Already a discipline at the forefront of surgical innovation, plastic surgery is entering a new frontier: the era of artificial intelligence (AI). AI technologies are already part of the dermatology landscape, assisting in patient management, office operations, data analysis, simulations, and even generating alternative solutions. But what if embracing these new technologies could also improve patient outcomes, enhance surgical precision, and expand the boundaries of what is surgically possible? How close is AI to becoming a major factor in plastic surgery procedures?
Today, the impact of AI can be felt primarily in the realms of patient care, education, and research, helping clinicians with decision-making, forecasting surgical outcomes, and engaging patients virtually. Modern AI tools are designed to support clinical judgment — not replace it.
As AI becomes more accessible, patients often consult AI-powered chatbots before speaking with a clinician. While chatbots offer moderately accurate responses to common dermatology questions, research suggests gaps in accuracy remain. Clinicians need to understand how these technologies are shaping patient expectations and be prepared to address any misinformation patients may encounter during AI interactions.
“Patients don’t come as nicely packaged vignettes,” observed Roxana Daneshjou, MD, PhD. “In real clinical practice, I have to ask, ‘What’s going on?’ I have to do the skin check, identify lesions, gather history, and ask about duration, symptoms, occupation, and sun exposure. I have to collect all this information and make a judgment.”
“Sometimes, the history doesn’t match what you see, so you have to use clinical reasoning,” continued Dr. Daneshjou, a leading expert on AI in American dermatology. “This kind of clinical reasoning isn’t what they’re testing in research papers that claim AI can diagnose patients.”
Dr. Daneshjou uses AI extensively in her research lab: “I’ve used it to help with grant writing and to analyze recommendation letters I’ve written, asking it to identify weaknesses so I can improve them,” she said. “Clinically, I’ve shown my nurse how to use our secure AI to draft prior authorization letters or rebuttals to insurance [rejections]. But otherwise, I don’t really use it in clinic.”
Clinical use of AI is already underway, extending beyond patient education, engagement, and workflow improvements. By using AI and 3D imaging, clinicians can help patients visualize potential outcomes before undergoing surgery. AI-assisted imaging and facial/body analysis tools can also help surgeons refine their techniques.
Preoperative planning represents one of the most promising areas for AI integration in plastic surgery, from analyzing patient data to identify ideal candidates for specific procedures to predicting individual risk profiles. Machine learning models have been developed to predict complications following breast reconstruction, while AI algorithms in aesthetic surgery can predict satisfaction levels or identify patients with body dysmorphic disorder who might benefit from psychological support before surgery.
The ability to predict surgical outcomes, assess patient-specific risks, and optimize surgical approaches has significant implications for both patient satisfaction and clinical outcomes. For clinicians, the challenge lies in understanding both the potential benefits and limitations of AI tools.
AI-based imaging enhances diagnostic precision and supports tailored treatment plans, but procedural success still relies on the skill and artistic expertise of human clinicians. Essential precision-guided tools include:
Dermatoscopes: Examine skin lesions for early detection of conditions like melanoma.
Biopsy Punches: Extract tissue samples for diagnostic purposes.
Surgical Lasers: Provide high precision for lesion removal, scar revision, and skin resurfacing.
Mohs Micrographic Surgery Instruments: Enable accurate removal of skin cancers.
Cryotherapy Devices: Treat benign and malignant lesions through freezing techniques.
Electrosurgical Units: Utilize high-frequency electrical currents for various dermatological procedures.
These tools improve procedural efficiency while ensuring patient safety and comfort. A plastic surgeon equipped with these instruments and considerable aesthetic intuition cannot be replaced by AI.
As Dr. Daneshjou has pointed out, “AI is not replacing dermatologists…dermatologists who use AI will replace dermatologists who don’t.”
AI technologies continue to evolve, and plastic surgeons can stay ahead of the curve by actively engaging with new AI developments. In the future, successful plastic surgeons may need to boost their knowledge of data science and AI evaluation to effectively leverage AI while maintaining the human judgment and artistic sensibility that define the specialty.
From managing practice operations to predicting post-surgery outcomes and providing robotic assistance in highly precise procedures, AI is expanding possibilities—but it works best in partnership with skilled clinicians.
“This isn’t a new phenomenon,” Dr. Daneshjou said. “Whenever new technology comes along, it becomes incorporated into medical practice, and those who learn to adapt and adopt it eventually replace those who don’t.”
Sources: