Teaching 3D Sculpting to Facial Plastic Surgeons

This article describes the authors’ course, which takes facial plastic surgeons through specific exercises to demonstrate the esthetic impact of 3D manipulations of the nose and face. The course components are described, which include 3D assessment, exercises in manual dexterity, and improving imagination in sculpting facial and nasal features for the optimal esthetic result and match to a given facial shape. The overlap and relationship between a course in 3D sculpting in facial plastic surgery and current 3D tools for design and image analysis being used for facial plastic surgery are discussed.

The human body is a 3-dimensional (3D) object; and any changes, whether from movement during facial expression or from surgery, occur in 3 dimensions. The importance of thinking in 3D when doing facial plastic surgery extends to preoperative planning, consideration of esthetics, discussion with patients, surgical simulation, and manual dexterity in execution of the steps to attain the desired 3D goal.

Although ethnic differences exist in Turkey, we can describe the general structure of the Mediterranean nose as large and arched. The most common nasal surgery in this country currently is reduction rhinoplasty. Most patients requesting this surgery have a large nose associated with a nasolabial angle less than 90°, thick skin, and a deviated nose.

The interest in plastic surgery interventions has rapidly increased during the last 15 years and continues to rise. The interest in facial plastic surgery interventions is consistent with the general socioeconomic levels of society. The increased interest in rhinoplasty surgery began 25 years ago in the United States and was subsequently observed in European countries, including Turkey. Because of the increased interest in rhinoplasty, many otolaryngologists are keen to be taught rhinoplasty procedures and several courses and symposia continue to be organized to meet this need. These meetings are typically designed to improve theoretical knowledge in an engaging and educational manner. In accordance with the increased interest in rhinoplasty, the incidence of overcorrected noses has increased. This report is about 3D sculpting courses that the authors developed after realizing the need for education regarding planning the way to attain a suitable nose as an important element of plastic surgical interventions.

The authors have found clay to be an inexpensive, readily available medium that allows facial plastic surgeons to further explore the relationship between their 3D handwork and the 3D esthetic result. This article describes the authors’ course and study, taking facial plastic surgeons through specific exercises to demonstrate the esthetic impact of 3D manipulations of the nose and face. The authors describe the course components, which include 3D assessment, exercises in manual dexterity, and improving imagination in sculpting facial and nasal features for the optimal esthetic result and match to a given facial shape. In addition, the authors discuss the overlap and relationship between a course in 3D sculpting in facial plastic surgery and current 3D tools for design and image analysis that are used now for facial plastic surgery. This has implications for the 5 previously mentioned areas incorporating 3D thinking in facial plastic surgery: planning, esthetics, discussion, simulation, and performance.

Teaching 3D sculpting to facial plastic surgeons

Using clay, the authors produced and duplicated sample masks for these education courses ( Figs. 1 and 2 ). The objectives of the course are

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Internalization of nose ratios
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Development of eye measurements
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3D thinking
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3D planning
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Improving manual dexterity and eye-hand coordination
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Improving imagination.

Internalization of Nose Ratios

The face is divided into 3 equal parts. These parts include 3 horizontal planes and a vertical division of the face with 5 vertical lines. To know these ratios in theory is not enough. Thus, the course starts with practice in measuring these ratios with a compass on a mud mask ( Fig. 3 ), learning to equalize these portions by making appropriate changes, and observing the results. Such practice is beneficial in the internalization of nose ratios and giving an appreciation of the relationship between measurements and the 3D facial esthetic.