Letter to the Editor: March 2023

J Clin Aesthet Dermatol. 2023;16(3):20.

Introduction to Metaverse: Future of Surgical and Cosmetic Dermatology

Dear Editor:

A new universe in healthcare is on the rise, the “metaverse” is bridging science and technology that could transform future digital services (telemedicine), social interactions, education, training, and medical care. Metaverse technology includes virtual reality (VR), augmented reality (AR), and mixed reality (MR) integration through virtual three-dimensional (3D) space allowing for a real-time, immersive, and interactive experience using special equipment.1 These technology-based education tools have a broad application in medical education and clinical training and have successfully demonstrated utility in teaching anatomical correlations.2 

The metaverse in both surgical and cosmetic dermatology has extensive potential benefits as skin is an accessible organ particularly suitable for visualization facilitated by augmented and virtual reality. Furthermore, the metaverse facilitates the immersion experience for physicians as well as patients into a synthetic environment, which not only optimizes the shared decision-making process but also provides a realistic physician-patient experience in a virtual clinic.3 This virtual world with mixed reality could enable the development of training and sharing of techniques used for planning and performing surgical or cosmetic procedures for physicians practicing surgical or cosmetic dermatology. Implementation of metaverse technology will practically use 3D anatomic visualization and virtual navigation for procedural and surgical planning, such as simulation of flap design, botox/dermal filler injection, and laser procedures. Moreover, this platform may integrate solutions for cosmetic evaluation, patient education, and patient engagement, including promising applicative roles in Mohs micrographic surgery and scalp injections. 

Haptics-assisted surgery planning can provide comprehensive parameters for surgical and aesthetic outcomes. With haptic communication technology, operators can benefit from real-time kinesthetic and vibrotactile feedback to streamline operations and increase precision.4 Measurements of skin biomechanical properties including elasticity, firmness, and underlying structure can also be closely tracked, which can then be used to build personalized interconnected data. In addition, blockchain technology, which is an imperative component of the metaverse, can generate a decentralized platform that allows encrypted health databases to be securely stored, acquired, and distributed. The disclosure of medical records, selection of specialists, and verification of interventions are all based on shared consensus networks in the blockchain.

The introduction of metaverse to telemedicine and remote monitoring in surgical and cosmetic dermatology can provide a shared interface for patients to obtain real-time preoperative instruction and postoperative care from physicians in different cities and countries. The synchronous teleconsultation utilizing the synergistic combination of the metaverse tools plays a crucial role in addressing health disparities by overcoming physical barriers nationally and globally in improving consult efficiency.5 Therefore, the expansion of these technologies could ameliorate the inequities in access to dermatological care and curtail the cost of clinic- or hospital-based visits.

With the advent of the metaverse and virtual healthcare, advanced technology has led policymakers and stakeholders to pave their way by implementing innovative ideas around immersive reality. It is important for dermatologists to acknowledge the strengths and limitations of the technology and prepare for a dramatic change to accommodate shifting lifestyles and demand for the next normal in dermatology.

With regard,

by Yu-Feng Chang, MD, MS,
and Li-Chi Chen, MD

Affiliations. Dr. Chang is with the Department of Dermatology at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, Massachusetts. Dr. Chen is with Harvard T.H. Chan School of Public Health and Massachusetts General Hospital in Boston, Massachusetts.

Funding. No funding was provided for this article.

Disclosures. The authors report no conflicts of interest relevant to the content of this article.

Correspondence. Yu-Feng Chang, MD, MS; Email: yufengchang@hms.harvard.edu


  1. Sun Z, Zhu M, Shan X, et al. Augmented tactile-perception and haptic-feedback rings as human-machine interfaces aiming for immersive interactions. Nat Commun. 2022 Sep 5;13(1):5224. 
  2. Lee GK, Moshrefi S, Fuertes V, et al. What Is Your Reality? Virtual, Augmented, and Mixed Reality in Plastic Surgery Training, Education, and Practice. Plast Reconstr Surg. 2021 Feb 1;147(2):505–511. 
  3. Kassutto SM, Baston C, Clancy C. Virtual, Augmented, and Alternate Reality in Medical Education: Socially Distanced but Fully Immersed. Sch. 2021 Dec;2(4):651–664. 
  4. Bonmarin M, Läuchli S, Navarini A. Augmented and Virtual Reality in Dermatology—Where Do We Stand and What Comes Next? Dermato. 2022 Mar;2(1):1–7. 
  5. Tan TF, Li Y, Lim JS, et al. Metaverse and Virtual Health Care in Ophthalmology: Opportunities and Challenges. Asia-Pac J Ophthalmol. 2022 Jun;11(3):237–246.