Plastic surgery is built on a foundation of patient satisfaction, a happy place of newfound confidence that can open personal and professional doors, maintain the practice’s proponents. With artificial intelligence on the rise, Northeast Ohio cosmetic surgeons are determining the technology’s capacity for an even more gratifying patient experience.
Board-certified Cleveland practitioner Diana Ponsky is a vocal backer of AI. Although the innovation remains in its infancy, Ponsky forecasts a future where the exact science of proportion and measurement is married to the subjective art of aesthetics.
“AI can help us figure out the science a little bit more and give us precision with it,” said Ponsky. “The art is more subjective, but if you tell (AI) to use certain calculations, it can morph a picture to that specification.”
AI-powered software can be trained to recognize facial beauty patterns, or precisely gauge a procedure’s age reduction results. A powerful tool that, in theory, can analyze facial features in a more standardized and consistent way, potentially aiding in evaluating surgical outcomes, Ponsky said.
Ponsky, a facial plastic and reconstructive surgeon, dove down the AI well when an airport facial recognition kiosk failed to identify a patient post-procedure. The first-hand account motivated Ponsky to study the technology’s potential for her industry, she said.
While the possibilities of AI are exciting, supporters including Ponsky are still figuring out when and how best to use it. Her practice uses chatbots to schedule patients, and contracted Cleveland digital marketing firm Fathom to transcribe meetings through artificial intelligence.
Casting ahead, Ponsky might harness AI prior to a rhinoplasty – commonly referred to as a nose job – allowing for more precise pre-op preparation, she said. For instance, a 3D planning software called Deep Surface AI recommends specific “aesthetic possibilities” to fit an individual’s unique facial characteristics.
The innovation could also make these procedures safer, said Ponsky.
“It can take someone’s CAT scan and compare it to a database,” Ponsky said. “(Surgeons) can figure out that the patient has a blood vessel that runs differently and offer approaches that would be of benefit rather than someone going in and discovering the problem.”
A stronger vision
Jason Leedy, founder of the Cleveland Plastic Surgery Institute, offers clients a range of cosmetic, reconstructive and plastic surgery procedures, including tummy tucks and breast augmentations. His practice uses simulation imaging software to help patients visualize their surgical outcomes with greater clarity.
“When a patient wants to change the features of their nose, I can take their picture and create a 3D image,” said Leedy. “Using that image, I can make changes to it, and give them an approximation of what surgery can do. I can do things like bring the bump on their nose down, or turn the tip of the nose up. Make all these little changes the patient can view, and see this new nose on themselves.”
In addition, AI algorithms can analyze and identify existing asymmetry in breast size, position or nipple placement, providing important insight on implant sizes, shapes and placement techniques, said Leedy.
Sophisticated machine learning also has a place in non-cosmetic areas encompassing burn treatment, hand surgery and wound analysis, said Leedy. AI tools currently assist surgeons in assessing burn severity and in the recommendation of optimal treatment options. Such applications also have a place in the precise planning and execution of reconstrcutive hand procedures, as well as in the monitoring and treatment of wounds.
Though artificial intelligence is not a permanent substitute for Leedy’s catalog of “before and after” cosmetic shots, another layer of detailed data is nothing but beneficial, he said.
“Or when it comes to an abdominoplasty (tummy tuck), you can look at a body type and say, ‘Okay, let me show someone who looks similar to you, and this is what their outcome was like,’” Leedy said. “That still is the best way to educate people; to show them real-life examples of people you operated on. AI just furthers the conversation - a supplement to what’s already done.”
A few ground rules…
AI will never fully replace physicians and surgeons, noted the technology’s Cleveland-based backers. However, clinicians who use it properly will enjoy a professional and competitive advantage.
Responsible implementation starts with training algorithms to avoid perpetuation of unrealistic beauty standards, said Leedy. Anything to keep people from believing in airbrushed “wish” pictures, or social media images that cannot be realistically replicated.
Ultimately, trying to “quantify beauty” with AI represents a slippery slope, Leedy said.
“(Beauty) is so individualized – what looks good for one person may not look good for another,” he said. “It varies across ages and race, and all sorts of other variables. I hope AI doesn’t change our perception of beauty, because there isn’t one standard. We shouldn’t be chasing something that’s computer-generated.”
Ponsky, the Cleveland facial plastic surgeon, pointed to the 2022 Miss Korea pageant as a warning of a dire future. Onlookers criticized the contestants for looking too similar to one another – an attractiveness ideal sculpted by rampant plastic surgery with the women involved compared to “virtual AI humans.”
With AI a relatively new development in the field, there are few established rules governing its use. Any regulatory framework should include rigorous testing of algorithms to ensure their accuracy, effectiveness and freedom from bias, Ponsky said.
As a skilled and experienced cosmetic surgeon will always be essential to successful outcomes, these practitioners will need training on not only AI’s wide-ranging capabilities, but its limitations and prejudices as well, she said.
“Already, there’s an abundance of things on social media that are probably unrealistic results produced by AI,” said Ponsky. “Regulations will help us, but governmental regulations will be a lot slower to evolve. It will depend on the physicians who are versed in doing this - for those professionals to say, ‘Hey, that doesn’t seem like it’s possible.’ We can only hope to educate everyone on it.”
