Protocol for Integrating Augmented Reality Into the Cosmetic Rhinoplasty Workflow

Cosmetic rhinoplasty often relies on intraoperative reference images to help achieve the patient's desired aesthetic outcome. However, these images are typically displayed in a two-dimensional (2D) format, which oversimplifies three-dimensional (3D) nasal anatomy and requires the surgeon to divert attention away from the operative field. Augmented reality (AR) technology may address these limitations by projecting patient-specific 3D holographic images into the surgeon's field of view, providing real-time spatial visualization. This article describes a protocol for integrating AR into the cosmetic rhinoplasty workflow using a 3D facial imaging system and a head-mounted mixed-reality display. Preoperative 3D facial images are acquired, collaboratively morphed with the patient to represent the desired surgical outcome, exported as holographic models, and displayed intraoperatively for visual comparison with the surgical field. The protocol was successfully incorporated into the surgical workflow, allowing surgeons to manipulate holographic models in real space during preoperative planning and intraoperative assessment. This protocol provides a reproducible workflow for incorporating AR into cosmetic rhinoplasty and may enhance intraoperative visualization, support surgical decision-making, and facilitate comparison between preoperative planning and intraoperative anatomy.