology, computer imaging systems will be used by almost half of all cosmetic surgeons by the year 2001. Ethical physicians address only what's bothering patients (with exception, e.g., advancing the patient's chin to get a good profile in proportion to a smaller nose). Critics charge that imaging machines promise more than they deliver by giving patients a false sense of security when they need to understand the limitations of surgery. And there are limitations.
"For example, you'll never be able to make a thick-skin nose into a projecting aquiline nose," says William J. Binder M.D., assistant clinical professor of head-and-neck surgery at UCLA, "because thick skin limits your ability to shape and form the nose. But the computer doesn't know that, nor does the techician who's operating it. It takes a doctor to calculate how thick the skin is compared with how thin and weak the cartilages are underneath."
The job of "imaging" is mostly delegated to a nurse or even a marketing assistant, but the imaging doctor can be penalized for telling the truth.
"It's the surgeon's job to explain to the patient what can and can't be accomplished," says Binder. "But if he draws a less-than-perfect nose on the computer...the patient will go elsewhere."
Fans of computer imaging say that it helps in being objective, e.g., that by bringing out the worst features, it also shows fine imperfections that may not have been seen in the exam chair. Ancillary procedures represent a profitable side benefit to imaging, according to a systems spokesman. Procedures secondary to one that a patient may originally seek are almost pure profit and can pay for a system. Patients may use computer imaging to their own advantage in seeking a surgeon. One charges $100 for imaging, applied toward the surgical fee. As a tool, the main advantage to computer imaging is in making a patient's wants clear and communicating that to the surgeon. Questions of more importance concern a doctor's board certification and patients' testimony.
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