The senior author’s philosophy of revision rhinoplasty is driven by one essential goal—to make the patient happy. Clear communication between surgeon and patient, and clear understanding of the patient’s surgical goals, are important ingredients for success. Though obviously not a surgical technique, computer imaging has been an indispensable communication tool in revision rhinoplasty and warrants highlighting here. The senior author rarely performs cosmetic rhinoplasty when computer imaging has not been performed.

The senior author’s office computer network provides for imaging in each examination room. The patient’s photos are uploaded onto the computer screen in the examination room, and computer imaging is undertaken.

The senior author explains to the patient that computer imaging is just a ‘‘video game,’’ that it is a way to communicate a shared surgical goal. It is further explained that of course this is not an ‘‘after’’ picture, that it is not a guarantee and should not be taken to even offer the slightest implication of a guarantee. It is simply a way to communicate the shared surgical goal. The senior author does not provide the patient with printouts of the computer imaging.

The senior author explains to the patient that he routinely prints out the preoperative photo and shared surgical goal photo and tapes them to the wall in the operating room during surgery, so that he can refer to the pictures as surgery progresses.