Various example embodiments of the present disclosure provide systems and methods for performing image-guided navigation during medical procedures using intraoperative surface detection. A surface detection device is employed to obtain intraoperative surface data characterizing multiple surface regions of a subject. Pre-operative volumetric image data is registered to each surface region, providing per-surface-region registration transforms. In some example embodiments, navigation images may be generated intraoperatively based on the dynamic selection of a suitable registration transform. For example, a registration transform for generating navigation images may be dynamically determined based on the proximity of a tracked surgical tool relative to the surface regions. In an alternative example embodiment, multiple navigation images may be displayed, wherein each navigation image is generated using a different registration transform.