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The impact of three-dimensional simulation and virtual reality technologies on surgical decision-making and
Mert Ersan1, Hasan Demirbaşoğlu2, Begüm Kolcu3
1Department of Plastic, Reconstructive and Aesthetic Surgery, Yeditepe University Faculty of Medicine, Istanbul, Türkiye.
Background:
Three-dimensional (3D) simulation and virtual reality (VR) technologies are increasingly used in aesthetic surgery consultations to enhance decision-making and expectation management. However, their impact on surgical decision-making and postoperative satisfaction across different procedures remains unclear.
Objectives:
This study aimed to evaluate the influence of 3D simulation and VR technology in patients undergoing rhinoplasty, breast augmentation, mastopexy, augmentation-mastopexy and breast reduction.
Methods:
A retrospective study was conducted with 75 female patients who underwent primary aesthetic surgery. Preoperative 3D simulations and VR visualizations were generated using the Crisalix Virtual Esthetics system (Crisalix S.A., Switzerland). Patients were assessed postoperatively at one year using structured surveys to evaluate the influence of 3D simulation and VR technology on their decision-making and satisfaction. Statistical analyses included the Kruskal-Wallis H test, the Chi-Square test, and Spearman's correlation.
Results:
3D simulation had the greatest influence on breast augmentation (8.4/10), rhinoplasty (7.6/10), and augmentation-mastopexy (7.1/10) patients but was less impactful for mastopexy (6.6/10) and breast reduction (3.8/10) patients (p < 0.001). The most decisive factors were previous patient photos (30.7%) and communication with the surgeon (29.3%), with simulation ranking third (18.7%). Postoperative similarity ratings were highest in breast augmentation (7.9/10) and rhinoplasty (7.5/10) patients. While 70.7% of patients would recommend 3D simulation, VR headset use did not influence decisions (p < 0.001).
Conclusions:
3D simulation enhances patient engagement and expectation management across various aesthetic procedures. While its influence is more significant in surgeries primarily focused on aesthetic outcomes, it serves as a complementary tool rather than a definitive factor in decision-making.

