Computer Imaging for Surgical Planning

Rhinoplasty computer imaging can give you a realistic idea of how the changes discussed for your nose might look on your face, especially in profile and three-quarter views. It's a guide, not a promise. Your nose probably won't look exactly like the image, but it helps you and your surgeon agree on what's realistic before surgery.

In this video, Dr. Thomas Buonassisi, MD, FRCSC, Specialist in Otolaryngology – Head and Neck Surgery, with a practice limited to facial plastic surgeries, explains what imaging can and can't show, and why realistic expectations matter as much to the surgeon as they do to the patient. The patient in this video agreed to share it.

What is rhinoplasty computer imaging?

In general, computer imaging works by taking standard photos of your face and adjusting the nose on screen to show the kind of change being talked about. At 8 West, it's part of the rhinoplasty consultation, where it's used to align expectations and to talk through what you'd like to change.

Dr. Buonassisi says the most important thing about these tools is that they show, in general terms, what the surgical steps would look like on your entire face. If the tip of your nose is going to be lifted, for example, you need to know roughly what that lift will look like with your eyes, lips and chin, not just on the nose by itself.

That's the real value of rhinoplasty imaging. It turns a conversation about angles and millimetres into a picture you can react to, so you can say "that's about right" or "that feels like too much" before anything is decided.

How accurate is rhinoplasty imaging?

Dr. Buonassisi explains that with rhinoplasty, profile and three-quarter views can usually show what's expected with a reasonable amount of accuracy. He's also candid that the nose isn't necessarily going to look exactly like the image. Will it be identical? Probably not.

In general, an image on a screen can't account for how your own skin and tissues heal, which is one reason it stays a guide rather than a promise. Changes that show up mainly in profile, like the height of the bridge or how much the tip turns up, are the kind these views show clearly.

So it helps to treat the image as a shared reference point. It helps you see the direction and the scale of the change, and it gives Dr. Buonassisi a clear sense of what you're hoping for.

Why does seeing the change on your whole face matter?

A nose doesn't exist on its own. It sits in the middle of the face, so even a small change to the tip or the bridge affects how it balances with everything around it. Seeing the change on your whole face helps you judge whether it still looks like you.

That matters because the aim at 8 West is natural harmony: a nose that looks like you, just refined, with your identity kept intact. Looking natural and breathing well are treated as the same goal. Imaging helps with the first part of that by letting you see whether a change feels in keeping with the rest of your face.

Many people have thought about their nose for years before they come in, and the main worry is often ending up with something that doesn't look natural. Talking through an image is one of the ways that worry can be discussed openly, early on.

Can imaging show every type of facial surgery?

No, and Dr. Buonassisi is clear about that. He explains that some facial procedures are much harder to image. A profile view can give a rough idea of a change to the neck, and a change in chin position can be imaged quite well, but procedures around the eyelids or lips can't really be shown with a computer program.

For those, other strategies help. He describes showing a change in the office by lifting the brow by hand, and looking through photos of other patients who've had the same procedure so people can see what it does in general. Comparing those with your own photos can then give a rough idea of where you stand, for example how long the upper lip is or how low the brow sits.

For rhinoplasty, though, imaging is one of the more useful tools, because many of the changes people ask about show up clearly in profile and three-quarter views.

What can rhinoplasty achieve, realistically?

Dr. Buonassisi says there isn't a great way to say "this is exactly what your result will look like," but there are lots of tools and strategies surgeons use to give people a realistic expectation of what rhinoplasty can achieve. Imaging is one of them.

He makes a point that often surprises people: having a clear expectation is just as important for the surgeon as it is for the patient. Promising something that isn't possible would leave everyone unhappy. In his view, the onus is on the surgeon to give an honest and accurate recommendation, so the patient knows what to expect.

That's why the conversation about what's achievable carries as much weight as the image itself. Our video on setting realistic rhinoplasty expectations goes into this in more detail.

What happens at a rhinoplasty consultation at 8 West?

Every rhinoplasty Dr. Buonassisi performs is bespoke. He meets one-on-one with each patient and recommends an approach tailored to your anatomy and objectives, drawing on over 25 years of experience in facial plastic surgery and over 2,500 rhinoplasties. The rhinoplasty consultation is a critical step, not a formality: it's where expectations are aligned, candidacy is assessed and you learn what is and isn't achievable. Surgeon consultations at 8 West have a fee.

Recovery is part of that conversation too. Most people are socially presentable in about 1–2 weeks, and final results take about 12 months. To see how imaging fits into a real consultation, watch a patient's consultation with her mom.

What should you ask about computer imaging?

If you're comparing rhinoplasty consultations in Vancouver and North Vancouver, it helps to ask each surgeon how they use imaging. A few questions to bring along:

• Which views will the imaging show, and which changes are easiest to see in them?
• How closely does the image usually match what's realistic for a nose like this?
• Which parts of the image are the most uncertain, given the skin and the structure of the nose?
• Can a more conservative version be shown alongside the one being discussed?

The free Essential Guide to Rhinoplasty has more questions for your consultation, and you can find more short videos in the Rhinoplasty Knowledge Hub.

Frequently asked questions

Can computer imaging show exactly what my nose will look like?

No. Computer imaging is a guide to talk through goals, not a promise. Dr. Buonassisi explains that for rhinoplasty, profile and three-quarter views can usually show what's expected with reasonable accuracy, but the nose probably won't look exactly like the image. In general, an image can't account for how your own tissues heal, so it works as a shared reference point rather than a prediction.

How should I prepare for computer imaging at my consultation?

It helps to think beforehand about which features bother you and why, and in which views you notice them most, such as photos taken from the side. Some people jot down a few notes. The imaging adjusts standard photos of your face, so the more clearly you can describe what you'd like to change, the more useful the conversation with Dr. Buonassisi will be.

Why do surgeons care so much about realistic expectations?

Dr. Buonassisi says a clear expectation is just as important for the surgeon as it is for the patient. Promising something that isn't possible would leave everyone unhappy, so the onus is on the surgeon to give an honest and accurate recommendation. Computer imaging, photos and a detailed conversation are all ways of getting there before surgery.

Do I have to agree with the version shown in the imaging?

No. Imaging is a starting point for conversation, so it's helpful to say if a change looks like too much or not enough. Many people find it easier to react to a picture than to describe what they want in words. The recommendation that follows is tailored to your anatomy and what will look natural on your face.

When is computer imaging done during the rhinoplasty process?

At 8 West, computer imaging is part of the rhinoplasty consultation with Dr. Buonassisi. It's used alongside the examination and discussion of your nose to align expectations and talk through what you'd like to change. Consultations are one-on-one and have a fee, and they're where candidacy is assessed and you learn what is and isn't achievable.