Summary Objectives: This paper intends to investigate the role of virtual reality (VR) in medicine. In particular it outlines the current state of research and technology that is relevant to the development of effective virtual environments in medicine. Methods: After describing the two different visions of VR we can find in medicine – the presentation of virtual objects to all of the human senses in a way identical to their natural counterpart, and a new human-computer interaction paradigm in which users are active participants within a computer-generated three-dimensional virtual world – the paper presents some of the most interesting applications actually developed in the area. Finally, it discusses the clinical principles, technological devices and safety issues associated with the use of VR in medicine. Results: With more than 1,000 VR papers already indexed in Medline, VR is a reality health care. Even if the number of controlled studies is still limited, its merging with emerging technologies like Ambient Intelligence and wireless communication will further improve its diffusion. Conclusions: The possible impact of VR on health care could be even higher than the one offered by the new communication technologies like Internet. In fact, VR is at the same tima technology, a communication interface and an experience: a communication interface based on interactive 3D visualization, able to collect and integrate in single real-like experience different inputs and data sets. However, significant efforts are still required to move VR into commercial success and therefore routine clinical use.

Introduction:Based on clinical impressions personality disorders (PDs) and psychiatric disorders characterized by body image disorder (BID) have been suggested to be relatively common in cosmetic surgery settings and closely associated with patient's post-operative dissatisfaction despite technically satisfactory surgical results, leading to problems for both patients and surgeons.Aims:The study investigated the prevalence and the comorbidity between BID and PDs in patients seeking cosmetic surgery, as well as the impact of the following clinical variables on patient's post-operative dissatisfaction: number of pathological personality traits, severity of body uneasiness and worries about particular body parts and intensity of these concerns.Methods:Two hundred fifty patients scheduled for profile, breast and body contouring cosmetic surgery from two Italian hospitals (90% F; Mage = 31.5 ± 4.0) completed the Body Uneasiness Test (BUT), the Personality Diagnostic Questionnaire-4+ (PDQ-4) before surgery and a measure of patient satisfaction 13 months after surgery.Results:18.9% of subjects, had at least 1 PD (cluster B and C's in particular). Using the BUT cut-off score as a marker of clinical significance, 48.8% of subjects had a BID, and all PD patients showed comorbidity with BID. The number of pathological personality traits, the severity of body uneasiness and the intensity of worries about body parts showed a predictive power on patients’ post-operative dissatisfaction.Conclusion:PDs and BID are common in cosmetic surgery settings. Our data suggest also that a thorough pre-operative clinical assessment may allow the pre-operative identification of patients with low levels of post-operative satisfaction.

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