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Patient Perspective on Preoperative Simulation in Plastic Surgery: A Systematic Review of Patient-Reported Outcomes
Omar El Sewify1, Andrew Gorgy2, Marion Sylvain3
1Faculty of Medicine, Laval University, Québec City, Quebec, Canada.
Introduction:
Preoperative simulation technologies are increasingly utilized in plastic surgery to enhance surgical planning and patient communication. While their technical benefits have been established, the impact on patient-reported outcomes (PROs), in particular satisfaction and perceived accuracy, remain underexplored. This systematic review evaluated the effect of preoperative simulation on patient-reported satisfaction, decision-making, and perceived accuracy in breast and facial aesthetic plastic surgery.
Methods:
A systematic search of MEDLINE, Embase, and Cochrane databases up to April 2025 identified studies reporting PROs in adult patients undergoing breast (aesthetic or reconstructive) or facial aesthetic surgery with preoperative simulation. Data on demographics, simulation type, satisfaction, accuracy, and complications were extracted and analyzed.
Results:
Seventeen studies (1333 patients; 970 simulation, 363 control) met inclusion criteria. Breast surgery patients using simulation showed higher satisfaction with appearance (Breast-Q: 75.0 vs 58.1), surgical outcomes (84.9% vs 78.8%), and psychosocial well-being. Simulation patients reported higher satisfaction with the simulation experience (95.4%) and greater trust in their surgeon (95.2%), with lower complication rates (4.1% vs 41.5%). In facial surgery, simulation users demonstrated greater overall satisfaction (79.2% vs 67.3%) and improved understanding of outcomes. Perceived accuracy was higher in breast (91.0%) than facial surgery (74.1%). Across procedures, simulation enhanced shared decision-making and surgeon-patient rapport.
Conclusion:
Current evidence suggests that preoperative simulation may enhance patient satisfaction, trust, and engagement in plastic surgery, particularly in breast procedures. However, findings are based on heterogeneous studies with diverse patient populations, simulation technologies, and outcome measures. Further prospective comparative studies using standardized PRO measures are needed to better define the role of preoperative simulation across aesthetic and reconstructive plastic surgery.
