From Augmented to Virtual Reality in Plastic Surgery: Blazing the Trail to a New Frontier

Janessa Sullivan, Rachel Skladman, Kaamya Varagur, Elijah Tenenbaum, Jacob Sacks, Cameron Martin, Terry Gordon, Jack Murphy, William R. Moritz, Justin Michael Sacks

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Augmented reality (AR) and virtual reality (VR)-termed mixed reality-has shown promise in the care of operative patients. Currently, AR and VR has well-known applications for craniofacial surgery, specifically in preoperative planning. However, the application of AR/VR technology to other reconstructive challenges has not been widely adopted. Thus, the purpose of this investigation is to outline the current applications of AR and VR in the operative setting. Methods: Literature pertaining to the use of AR/VR technology in the operative setting was examined. Emphasis was placed on the use of mixed reality technology in surgical subspecialities, including plastic surgery, oral and maxillofacial surgery, colorectal surgery, neurosurgery, otolaryngology, neurosurgery, and orthopedic surgery. Results: Presently, mixed reality is widely used in the care of patients requiring complex reconstruction of the craniomaxillofacial skeleton for pre- and intraoperative planning. For upper extremity amputees there is evidence that VR may be efficacious in the treatment of phantom limb pain. Furthermore, VR has untapped potential as a cost-effective tool for microsurgical education and for training residents on techniques surgical and non-surgical aesthetic treatment. There is utility for mixed reality in breast reconstruction for preoperative planning, mapping perforators, and decreasing operative time. VR has been especially well documented for the planning of deep inferior epigastric perforator (DIEP) by creating 3D immersive simulation based on a patient's preoperative CT angiogram. Conclusions: The benefits of AR and VR are numerous to both patients and surgeons. Virtual reality has been shown to increase surgical precision and decrease operative time. Furthermore, it is effective for patient specific rehearsal (PsR) which uses the patient's exact anatomical data to rehearse the procedure before performing it on the actual patient. Taken together, AR/VR technology can improve patient outcomes, decrease operative times, and lower the burden of care on both patients and healthcare institutions.

Original languageEnglish
JournalJournal of reconstructive microsurgery
StateAccepted/In press - 2023


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