3D rhinoplasty simulation accuracy is how closely a simulated nose matches the actual result after surgery. Published evidence is limited and the findings vary, so a simulation should be presented to patients as a planning aid and not as a promise of the outcome.
What Does the Evidence Show?
A 2026 systematic review in Plastic and Reconstructive Surgery Global Open (Atiyeh and colleagues) found 17 clinical studies that measured how well preoperative simulation matched the outcome: 12 on breast augmentation and only 5 on rhinoplasty. The authors report that simulation accuracy varied for rhinoplasty and that relying on simulation alone can lead to inaccuracies. They also note the lack of objective assessment of the factors that affect accuracy.
A 2025 retrospective study in Aesthetic Surgery Journal Open Forum (Yamamichi and colleagues) looked at 38 rhinoplasty patients who had 3D simulation with the Crisalix platform. Simulation accuracy correlated with postoperative satisfaction on the FACE-Q scale (rho 0.66), second only to the physician aesthetic score (rho 0.71). Differences were larger and satisfaction lower in revision cases, although this was not statistically significant. The study is level 4 evidence from a small single group and covers one platform.
What Does This Mean for Surgeons?
- Simulation helps communication and shared decision making, but accuracy is not guaranteed.
- Revision cases may show larger gaps between simulation and result.
- Evidence for individual platforms is limited, so avoid claims that one product is the most accurate.
What Should You Ask a Software Vendor?
- Is there a published or independent study of this platform, and how many patients did it include?
- What was compared: surface shape, specific angles, tip projection, or patient satisfaction?
- How does accuracy differ in primary versus revision cases?
- Which measurements does the software output as numbers, not only as images?
How Should You Present a Simulation to Patients?
Explain that healing, swelling and skin thickness change the final result, show the simulation as a plan next to the original, and document the discussion in the patient file. Always verify measurements clinically.
Sources: Atiyeh BS et al., Preoperative 3-dimensional Simulation in Aesthetic Surgery, Plast Reconstr Surg Glob Open, 2026 (PMC13441132). Yamamichi K et al., Three-Dimensional Simulation Accuracy and Patient Satisfaction With Rhinoplasty, Aesthet Surg J Open Forum, 2025 (PMC12493035, DOI 10.1093/asjof/ojaf110).
