Given the geometric complexity of anatomical structures, realistic real-time deformation of graphical reconstructions is prohibitively computationally intensive. Instead, real-time deformation of virtual anatomy is roughly approximated through simpler methodologies. Since the graphical interpolations and simple spring models commonly used in these simulations are not based on the biomechanical properties of tissue structures, these "quick and dirty" methods typically do not accurately represent the complex deformations and force-feedback interactions that can take place during surgery. Finite element (FE) analysis is widely regarded as the most appropriate alternative to these methods. Extensive research has been directed toward applying the method to modeling a wide range of biological structures, and a few simple FE models have been incorporated into surgical simulations. However, because of the highly computational nature of the FE method, its direct application to real-time force-feedback and visualization of tissue deformation has not been practical for most simulations. This limitation is primarily due to the overabundance of information provided by the standard FE approaches. If the mathematics is optimized to yield only the information essential for the surgical task, computation time can be drastically reduced. Parallel computation and preprocessing of the model before the simulation begins can also reduce the size of the problem and greatly increase computation speed. Such methodologies are being developed in a combined effort between the Human Interface Technology Laboratory (HIT Lab) and the Mechanical Engineering Department of the University of Washington. We have created computer demonstrations which support real-time interaction with simple finite element soft tissue models. In collaboration with the Division of Dermatology, a real-time skin surgery simulator is being developed using these fast FE methods.