Visual Simulation in the Consultation: What It Shows and Doesn't

An image persuades more than a thousand explanations. That is why visual simulation is such a powerful tool in the orofacial harmonization (HOF) consultation: in a minute, the patient sees what would take twenty minutes to describe. And that is exactly why it needs clear limits. A convincing image, poorly framed, becomes a promise in the patient's mind, and an unkept promise is the source of a good share of complaints.

This guide explains what simulation shows well, what it cannot show, how to talk about this in the consultation and how to protect yourself. The goal is to use the tool to improve the conversation and the decision, without creating an expectation the procedure cannot meet.

What simulation is, and what it is not

An illustrative simulation is a computer-generated image, made from a photo, that represents one possibility of the plan. It is a visual hypothesis. It is not a photograph of the future, not a test and not the professional's commitment to a result.

Saying this out loud, right at the start, changes the kind of conversation. See presenting before and after in the consultation.

What simulation usually shows well

• The direction of the plan: which areas would be treated and how the whole might become more balanced.
• The proportion between areas: the patient realizes that working on one area may call for care with another.
• The difference in intensity: comparing a subtler proposal with a more pronounced one helps decide.
• What the patient imagines: the image surfaces what they expect, and often reveals expectations different from yours.
• The conversation about naturalness: discreet simulations help show that the aim is balance, not dramatic change.

What simulation cannot show

This is the part that demands the most honesty:

In addition, the quality of the simulation depends on the quality of the photo: light, angle, framing and expression all affect the result. See standardized clinical photography and camera and lighting for clinical photos.

How to communicate the limits in the consultation

Before showing

Say what you are going to show and why: "I am going to show you an image so we can talk about the plan. It is an illustration, not a promise."

While showing

Point out what the image represents (area, intensity) and what it does not capture (movement, swelling, individual response). Ask what the patient thinks, instead of saying it looks "great".

After showing

Reinforce that the actual result may be different and that the decision is made based on the assessment. Record in the patient record that the simulation was shown and explained. See aligning expectations in writing and illustrative simulation notice to the patient.

How to use it to align expectations

Simulation is a great doorway into the conversation about expectations:

1. Show a subtle version and a more pronounced one, and ask the patient to point to the one closer to what they want.
2. If the patient wants something the image does not show or the plan does not deliver, say so clearly.
3. If the expectation is incompatible with what is possible, take the chance to redirect the plan or politely decline. See script for politely declining a procedure.
4. Record what was agreed.

See also explaining natural facial asymmetry and the script for explaining the simulation to the patient.

Ethical and privacy precautions

• Consent: the photo is sensitive data, and sending it to an AI tool requires notice to the patient and their acceptance. See AI with the patient's photo: consent.
• Advertising: simulation on social media only with a label, specific authorization and respect for the board's rules. See what you may advertise.
• No promises: nothing like "it will look like this" or "I guarantee".
• Record: note that the simulation was explained as illustrative.

When not to use simulation

• A patient showing signs of unrealistic expectations or intense dissatisfaction with their own image. See body dysmorphic disorder in HOF.
• When there is no clinical indication for the suggested procedure.
• When the patient did not authorize use of the photo.
• When the photo is not good enough for an honest simulation.

In these cases, conversation and examination are worth more than any image.

Common mistakes

• Showing the image without explaining that it is an illustration.
• Using only the most impactful version.
• Letting the patient take the image away without the simulation notice.
• Posting the simulation as if it were a result.
• Forgetting to record the conversation.
• Using the simulation to pressure a decision.
• Comparing the simulation with another patient's result.

How Harmy fits in

Harmy generates the projection from a frontal photo, with ml per area and Subtle, Moderate or Pronounced intensity, and shows the Before/After on a slider. Presentation mode leaves only the slider in full screen so you can turn the phone toward the patient, and the magnifier enlarges the treated area, before and after side by side. The shared image carries the illustrative simulation notice. The projection changes only what was marked and does not predict results; that is why it supports the conversation and does not replace it.

Summary

Simulation shows a possibility, not the future. Explain that before, during and after showing it, record the conversation and protect the patient's data. When the limits are stated clearly, the image stops being a promise and becomes what it should be: a good starting point for deciding together.