AI-supported plastic surgery planning: Is technology changing the plastic surgery landscape?

There is a lot of talk about artificial intelligence (AI), how it is reshaping the world and our perception of it. Some people herald the arrival of AI as a tool that will make life infinitely easier, taking over menial tasks that no one wants to do and transforming the world for the better. Some people see the rise of AI as a harbinger of doom where supercomputers prepare for their eventual takeover, Skynet style.

Whichever side of the coin you land on, there is no question that AI is changing how we work, play and interact with each other and the world. It is also reshaping the plastic surgery landscape in new and unexpected ways. Technology will not replace the skill, art and craftsmanship of an experienced board-certified plastic surgeon, but AI-powered tools are changing the doctor-patient experience.

What is AI?

AI stands for artificial intelligence, which was once only portrayed in science fiction novels and movies. In reality, modern artificial intelligence means the ability of a computer system or program to perform a task that once required human intelligence to complete. AI is designed to mimic human cognitive functions, enabling computers to solve problems or complete tasks more smoothly and efficiently than living, breathing humans.

How is AI changing the plastic surgery landscape?

Robots and AI are not in the operating room opening plastic surgery patients, at least not yet. However, some plastic surgeons use powerful AI tools to enhance the patient experience. These tools may also make tedious or time-consuming tasks faster and easier, allowing plastic surgeons to focus more on patient care and education.

But is AI invading a plastic surgeon's office near you? The answer depends. Some plastic surgeons are embracing the technology faster than others, blazing the artificial intelligence trail and finding innovative ways to use AI in their own practices to help them save time and benefit patients.

"I use AI all the time in my practice," said Roy Kim, MD. "I use it mainly for patient education materials – helping me make videos, B-rolls or 'aftercare' booklets. I am careful to make sure everything I publish is correct. I review everything, but the actual design of videos, booklets and more is all done with the help of AI."

AI is also helping plastic surgeons improve workflow and office efficiency in their practices.

"I think AI can be used to assist with efficiency in booking consultation appointments, streamlining practice management and assisting with backend tasks," said Karen Horton, MD, MSc, FACS.

With a close family member working as an AI developer, Kelly Killeen, MD, has an intimate knowledge of AI and its potential in the plastic surgery practice. She said some emerging AI tools are a "game changer" for the field. For her, this includes AI assisting with insurance responses to help cover procedures for patients, AI scribe tools that can take notes and make charting faster and more efficient and preparing presentations to show patients during consultations and visits.

Dr. Kim also uses AI to help narrate audio podcast scripts, which saves him time reading and recording. He said he creates the scripts, then lets an AI voice take over the work. This approach allows him to share his knowledge and expertise with the public without sacrificing valuable time. Coincidentally, he is so fascinated with AI and how it advances the plastic surgery field that he is putting together a series of YouTube videos on the topic.

In the same vein, Dr. Killeen also mentioned using AI to help streamline her social media presence, saying that AI is "amazing" for creating Google ads and helping plastic surgeons and their staff monitor comments or let them know when they need to reply to social media feedback.

Yet another area where AI can reshape the patient experience is by tailoring the aftercare and recovery experience of each plastic surgery patient.

"AI can definitely help with crafting personalized 'aftercare' instructions," said Dr. Kim. "I have a template, and then you can plug in the patient's individual issues, and the aftercare instructions are tailored to the patient. Right now, it's totally manual and slightly annoying to produce, but I think it could be more automated very quickly."

Other applications for AI that may make their way into the plastic surgery world – which are not fully integrated into the field yet – could include specific cancer screening tools.

"In the cancer field, AI will definitely be of benefit in detecting and monitoring skin cancers, breast cancers, head and neck cancers and the plethora of other types of cancers that plastic surgeons treat or reconstruct," said Dr. Horton. "Knowing ahead of time what the defect will be with AI's assistance will be a game changer for reconstruction, just as 3D printing was for cases of mandible reconstruction."

Where to draw the line between high-tech patient care and the doctor-patient experience?

AI technology has some incredible applications in the medical field. However, there are some things that artificial intelligence can't do. One area where plastic surgeons recommend that doctors and patients use caution with AI tools is in the use of before and after photographs, as well as computer-generated images that allow patients to visualize what they "may" look like after a plastic surgery procedure.

"There are some apps available now that do exactly this," said Dr. Horton. "Just like morphing software, once a patient sees a computer-generated image of what could be possible surgically, even with disclosure that the image generated is not possible in real life, it becomes the expectation for the result. I fear that if AI is used to show how patients could look after a procedure, it may lead to dissatisfaction when the surgical outcome is not what AI told them could be achieved."

She makes a valid point, as plastic surgery is not a one-size-fits-all specialty.

"Every surgeon is different, with a unique skill set, surgical style and aesthetic," said Dr. Horton. "Perhaps if AI really studied the surgical outcomes for each practicing surgeon individually, a more accurate image could be generated, but this is not something I'm interested in pursuing yet."

Instead, in her practice, she prefers adding new cases to her website and gallery that show real patients' before and after photographs that illustrate how incisions heal, what residual swelling looks like and images that accurately reflect a real patient's recovery experience during the first year after surgery.

Dr. Killeen also cautioned against using AI for before and after photos.

"You can use AI potentially to remove backgrounds or upscale images, but there is often too much differentiation from the original photos, and this can be misleading," said Dr. Kileen. "I'd be cautious using AI to show potential results to patients; we are not quite yet there with the technology."

Another concern with specific AI tools that Dr. Horton voiced concerns about is confidentiality and patient privacy.

"Companies that are pushing AI on plastic surgeons to the benefit of their companies have minimized confidentiality and informed consent concerns that have been raised at our annual scientific meetings, which also puts a bad taste in my mouth," said Dr. Horton.

AI has its uses, but it is also clear that it cannot replicate or replace doctor-patient interactions that can help patients manage post-surgery mental health issues. Plastic surgery is not just physically taxing; it can also be mentally challenging for some patients. AI tools are not equipped to help patients handle emotional responses to their evolving aesthetic or post-surgery recovery the way a compassionate plastic surgeon and their staff can.

Perhaps the best part of implementing new technology, AI or otherwise, is that it doesn't have to be an all-or-nothing approach.

"Nothing can take the place of the intimate doctor-patient relationship, an artistic and creative eye, surgical plan and execution and the necessary hand-holding and personal care of a board-certified plastic surgeon," said Dr. Horton.

How AI is used in plastic surgery ultimately comes down to the surgeon's perspective on the technology.

"Overall, I am positive about technology in plastic surgery," said Dr. Kim. "I think it just depends on your outlook on life!"

There may be a lot of stress and worry over an AI takeover, but technology can't compete with the nuance, skill and compassion of humans. New tools may help bring plastic surgeons and patients closer together by tackling tasks that take surgeons away from hands-on patient care. As with anything, moderation tends to be the key.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.