title: Digital Imaging in Secondary Rhinoplasty.
abstract: BACKGROUND
  Rhinoplasty remains one of the most commonly performed operations in plastic surgery. Little is known regarding the use of imaging in secondary rhinoplasty. Secondary rhinoplasty is a far more complex operation than primary rhinoplasty. The objective of this study was to assess the role of software imaging in patients undergoing secondary rhinoplasty.
  
  
  METHODS
  A retrospective review was performed to identify patients undergoing secondary rhinoplasty performed by the senior author (R.J.R.) from January of 2000 to August of 2013. Forty consecutive patients met inclusion criteria. The degree of improvement was graded in comparison with both the preoperative photographs and software imaging using a graded scale.
  
  
  RESULTS
  A total of 40 patients met inclusion criteria. There were 35 women (87.5 percent) and five men (12.5 percent). The nasal dorsum was found to have an average rating of 2.36 between the two observers, the midvault had an average rating of 2.65, the nasal tip had an average rating of 2.27, the nasal alae had an average rating of 2.63, and the nasal base had an average score of 2.99 CONCLUSIONS:: Based on the results of this study, the authors have determined that preoperative digital imaging can provide a reasonable expectation for patients undergoing secondary rhinoplasty. However, digital imaging must be used with caution, as secondary rhinoplasty patients have heightened expectations and unknown anatomy from their previous operation. The nasal tip and dorsum are especially difficult to adequately predict, and this should be discussed with the patient before surgery.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Dallas, Texas.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Craig R
authors.initials: CR
authors.lastname: Lehrman
authors.affiliation: Dallas, Texas.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Lee
authors.affiliation: Dallas, Texas.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Smita
authors.initials: S
authors.lastname: Ramanadham
authors.affiliation: Dallas, Texas.|From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D011856:Radiographic Image Enhancement / Q000379:methods*; D012086:Reoperation / Q000379:methods*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D055815:Young Adult