Subscribe to RSS

DOI: 10.1055/s-0045-1807751
The Ethical Challenges of Artificial Intelligence in Plastic Surgery
Article in several languages: português | EnglishFinancial Support The authors declare that they did not receive financial support from agencies in the public, private or non-profit sectors to conduct the present study.

Abstract
Introduction
Artificial intelligence (AI) has been growing around the world and in Portugal due to the rapid progress of technology. Its use raises important ethical questions; therefore the establishment of ethical standards is essential for an adequate and lasting application of AI. The present article aims to explore the role that AI may have in plastic surgery as well as the ethical issues that may arise due to its use.
Objective
To investigate the barriers to the introduction of AI in the field of plastic surgery. The subsidiary objective is to address the ethical aspects related to this topic.
Materials and Methods
Between December 2023 and February 2024, we conducted a search on the PubMed/MEDLINE and Science Direct databases for articles that answered the research question. All titles and abstracts found were systematically evaluated. Those that were considered relevant were later read in full to be compared with the inclusion and exclusion criteria. For each of the studies, a table was created with the authors, the place and year of publication, and the conclusions.
Results
We selected eight articles that enabled us to discuss several points, namely: the consequences of the use of AI in plastic surgery in terms of data protection, privacy, equity, and transparency of algorithms.
Conclusion
Being aware of the barriers and ethical dilemmas that arise when using AI in plastic surgery is essential for quality clinical practice. Recognizing and addressing these barriers earlier makes it possible to legislate and regulate this surgical filed with technological advances to maintain safety in clinical practice and patient confidence.
Ethics Declaration
No primary data were collected in this study. Ethical approval and consent to participate do not apply, according to legal regulations, consent for publication is also not applicable.
Authors' Contributions
FVP: methodology and writing – original draft. AGA: final manuscript approval and writing – review & editing.
Publication History
Received: 04 September 2024
Accepted: 16 November 2024
Article published online:
14 May 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil
Francisca Vieira Pais, Abel García Abejas. Os desafios éticos da inteligência artificial na cirurgia plástica. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451807751.
DOI: 10.1055/s-0045-1807751
-
Referências
- 1 Choi E, Leonard KW, Jassal JS, Levin AM, Ramachandra V, Jones LR. Artificial intelligence in facial plastic surgery: A review of current applications, future applications, and ethical considerations. Facial Plast Surg 2023; 39 (05) 454-459
- 2 Mijwil MM, Aggarwal K, Al-Mistarehi AH. et al. Has the future started? The current growth of artificial intelligence, machine learning, and deep learning. IJCSM 2022; 3 (01) 115-123 . Available from: https://www.iasj.net/iasj/download/cefbfd60eb11898
- 3 Auger SD, Jacobs BM, Dobson R, Marshall CR, Noyce AJ. Big data, machine learning and artificial intelligence: a neurologist's guide. Pract Neurol 2020; 21 (01) 4-11
- 4 Rokhshad R, Keyhan SO, Yousefi P. Artificial intelligence applications and ethical challenges in oral and maxillo-facial cosmetic surgery: a narrative review. Maxillofac Plast Reconstr Surg 2023; 45 (01) 14
- 5 Sterodimas A, Radwanski HN, Pitanguy I. Ethical issues in plastic and reconstructive surgery. Aesthetic Plast Surg 2011; 35 (02) 262-267
- 6 Amaral MJ. View of Plastic surgery or esthetic surgery?. Acta Med Port 1998; 11 (02) 97-99 . Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2221/1640
- 7 Jonas H. The imperative of responsibility: In search of an ethics for the technological age. University of Chicago Press; 1985
- 8 Beauchamp TL, Childress JF. Principles of biomedical ethics. Oxford University Press; 2019
- 9 Solove DJ. Understanding privacy. Harvard University Press; 2008
- 10 European Union. General Data Protection Regulation (GDPR). 2016
- 11 Angwin J, Larson J, Mattu S, Kirchner L. Machine bias. . ProPublica; 2016 . Available from: https://www.propublica.org/article/machine-bias-risk-assessments-in-criminal-sentencing
- 12 Barocas S, Selbst AD. Big data's nonsense impact. Calif Law Rev 2016; 104 (03) 671-732
- 13 Mittelstadt BD, Allo P, Taddeo M, Wachter S, Floridi L. The ethics of algorithms: Mapping the debate. Big Data Soc 2016; 3 (02)
- 14 Jobin A, Ienca M, Vayena E. The global landscape of AI ethics guidelines. Nat Mach Intell 2019; 1: 389-399
- 15 Koerich MS, Machado RR, Costa E. The ethics and the bioethics: an initial reflection. Text Context Nursing. 2005; 14 (01) 106-110
- 16 Hawker S, Payne S, Kerr C, Hardey M, Powell J. Appraising the evidence: reviewing disparate data systematically. Qual Health Res 2002; Nov 12 (09) 1284-1299 PMID: 12448672.
- 17 Sun Y, Huang X, Zhang Q, Lee SY, Wang Y, Jin K. et al. A fully automatic postoperative appearance prediction system for blepharoptosis surgery with image-based deep learning. Ophthalmol Sci 2022; 2 (03) 100169
- 18 Kato T. An attempt to analyze facial photographs of patients with jaw deformity using artificial intelligence. J Oral Maxillofac Surg Med Pathol 2024; 36 (04) 478-482
- 19 Elliott ZT, Bheemreddy A, Fiorella M, Martin AM, Christopher V, Krein H, Heffelfinger R. Artificial intelligence for objectively measuring years regained after facial rejuvenation surgery. Am J Otolaryngol 2023; 44 (02) 103775
- 20 Yun JY, Kim DJ, Lee N, Kim EK. A comprehensive evaluation of ChatGPT consultation quality for augmentation mammoplasty: A comparative analysis between plastic surgeons and laypersons. Int J Med Inform 2023; 179 (105219): 105219
- 21 Goodyear K, Saffari PS, Esfandiari M, Baugh S, Rootman DB, Karlin JN. Estimating apparent age using artificial intelligence: Quantifying the effect of blepharoplasty. J Plast Reconstr Aesthet Surg 2023; 85: 336-343
- 22 Akgün FA, Fındık Y, Solak S, Uçar MHB, Büyükçavuş MH, Baykul T. Face comparison analysis of patients with orthognathic surgery treatment using cloud computing-based face recognition application programming interfaces. Am J Orthod Dentofacial Orthop 2023; 163 (05) 710-719
- 23 Abdelhady AM, Davis CR. Plastic surgery and artificial intelligence: How ChatGPT improved operation note accuracy, time, and education. Mayo Clin Proc Digit Health 2023; 1 (03) 299-308
- 24 Patcas R, Bernini DAJ, Volokitin A, Agustsson E, Rothe R, Timofte R. Applying artificial intelligence to assess the impact of orthognathic treatment on facial attractiveness and estimated age. Int J Oral Maxillofac Implants 2019; 48 (01) 77-83