Bioethics and Controversies in the Use of Artificial Intelligence Technologies in Cosmetic Surgery

Artificial intelligence (AI) tools have become an essential part of modern medicine and surgery in recent years. Potential cosmetic surgery patients can visualize possible outcomes of a surgical procedure with the swipe of a finger and get a quote for surgical treatments without leaving their homes. Most of these AI tools use high-quality 2D or 3D photographs, as well as sensitive personal data regarding medical history and other important parameters, which certainly raise concerns about the bioethical aspects, accountability, and personal data protection. This article points out the key ethical principles and issues that may arise in the implementation of these tools, especially in facial cosmetic surgery. It discusses the possible pre-programmed bias and other considerations and controversies that can lead to unintentional violation of sensitive information and resulting legal issues. A search was performed across PubMed and Web of Science, using a combination of keywords related to “cosmetic surgery” and “artificial intelligence,” such as “bioethics,” “AI preprogrammed bias,” and “AI liability.” The search was focused on published articles in the past 5 years to point out the recent trends and opinions among plastic cosmetic surgeons about the use of AI in the field. The main potential issues associated with the use of AI in plastic cosmetic surgery were summarized as “Possible pre-programmed Bias,” “Key ethical principles” and “Other considerations and controversies,” such as compromised traditional patient-clinician relationships, including loss of empathy and patient-centered care. Further considerations include the potential dehumanization of health care, AI-generated threats to patients’ safety and efficacy, and limited liability. The current experts’ opinions regarding the use of AI in cosmetic surgery and health care seem to be very controversial despite the increase in its use and the recent improvements in the quality and versatile facets of AI tools and their implementation. There are supporters and opponents, whose common goal remains to be the quality of care, patient safety, and bioethics, including data protection and liability. Artificial intelligence technologies can potentially improve patient care by supporting surgeons without having to replace them. Strict regulations are crucial for any kind of AI technology, especially the one involved in direct patient care, such as cosmetic surgery.