How MirrorMe3D Started Printing 3D Plastic Surgery Models

 
I call this [3D model] a paradigm shift. You actually have a printed scorecard telling you the volume of tissue, whether it be bone, soft tissue, or fat injections that’s required to evaluate the patient, present your surgical plan to the patient, and approve your results to the patient.
— Dr. Glen Jelks, Associate Professor of Plastic Surgery & Associate Professor of Ophthalmology at New York University

The plastic surgery field is in the midst of a transformation. At MirrorMe3D, we're excited to be working on this transformation at the intersection of cutting-edge technology and exceptional patient care.

Disrupting a surgical field isn't an easy task. There's a lot of momentum to keep doing things the old way, even if they're not the best way, simply because it's familiar. But we've been excited and inspired by the opportunities we saw to improve the surgical experience for both the physician and the patient—and that's what has pushed us forward on this journey.

The Idea for MirrorMe3D:  How We Found the Problem, and How We Fixed it

Our company began in a medical and technological climate ripe for change. For a long time, surgeons have relied on 2D images (aka photos) to plan, communicate about, and perform cosmetic and reconstructive surgeries. But this wasn't actually the best way to plan for surgery. That's because 2D can never quite capture the anatomical detail and scale that would best guide them in the operating room, especially when dealing with soft tissue. What surgeons really needed was a three-dimensional model to faithfully plan for the anatomy that they'd operate on.

Our founders, all leading plastic surgeons with years of experience working with 3D technology, realized the potential 3D models had for soft tissue modeling. By sourcing detailed, visually constructive models around the country, our founders began to change the face of plastic surgery.

Before they had 3D technology, physicians used photos to plan, communicate with patients about, and perform plastic surgery. 

Before-and-after photos have been a popular application of 2D technology to visualize patient surgical transformations since the mid-1800s. They have been used to accurately document patient appearance without any embellishment. The photos' objectivity is critical to maintaining ethical medical practice and transparency with patients about their treatment.

Despite their objectivity, photos aren't always as accurate to life as surgeons need them to be. There are a number of ways surgeons try to overcome this and correct for any inaccuracies—they'll make sure to use the same camera and lenses, ask the patient to photograph with the same facial expressions pre and post surgery, and request that all photos are taken make-up free. 

But photography is not an exact science, and it can lend itself to enhanced visuals that fall short of post-surgery results. The most common causes of photograph inaccuracies are:

1) Inconsistent backgrounds: The coloring of backgrounds can sometimes enhance or detract from patient appearance. Using different backgrounds in pre and post-op pictures can create distorted perceptions of the surgery's effectiveness.

2) Poor Aspect Ratio: When the sizing of a patient's face or body differs from picture to picture, it can create misleading visuals of surgery outcomes. 

3) Irregular Positioning: Taking photos of the same body part at different angles can produce images of inflated surgical outcomes. Depending on the angle and body part, the photograph might conceal facial or bodily inconsistencies. 

4) Irregular lighting: Inconsistent lighting can emphasize or minimize patient anatomical and tissue irregularities. Even the choice to use flash can have drastic consequences for a photograph's quality, as shown below. 

    A front-view of a patient helps doctors take both horizontal and vertical measurements of the patient's face ( Source ).

A front-view of a patient helps doctors take both horizontal and vertical measurements of the patient's face (Source).

In the images above, it may appear as if the patient's eye received an impressive upgrade, compliments of a high-quality tuck or injection. But both pictures were taken on the same day, within minutes of each other. 

What looks like the work of a seasoned surgeon is only the work of inadequate lighting. 

Another huge disadvantage of photography is that it can't faithfully represent soft tissue. Soft tissue is important in many cosmetic and reconstructive surgeries, but with photography, there wasn't a great way to capture its properties. That's because, unlike other parts of the body, soft tissue:

1) Is non-homogenous: Soft tissue is an umbrella term used to describe several components of the body, a few of which are fat, muscle, and skin. Its aggregate nature means understanding how each component is to be modeled and working through the challenges of those that prove difficult.

2) Exhibits non-linear behavior: Comprised of an extracellular matrix and interstitial fluid, soft tissue doesn't behave as a solid does. Unlike bone, it moves. 2D imaging doesn't consistently capture this well. 

3) Exhibits time-dependent behavior: Functions occurring in tissue matrices and fluids are time-dependent. Based on the reaction or process occurring, the shape of the tissue can look vastly different. Photos struggle to account for the tissue's dynamic fluctuations in shape. 


