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  • A nonphysician professional designer has launched an online service to provide prospective patients a view of what they might look like following cosmetic surgery

(Left) Original client image. (Right) Client image of projected cosmetic outcomes following digital imaging via ConceptFace facial design service.
LOS ANGELES When James Bernard's friend asked him if he would alter a friend's looks on his computer from a digital image, Mr. Bernard, a professional designer, obliged. He filled in the friend's receding hairline and more.

Mr. Bernard, who has a degree in industrial design, has since built a business designing faces, with the aim of providing prospective patients with prospective "after" pictures of how they might look following cosmetic surgery.

Mr. Bernard, lead designer of Los Angeles-based, started the business by sitting with clients and probing for their input about what they would like to change about their appearance. Earlier this year, ConceptFace launched an online service, where, for $499, Mr. Bernard uses his design sense and computer savvy to morph the image the client provides based on what he or she wants to change.

The fee covers a facial design, some subsequent revisions and finished before and after images for clients to take to a cosmetic surgeon if they so choose.

"People are interested in seeing what they could look like if they would change some elements of their faces," Mr. Bernard tells Cosmetic Surgery Times .

"Before they even approach a plastic surgeon, they want to see for themselves what the possibilities would be if they changed their nose or got a face lift."

While he will not reveal how many faces he has "designed," he says he is busier than he would like to be.

DOC-FREE DESIGN implies on its Web site that its facial designs predict what cosmetic surgery might be able to provide. The site features information about specific cosmetic procedures and employs a holistic conceptual design approach, according to Mr. Bernard, for addressing wrinkles, jowls, the nose, brow and eyelids, eyebrow color, hair color and bags under the eyes. Mr. Bernard uses his design sense to facilitate the morphing and states freely that he does not have a medical background — although he has been a cosmetic surgery patient. He has not sought the guidance of plastic or cosmetic surgeons in creating the service; nor does he think that it is necessary.

"We make clear to our clients that we are not actually trying to create an image that is going to be the result if they get plastic surgery. What we are trying to do is create ideally what they are looking for. They can then take this image to the plastic surgeon and say, 'This is what I am looking for...'," he explains.

DESIGN FLAW? The concept has pitfalls, says Westport, Conn. plastic surgeon and American Society of Plastic Surgeons spokesperson Joseph O'Connell, M.D. He thinks that ConceptFace is yet another example of people trying to take the plastic surgery world out of the hands of doctors.

"People who do aesthetic surgery of the face are physicians," Dr. O'Connell says. "And there are medical issues that have tremendous influence on our decision making — issues that limit what we can do. For example, when I see a smoker for facial rejuvenation, I often do a different procedure than on a nonsmoker. When I do a blepharoplasty on someone with a history of dry eye, I often modify my blepharoplasty."

A nonphysician professional designer would not have the background to take into consideration many medical issues, Dr. O'Connell says.

The plastic surgeon says it has taken him four years of medical school, seven years of residency, two board certifications and nearly 20 years in private practice to begin to understand the facial aging process, which current literature suggests is a combination of deflation and gravitational pull.

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