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Case study · Plastic surgery, Ghent

Coupure Center: building an AI-native record around the face.

Dr. Patrick Tonnard and Dr. Alexis Verpaele are a world reference in natural facial rejuvenation, known for the MACS-lift and for nanofat. Their practice on the Coupure in Ghent runs a high volume of consultations, surgery and long follow-up. Tiro.health was designed, from the first line, in their consultation rooms.

Coupure Center for Plastic Surgery in Ghent
Practice
Coupure Center for Plastic Surgery
Surgeons
Dr. Tonnard, Dr. Verpaele, Dr. Van Renterghem
Focus
Facial rejuvenation, MACS-lift, nanofat
Relationship
First design partner, live since 2025
The situation

A world-class practice on three disconnected systems.

A facelift patient is not one visit. There is a consultation with drawings and a quote, a decision, an operating day, and then photographs at week two, month three and month twelve. Each of those steps used to live somewhere else: photographs on a camera and a shared drive, plans on paper, letters in a word processor, the money in an accounting tool.

None of it was broken enough to replace, and all of it cost time in the evening. The clinical reality, meaning what was injected where, which technique was used and what the patient looked like eighteen months later, was spread over four places and only fully present in the surgeon's head.

  • Photographs disconnected from the case they belonged to
  • Quotes rebuilt by hand after every consultation
  • Letters written after hours, from memory
  • No way to compare outcomes across a technique

The consultation writes itself.

The surgeon marks the anatomy on a facial schema and talks through the plan as usual. Tiro listens, structures what was said and files it against the schema, so the note exists before the patient has left the room.

Facial schemas drawn in the recordDictation structured into the note, not a transcriptDiagnoses and plan captured as dataNote signed the same minute, not the same evening

The estimate leaves with the patient.

Most of this work is self-pay, so the estimate is part of the clinical conversation. Because the plan is structured, the quote is generated from it rather than retyped, and reimbursed acts sit next to private ones on the same case.

Quotes generated from the marked planSelf-pay and RIZIV acts on one caseSent and tracked from the recordNo second pass in a separate tool

The operating day is prepared before it starts.

Theatre slot, consent, materials and the pre-operative checklist hang on the same case. The team opens one view in the morning instead of reconstructing decisions from four sources.

Case linked to the theatre slotConsent captured and versionedChecklist visible to the whole teamOperative note structured per technique

Twelve months of follow-up on one timeline.

A post-operative program sets the rhythm: standardised photographs at week two, a questionnaire at week six, review at month three and month twelve. Each milestone lands on the case, so a MACS-lift from three years ago can be compared with one from last month.

Photo milestones on a scheduleStandardised views, filed to the casePROMs answered on any deviceSecure threads with the patient

A technique you can show, not just describe.

Because every case is structured the same way, the practice can look at a technique across hundreds of patients, which is exactly what a practice that teaches and publishes needs.

Outcomes grouped per techniqueSeries ready for teaching and publicationExport for reportingNothing re-entered to get there

Photos, plans and letters used to live in three systems. Now the whole patient is one view.
Dr. Alexis Verpaele · Plastic surgeon, Coupure Center, Ghent
Preparing a patient before surgery
Preparing a patient before surgery
Reviewing a case together
Reviewing a case together
Dr. Patrick Tonnard
Dr. Patrick Tonnard
In consultation at the Coupure Center
In consultation at the Coupure Center

Photography courtesy of Coupure Center for Plastic Surgery, tonnardverpaele.com.

What changed in the day.

One
record for consult, surgery and follow-up
Same day
notes signed instead of evening admin
12 months
of photo milestones on one timeline
Per technique
outcomes, comparable across cases
I want to look at the patient, not at a screen. The record has to be finished when the consultation is finished.
Dr. Patrick Tonnard · Plastic surgeon, Coupure Center, Ghent

What we learned.

Designing with a practice at this level set the bar for everything after it: the record has to be finished when the consultation is finished, structure has to be a by-product of normal clinical work, and follow-up over years is the product, not a feature. Dermatology and aesthetic medicine inherited all three.

Walk your own case through Tiro.

From the consultation drawing to the twelve-month outcome, on your own procedures.