What Surgeons Needed

Surgeons needed a tool that would correct for photo distortion and model dynamic, changing, tissue. Our founders saw the opportunities for 3D models to meet surgeons' needs:

1) Inconsistent backgrounds, poor aspect ratio, irregular positioning, and irregular lighting are a non-issue: The medium for 3D models is entirely different from that of a picture. We can consider 3D models to be faithful replicas of a patient's body, and no matter the lighting, positioning, or any other interfering factors, a patient's face is a patient's face.

     3D models capture the patient's face irrespective of poor lighting, irregular backgrounds, or any other complicating factor ( Source ). 

3D models capture the patient's face irrespective of poor lighting, irregular backgrounds, or any other complicating factor (Source). 

2) 3D modeling is the most effective tool for modeling soft tissue: 3D models most effectively model soft tissue because they are made only after getting loads of patient-specific information. Before they're made, patients are scanned, either through MRI or CT technologies, to ensure that doctors know the existence, locations, and changing behaviors of soft tissue. Knowing these properties helps them create a more accurate model. This means that surgeons now have intra-operative soft-tissue guides, giving them reference knowledge that they never had before and would never have gotten from a photograph.

     3D models capture the patient's face irrespective of poor lighting, irregular backgrounds, or any other complicating factor ( Source ). 

3D models capture the patient's face irrespective of poor lighting, irregular backgrounds, or any other complicating factor (Source). 

     3D models capture the patient's face irrespective of poor lighting, irregular backgrounds, or any other complicating factor ( Source ). 

3D models capture the patient's face irrespective of poor lighting, irregular backgrounds, or any other complicating factor (Source). 

                                                                                    

The need for and benefits of 3D models in plastic surgery are palpable—but until 2015, the market was largely uncharted.

 

Enter our founders and their epiphany moment. They recognized the problems presented by photographs, the potential presented by 3D models, and knew they had to help. A few months later, MirrorMe3D, was born. We are now one of the few 3D model vendors for the plastic surgery field and hope to continue trailblazing for the years to come.


The Implementation

The very first models that we began producing were miniature models of patients' faces that fit within a doctor's palm.

     ( Source )

The initial idea behind the miniature face models was to give patients realistic visuals of both their appearance and their anticipated results before surgery. 

These models were extremely well received. Within months of launching the product, patients were engaging with new technology that helped them feel more secure with their potential surgery outcomes. 

One patient, Emily Gorge, voiced how helpful and reassuring the models were to her when going into surgery. Seeing the models put to rest any fears that she'd leave the operating table looking like a new-age Frankenstein (an irrational fear shared by many patients new to plastic surgery). She remarked how she “can't imagine going through this without the 3D print.” That's because, as she later explains, “the scariest part of surgery is the fear of the unknown and with this technology, it really takes away the fear.”


Stepping Up Our Game: Creating Better Tools for Better Patient Care

Though surgeons and patients were finding the miniature face models useful, MirrorMe3D believed that there was a bigger opportunity to build an even better tool. We wanted to be the leading provider of state-of-the-art surgical technology—not just of interesting visuals for patients. Even more importantly, we wanted to be sure we were providing surgeons with the highest quality and most helpful tools they could find. 

That's why we evolved our products to begin producing detailed surgical tools focused on specific anatomical regions. The creation process is intricate because we want to make sure that every detail is accurate and helpful. We source the images by getting .mtl files from high-quality 3D camera companies. Then, our engineers work on the files to do quality correction, color control, and general cleaning. Finally, we cut the model to include exactly what the surgeon needs.

Today, we offer five different kinds of models that have applications in both reconstructive and cosmetic surgery. These tools include:   

1) Rhinoplasty Models: Featuring the key operating areas of and around the nose, rhinoplasty models help surgeons plan for surgery and simulate the procedure.

2) Full Face Models: Full face models also help surgeons plan for surgery with applications to orthognathic, reconstructive, and cosmetic procedures. 
 

Sunder-hand-holding-3D-model.jpg

3) Patient Education Models: More generally speaking, these models are used to educate the medical community, especially with regards to nose deformities and differing nose ethnicities. Kits demonstrating both are available, and doctors can also ask us to customize kits as they deem appropriate.


 

How We Will Continue Innovating Soft Tissue Management 

We’re leading the way in plastic surgery because our faces are key to our identity. It’s how humans connect, oftentimes without even speaking. We believe every patient deserves the best possible outcome and we’re here for surgeons who never settle for less.