OBJECTIVESurgery to reshape the nose with an implant has been a regular procedure for enhancing a patient's appearance and self-confidence. The purpose of this study was to establish a three-dimensional surgical simulation system. which can provide the patients with realistic prediction of their own postoperative appearance in computer and specifically produce a nose implant for an individual patient.

METHODSPreoperative CT data and image-processing techniques were employed to generate a three dimensional template of the papatient' s face. Three-dimensional morphing processes were then applied to predict and compare the outcome of plastic procedures on a patient-specific nose surface, according to the patient' s expectation. By comparing and revising the changes before and after simulation, digital prototypes of the nose implants could be generated. The templates to create custom-made silicone implants were than produced by a computer controlled device.

RESULTSAccurately regeneration of 3-D images and realistic operative simulations could be achieved with this system. The implants produced exactly conformed to the results of simulation. No curving and reshaping were needed during operating. The clinical results extremely matched with the simulations.

CONCLUSIONThe system enhances surgeon-patient communication and facilitates preoperative planning. It is especially desirable for implant surgery with less guesswork of size, contour, and orientation of the implant. The best chance of optimal results could be achieved.