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Face simulation module allows sneak peek of results before surgery


INTERNATIONAL REPORT — Innovative technological advances have given birth to Axis Three's Portrait Face Simulation Module, allowing patients to view a three-dimensional (3-D) simulation of what their aesthetic outcome will look like prior to the actual cosmetic procedure taking place. The technology benefits both physicians and patients, as realistic aesthetic goals can be discussed and agreed upon well before the first cut.

Using Axis Three's 3-D face simulation software, surgeons can improve the expectations and experiences of patients seeking surgical improvements to their nose, chin, cheeks and jaw.

The face simulation module is based on the same technology as Axis Three's Portrait 3D Surgical Simulation Platform, which shows patients who plan to undergo breast procedures a more accurate visualization of the surgical outcome prior to the surgery. Using a 3-D camera, the patient's image is captured, processed and displayed on a viewing screen. The captured images give a realistic representation of the body, and they can be rotated, altered and viewed from all angles.

"This technology is a major advantage, as it allows for a more constructive, precise and interactive discussion of what the patient's cosmetic goals are. The face module is particularly useful for cosmetic rhinoplasty procedures, chin augmentation or chin reduction, cheek augmentation, jaw contouring, and even neck contouring when planning a lipoplasty and reduction in the neck/jaw area," says Paul C. Zwiebel, M.D., D.M.D., F.A.C.S., Littleton, Colo.

Axis Three's technology differs from other, similar technologies in that its integrated physics engine can address and measure tissue characteristics such as tissue elasticity and density. In software terms, a mathematical model allows the skin elasticity and density to be profiled for each cosmetic patient individually.

RHINOPLASTY SIMULATION Compared to the breast module, the face module takes a softer approach, because there is more artistry involved in procedures such as rhinoplasty. Therefore, a "softer" software program was engineered, allowing the physician to more accurately control the fine nuances and sculpt the nose to the patient's specifications as they would in the operating room in real surgery time.

In the face simulation's rhinoplasty module, a series of landmark registration points are plotted in and around the nose. Within those points, the physician can move each of those regions to fit a nose that the patient would aesthetically desire post-procedure. The physician can profile backward and forward, widening or narrowing the nostrils and other physical aspects until the desired image is achieved.


Comparison screens such as these enable users to view all of a patient's case data together. Users can show pre-op images beside simulated views. (Photos credit: Axis Three)
"The software can even measure parameters such as volume, which is otherwise very difficult to measure and quantify without such technology in a real-world circumstance," says Paul Moffett, director of engineering at Axis Three, Belfast, Northern Ireland. "Getting a true volume calculation can help the surgeon better plan together with the patient just exactly what the aesthetic result should look like."

CONSULTATION COUNTS Most surgeons would agree that the essence of the consultation is communication. This is where the patient communicates goals and desires and the surgeon communicates what he or she thinks can be realistically achieved. The Axis Three face module represents a language that both patient and physician speak — namely, visual imaging.


Screen shot of the user interface showing the rhinoplasty toolbar, which allows control over the projection of the nose. (Photo credit: Axis Three)
"As a communication tool, imaging has been a fantastic advance, and being able to view images in 3-D as opposed to 2-D is a huge step forward. The patient not only feels much more comfortable that their doctor understands what it is that they want to achieve, but also can feel more confidence that they are not going to have a surprise when they wake up from surgery," Dr. Zwiebel says.

SCANNER ADDITION Recently, Axis Three introduced its XS-200 scanner, which captures anatomically accurate 3-D images of a patient's face in order to simulate surgery outcomes. This tool complements Axis Three's face simulation software module and allows surgeons to even more accurately showcase aesthetic surgical outcomes prior to the surgical procedure itself.

The XS-200 scanner is a mountable unit optimized to capture the face topology with a minimal hardware footprint and serves as a vehicle for delivering Axis Three's simulation software. The scanner attaches directly to the USB port of a surgeon's computer.

IMAGE PROCESSING Another advantage to the Axis Three simulation technology is the efficiency and speed at which images are processed. Virtual images can be altered and modified in only a few seconds.

"Many patients will see more than one doctor for consultation before they have a procedure done. My patients have commented explicitly on how tremendously helpful the 3-D imaging was in their decision process. Axis Three's technology has had a dramatic effect on my consultation and increased our patient flow for breast augmentation. I suspect that the 3-D imaging for face procedures will have a similar impact," Dr. Zwiebel says.

Of course, realizing the final cosmetic outcome close to the 3-D image pre-surgery has much to do with the skill and experience of the surgeon, the wound-healing quality of the patient's tissues and the type of procedure performed. However, according to Dr. Zwiebel, the surgeon's judgment in portraying an accurate image as opposed to getting creative and showing something that is impossible to do still remains the fundamental basis for the validity of the tool.

NEXT PHASES Axis Three's next project will concentrate on the top layer of the skin, focusing on the removal of wrinkles and skin tightening. According to Mr. Moffett, this is a state-of-the-art technology that offers a high-tech angle to cosmetic procedures, while adding an element of assurance to the patient.

"As we're bombarded with new technologies targeting cosmetic surgery, we always have to be discriminating and diligent. In this particular instance, this technology clearly is an advance, easy to embrace and intuitive," Dr. Zwiebel says.

Disclosures:
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