Augmented reality (AR) is a technology that combines computer-generated images on a screen with a real object or scene. The authors developed a sophisticated yet simple and modifiable AR technique for use during plastic and reconstructive surgery.

The researchers used a high-definition digital camera to capture 3-D image of the facial surface and computed tomography scans to obtain digital information on the underlying facial bones for each patient. These digital data were then manipulated to create 3-D simulations of the ideal final results.

Using a pair of commercially available smart glasses, the surgeon was able to superimpose the 3-D digital simulation image of the desired appearance over the patient's face during surgery. The group used free, open source software products to solve various technical problems, including manipulating and displaying the 3-D simulations and lining them up (registration) with the surgical field.

The researchers describe their preliminary experience with AR system in eight patients undergoing reconstructive facial surgery. The AR system helped in planning and confirming reconstruction of the underlying facial bones. In a patient with a congenital bone development disorder and another patient with a complex facial fracture. In all cases, the 3-D simulation of the body surface provided a visual reference to the final facial appearance.

Although the experimental system was not actually used to guide surgery in this initial experience, it helped in visualizing the planned correction and confirming the final outcome. "In all cases in this study, the body surface contour after the procedure and the ideal postoperative image almost coincided,” said Dr Ueda said, from Osaka Medical College, Japan.

Drs. Ueda and Mitsuno believe AR technology could become a useful tool for teaching surgical skills. They said, "Our findings are not only useful for body surface evaluation but also for effective evaluation of AR technology in the field of plastic surgery."