From pixels to precision: Imaging technologies shaping oculofacial plastic surgery practice

Recent advances in imaging technologies have transformed surgical practice, enabling more accurate diagnoses, refined perioperative planning, and improved patient outcomes. In oculofacial plastic surgery, these tools provide safer and more precise alternatives to traditional approaches, which often relied on invasive exploration or standard imaging with limited accuracy. This review summarizes the current state of imaging technologies in oculofacial plastic surgery and discusses their benefits, limitations, and challenges. Key developments include: (i) Endoscopic imaging, providing high-resolution, magnified visualization for minimally invasive procedures, particularly in lacrimal and orbital surgery, (ii) Exoscopic imaging, a 4K-three-dimensional (3D) external system enhancing precision and team collaboration in microsurgery, (iii) Magnetic resonance imaging offering detailed 3D images of internal structures, with emerging 7T systems providing higher resolution and improved tissue contrast, (iv) Stereotactic navigation, integrating preoperative imaging with real-time tracking to guide complex orbital procedures and fracture repairs, (v) Artificial intelligence-based imaging tools, including machine learning models for disease detection, surgical planning, and outcome prediction, as well as text-to-image systems for preoperative patient counseling. Together, these technologies reduce operative risk, improve functional and esthetic outcomes, and enable patient-specific approaches. Despite challenges such as cost, accessibility, technical limitations, and learning curves, the integration of advanced imaging is steering oculofacial plastic surgery toward minimally invasive, data-driven, and patient-centered practice.