How useful is virtual reality in aesthetics?
Georgia Seago explores the potential of VR as a training tool.
WHY USE VR FOR AESTHETICS TRAINING?
“If you go to a conference you often end up sitting next to someone who is texting, blocking your view or just generally being distracting,” says Mr Dalvi Humzah, consultant plastic, reconstructive and aesthetic surgeon and founder of Dalvi Humzar Aesthetic Training (DHAT). “With VR you’re completely in that scenario, everyone gets the same view and we can deliver it in any venue. Delegates don’t have to come to my clinical room; they can sit at home and still get the learning.” DHAT created a VR training platform for launch in March of last year, which was put on hold for further development and is due to re-launch in 2020.
For ophthalmic plastic reconstructive surgeon Dr Sabrina Shah-Desai, the training modules in her OFAA Virtual Reality App are particularly suited to international practitioners: “I really want this for the global practitioners because I get a lot of messages from abroad but they can’t all come to the cadaver labs here in the UK. This way, they’re with me seeing what I’m dissecting, hearing me all the time.” The online modules also allow unlimited playback – something that obviously isn’t possible in real life situations. “They can play back again and again. I see this as a really good tool for if they’ve attended a lab in their own country, or they’ve had industry training or attended a conference on the subject,” adds Shah-Desai. “Then they have something they can go back to as a reference to refresh their memory.”
Cost is also a factor; the OFAA App costs £250 for lifetime access. Compared to the investment in real life training, virtual reality options are often very affordable, even with the cost of a VR headset taken into account.
HOW DOES IT WORK?
Most VR training programmes can be accessed via VR headsets at a range of price points, from the under-£10 Google Cardboard to the Occulus device, which can cost up to £500 for the latest model and allows for sound reproduction. With Humzah’s training, the new version of which is currently still in development, delegates will have around 18 different modules to choose from – a whole face procedure split into different areas – that they can spend five to 10 minutes on and move on.
In a recent masterclass trial session in Italy involving 30 delegates, “they got transported into a virtual reality clinic situation where they could have a look around and see me there, presenting what we were planning to teach. Then they could see different screens, so there was one where I was actually doing a procedure from a point of view scenario, which we filmed with a camera mounted on my chest,” explains Humzah. “When they were looking at it, it was as though they were doing it, but I was narrating exactly what I was doing and they were able to understand without any disturbances.”
WHAT CAN BE TAUGHT?
Delegates using Shah-Desai’s app have access to content covering holistic facial assessment, advanced filler injection techniques, detailed cadaver anatomy and the use of hyaluronidase to manage complications. “I think that’s where this works so well, because it covers so many things,” she says, “Not all people who are injecting are surgeons, so they don’t know how to dissect and can get confused by needles and sometimes they just want to see it very clearly again and again with an explanation. There are also modules in clinic with me where I’m assessing male and female patients using different portfolios, trying to explain my philosophy.”
The DHAT VR training only includes injectables for the time being, but with the option for delegates to take part in in-depth anatomy sessions simultaneously. “Obviously we have a lot of anatomy that we tie into it, so they don’t just see the injectable but the anatomy too,” he explains. “There are two screens which they can switch on and off to run simultaneously or just turn one off while they watch the other one. It gives them the option to see how the anatomy relates to the injection.”
WHAT ABOUT COMPLICATIONS MANAGEMENT?
One area in which VR may be particularly helpful is complications management, as practitioners are able to see and experience a case right in front of them, the steps narrated by their expert trainer. “The reason I wanted to show management of a VO is that every time I’ve helped practitioners with complications they’ve been in such a state that they’ve forgotten what they’ve previously learned in their training,” says Shah-Desai. “With this mobile-based app, you can also use it as a normal video in 2D, so in theory that video can be played then and there; me mixing up the hyaluronidase and talking you through it.”
This is a big advantage of having refresher training in your pocket, and could well stop practitioners from panicking and not acting quickly enough to successfully and safely manage a complication. However, Humzah believes that the next step beyond VR could be even more beneficial in this crucial area of training. “Augmented reality is in its infancy for this kind of application, but potentially if a practitioner had a complication in front of them, they could be streaming that video feed directly to me and I could be marking things out on the ‘patient’, taking the practitioner through exactly what to do as they’re doing it with me on hand to monitor how it’s progressing,” he says.
Shah-Desai agrees that while the technology isn’t yet accessible or affordable, “VR is one thing but augmented reality is the next stage. It’s like you’re actually in the space, experiencing it differently for simulated learning, even practising on models and experiencing where to put the syringe and feeling the sensations of feedback,” she explains. “You could even experience things like going into a lymph node and seeing what it actually looks and feels like.”
WHAT’S NEXT?
Humzah predicts that within the next six months technology will be available in aesthetics training that allows delegates to move around in the VR environment, but is keen to ensure its use within DHAT is controlled. “We’ve just taken a very careful look at how useful it would be in aesthetics because it can change between being a good educational tool to just being a toy if you’re not careful,” he says, “Plus, the technology moves so fast that it quickly supersedes itself, which is why we were initially delayed with the DHAT VR platform.”
While nothing could ever replace the importance of real life, hands-on training in medicine, the capabilities and potential evolution of VR is promising. “I think this is a very useful tool for introducing a concept to somebody, or for them to see what a procedure is like before they embark on hands-on training,” says Humzah, “But it’s very easy to get carried away with it and make everything virtual reality. You’ve got to understand that our brains aren’t really designed to be in that kind of environment for more than about 20 minutes. After that, you can’t process the information and it just becomes a video show that you’re watching.”
“We’ve tried it with an hour-long dissection, but when people were in the virtual reality room for that long, they were almost losing interest. I think the current generation aren’t used to virtual reality, there’s a generational gap. Ten years from now though, people will just be used to sticking on a VR headset and going straight in.”
