Methods and systems for providing depth-resolved real-time visual feedback to a physician during cosmetic dermal filler injections with micrometer spatial resolution utilizing a noninvasive optical coherence tomography/elastography, 2D-3D virtual and real time system. This system can be automated to direct proper volumes and viscosity of the necessary injection substances. The methods and systems allow for assessment of the elasticity of the tissue before and after the injection to evaluate the efficacy of the injection, with predetermined virtual results before and matched post injection images. The elasticity assessment method preferably utilizes a focused air-pulse to induce a micrometer scale displacement in the skin and the optical coherence tomography system to image this displacement. By utilizing a model-based reconstruction method, the viscoelasticity of the tissue at a specific measurement position can be obtained and virtual and post injection real time projections can be imaged.
