One of the essential components of a virtual reality surgical simulation is deformation. Deformations in computer graphics and surgical simulations are commonly modeled with three different approaches e.g. geometry based methods, Finite Element method (FEM), and Mass-spring Method (MSM). The geometry based methods are quite fast and visually appealing. Late two methods take the physics of deformation into consideration. Even though the FEM results in more physically realistic deformations, a significant drawback of this method is its expensive computation cost and vulnerability to surgical procedures such as incision. However, MSM is relatively computationally inexpensive. Because of the real-time physics based behavior of MSM, it is widely accepted by surgical simulation community. This study summarizes deformation simulation methods and their pros and cons for surgical simulations. Moreover, because of wide usage of the MSM, optimized data structures for MSM are provided and analyze...