Improved devices, systems, and methods support and/or restrain a head of a patient, optionally for use in refractive surgery. Both the height of the patient's head and the angle of the patient's neck along the medial-lateral plane of the patient can be established independently, and compression pillow systems can gently and atraumatically compress the patient's head between protruding foam sidewalls or the like to inhibit movement of the patient from the alignment position.