Visualising a Possible Postoperative Body: Patient Experiences of 3D and AI-Generated Simulations in Reconstructive Plastic Surgery

Nie Man; Celvin Angkasa; Tri Lidya Anggraini

doi:10.61919/9tfwsq85

Authors

Nie Man Universitas Prima Indonesia, Indonesia Author
Celvin Angkasa Universitas Prima Indonesia, Indonesia Author
Tri Lidya Anggraini Universitas Prima Indonesia, Indonesia Author

DOI:

https://doi.org/10.61919/9tfwsq85

Keywords:

reconstructive plastic surgery; three-dimensional simulation; artificial intelligence; body image; shared decision-making; qualitative research

Abstract

Background: Three-dimensional (3D) and artificial intelligence (AI)-generated visualisations are increasingly used to communicate possible reconstructive surgical outcomes. Although visual representations may improve anatomical understanding, photorealistic imagery can imply greater predictive certainty than reconstructive surgery permits. Qualitative evidence is limited regarding how patients interpret these representations in relation to expectations, identity, trust, and decision-making. Objective: To explore how adults with reconstructive surgery experience interpret anatomy-based 3D and synthetic AI-generated visualisations and to identify conditions influencing their perceived usefulness and ethical acceptability. Methods: An interpretive qualitative study using semi-structured interviews and visual elicitation was conducted in Medan, Indonesia, from January to May 2026. Twelve adults aged 24–62 years with experience of considering, planning, revising, or undergoing reconstructive surgery were purposively sampled for maximum variation. Participants viewed an anatomy-based 3D representation and a synthetic, illustrative, non-predictive AI-generated image. Interviews were analysed using reflexive thematic analysis. Results: Six themes were generated: movement from abstraction to an imaginable body; hope that could become a visual promise; recognition, estrangement, and embodied fit; trust borrowed from the surgeon; unequal redistribution of agency; and ethical acceptability through boundaries. Participants generally regarded 3D visualisation as a provisional anatomical aid, whereas photorealistic AI imagery was more readily interpreted as a possible outcome and was more susceptible to expectation anchoring. Trust increased when uncertainty, provenance, clinician responsibility, privacy, and patient control were explicit. Conclusion: Patient-facing visualisation should prioritise bounded, transparent communication rather than photorealism. Clinician accountability, explicit uncertainty, representational fit, privacy safeguards, and patient control over viewing and reuse are central to ethically acceptable implementation

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