Do you need X-rays or a CT scan (Cat Scan) before facial bone contouring? The answer may surprise you. The truth is that in most cases you do not!

Now you may say, “It’s bone surgery. Don’t you need to see where the sinus is? Don’t you need to see my anatomy?”

Well, we can already see your anatomy during the pre-op exam. And, when we are actually doing the surgery the anatomy of the bone is directly visible.

A CT typically provides no real value to you or the surgeon. So why do some doctors do it? There are two good reasons to do it, and three not so good reasons.

The good reasons:

  1. If you have had complicated trauma or prior surgery or something is out of the ordinary then it could be worthwhile to get a CT scan before surgery. Maybe everything will be out of place after a prior injury and it is good to see what’s going on before a new procedure.
  2. Maybe your surgeon is inexperienced. A nervous doctor will get a lot of tests before surgery if they are not feeling comfortable or confident. While the CT scan doesn’t really help, if it makes the doctor feel more comfortable then that’s worthwhile.

The bad reasons:

  1. The doctor wants to have a “cutting guide” made for your surgery. This is another sign of someone who hasn’t done this very often. The most recent study of “cutting guides” showed them to be unsafe with an unacceptably high rate of severe complications.
  2. A marketing gimmick.
  3. Worst of all, sometimes the surgeon owns the CT machine. These machines are expensive and the doctor needs to use it to justify the cost. This cost, of course, gets passed onto the patient.

Experience and training mean safety. If an x-ray or CT scan shows you have a big sinus, or a small sinus, nothing changes in how the procedure is safely done. Before you pay for or subject yourself to the radiation exposure of a CT scan it’s important to know if it’s being done for the right reason.