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Digital Savant: 3-D modeling can give a prescient glimpse of plastic surgery

Omar L. Gallaga
Plastic surgeon Jennifer Walden looks at a 3-D image created using a Vectra 3D imaging system at her office in the West Lake Hills area. Using this tool, Walden can give patients a better idea of what to expect after a cosmetic surgery procedure.

“You don’t have a very bad nose,” the plastic surgeon told me. “There’s not a lot to do here.”

I breathed a sigh of relief. It’s one thing to have a healthy self-image; it’s quite another for a professional to tell you that a prominent feature on your face isn’t making her scalpel hand itchy.

I’ve never wanted (or, it turns out, needed) rhinoplasty, but I was very curious about a new technology housed in Dr. Jennifer Walden’s West Lake Hills-area plastic surgery practice. “Vectra 3D,” an imaging tool put out by a New Jersey company called Canfield Imaging Systems, has been in use there since September, and nearly 100 patients have been digitally scanned using it.

Vectra 3D looks like a tall piece of gym equipment with arms, but instead of working out on it, you stand in front of its six cameras, holding perfectly still as it photographs your face, breasts or any other body part expected to go under the knife.

The photographs go to a nearby computer that builds, in just a few minutes, a highly detailed 3-D model that can be rotated and adjusted with a set of tools used by plastic surgeons like Walden.

It was at this point, after my face had been swabbed with alcohol and I’d been scanned, my pores and eyebrows and beard and that nose digitally rebuilt, that my virtual plastic surgery consultation began.

Walden, an Austin native who brought her practice to town in December after a successful run in Manhattan, is well-known on TV channels like E! and VH1 for her frequent appearance on celebrity plastic surgery shows like “Extreme Dr. 90210.” One of her clients was “The Biggest Loser” winner Olivia Ward. Walden, who came back to town to raise her 2-year-old twin boys here, is an early adopter.

Though they’ve only been around four or five years and are still not mainstream, she believes such 3-D imaging systems will be standard in about 10 years. Walden’s Vectra system is the first of its kind in the Austin area and cost about $40,000.

As we examine my face in great detail, I decide to leave all vanity behind. That turns out not to be so easy. I’m not really planning on having surgery, but when a digital image of your face is blown up on a monitor and a doctor starts examining the contours of your schnoz, it’s difficult not to feel self-conscious.

“You have a very good bridge,” Walden tells me.

My confidence surges.

“If I were doing your nose, I’d probably lower it just a bit. You have good tip projection. I might just bring it back a bit.”

What? Is my bridge too high? Does my nasal tip stick out too much? You guys, DOES THIS NOSE MAKE ME LOOK FAT?!

Walden assures me that this is just a hypothetical to test out the technology. I try not to freak out.

What follows wouldn’t seem unfamiliar to anyone who’s watched a graphic artist do detail work in Photoshop or a video-game player who’s uploaded a webcam image of their face to use in a football or hockey game. Using the system’s software, Walden can make adjustments to the nose, narrowing it, eliminating a nasal lump or making other automated visual changes, then going in and fine-tuning manually.

She carefully carves the bridge of my digitized nose a bit, brings in the tip and, using a front view, narrows the nose carefully.

“Do you have anything in a Disney Princess nose?” I ask, trying to help.

The digital imaging appears much finer and the tools more subtle than those you’d find in most consumer photo-editing software. There are no seams in the constructed digital face, and you’d swear you could print out a fleshy copy of it and stick it on Nicolas Cage for a scene in the movie “Face/Off.” The image swings smoothly in 3-D from front to profile view. It can be rotated back so that you can get a clear view up my nostrils.

When the doctor is done, she shows me a side-by-side comparison of my nose before and after the digital rhinoplasty. It’s not an extreme change, but there’s a clear difference. My nose is a little thinner and sticks out a bit less but doesn’t seem out of place on my face.

“You just got a conservative nose job,” Walden says.

You could have a lot of fun with Vectra, I imagine, playing “Weird Science” with people’s bodies, but Walden says that above all else, the system is practical and useful for both patients and plastic surgeons.

“It shows people what they’ll look like, realistically, after the surgery. It really is just a better, more accurate analysis of the anatomy.”

Plastic surgeons typically use 2-D imaging tools now and in the past simply drew on printed photos to give patients an idea of what to expect.

In some examples that Walden showed me, a more extreme rhinoplasty eliminated a patient’s pronounced bridge bump. And in the case of a recent breast augmentation, the 3-D model was able to help the patient and doctor determine the appropriate size for implants and to see that, due to scoliosis, one implant would need to be slightly larger than the other.

“It confirmed the pre-operative analysis and aided in the decision making,” Walden said. “Not unlike a lot of women, (the patient) waffled in what size implants she wanted for a while. I was able to give her objective evidence of what it would look like.”

The imaging is so helpful that Walden doesn’t add the use of it to the cost of any of her procedures.

Despite the plastic surgeon’s obvious skills, I’m keeping my current nose. But if I decide in a few years that a brow lift or tummy tuck is in order (hey, don’t judge), it’s reassuring to know that I’ll be able to get a pretty detailed 3-D preview of the new me.