The Plastic Surgery Simulator was first released in 2004 (named “Photo Warping” back then), when simulating an outcome on a patient photograph still meant a general-purpose image editor and a slow afternoon. The idea was narrow and has not changed: give the surgeon the few operations that actually matter during a consultation, make them instant, and keep everything on the surgeon's own machine.
The comparison view — original and simulation on screen at once, zooming together — came out of that first release and is still, two decades later, the feature surgeons mention first.
We are a small independent team. There is no outside investment, no growth mandate and no data business behind the product; the licence fee is the entire revenue model. That is why the software collects nothing, uploads nothing, and costs a flat $99 a year.
Development continues in the open: every release is documented in the release notes, and feature requests from practising surgeons drive most of what ships.