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Artificial Intelligence and Plastic Surgery

By Dr. Deborah Ekstrom

Our first introduction to AI (Artificial Intelligence) probably occurred when we first asked Alexa to play us a song or asked a few simple questions about the weather or the drive to work.

The release of ChatGPT on the internet has brought AI front and center into our daily lives. Questions abound. “What is Artificial Intelligence?” “How is it used?” The common question, “Could it be misused?” And most importantly, “How is it likely to impact my life as an individual and the work that I do?”

Britannica describes Artificial Intelligence as “the ability of a digital computer or computer–controlled robot to perform tasks commonly associated in the intelligent beings.” Examples include the ability to reason, discover meaning, generalize, or learn from past experiences.

I’m skeptical that computers will completely replace human thinking, since humans are “meaning making machines” themselves, often getting the cues wrong and having trouble learning from past experiences, and not letting the past go…

To date, computers can carry out complex tasks, and beat the best masters at chess. But so far, computers cannot match humans at the intellectual flexibility and emotional intuition that remains unique to our species.

As far as the use of artificial intelligence in plastic surgery, iPhone pictures of skin biopsy specimens (with an attached magnification lens called a dermatoscope) can assist in the diagnosis of melanoma. Studies show that the accuracy of the photo with the dermatoscope is more accurate than inspection by a physician alone, but false positives and negatives still make a biopsy and pathological examination essential.

Without a doubt, we have only scratched the surface of what AI can do. I can imagine a day when you will be able to have a visit with an AI generated primary care robot that will review your symptoms, as you submit yourself for blood work and technology-based exams and then prescribe lifestyle changes and medications or treatments. This AI “physician” will always kind and will never be sleep-deprived or overburdened with administrative tasks and will always lends a listening, sympathetic ear. Research shows that patients respond well to such non-human interventions, and such a scenario could become more common in the future. But is it likely that robots and computers will take over cosmetic surgery? While I think that unlikely, who knows what might happen?

Italy just shut down ChatGPT due to a data breach. Others have concerns that AI is being adopted too quickly without fully exploring the dark side of Artificial Intelligence ………. and there always is a downside. Sundar Pichai, the CEO of Google, and Elon Musk have recently questioned the safety of AI.

So, stay tuned to the trials and tribulations of Artificial Intelligence and be ready to pivot if you find that AI wants to replace you (or me) in our work or professional lives. But this you can be sure of—AI is here to stay and probably in ways none of us has ever thought of! (P.S this blog post was not generated by ChatGPT.)

Spotlight on Plastic Surgery – What is the right age for a facelift?

by Juris Bunkis, M.D., F.A.C.S.

The answer to this question is the same as with any other aesthetic procedure we offer –
1) when there is enough of a deformity to warrant a surgical correction
2) when there is patient’s awareness of the issue
3) when there is a desire on the patient’s part to have an improvement
4) when the patient has an understanding of the procedure and an acceptance of surgical risks.

In other words, there isn’t an age that fits all patients for facial rejuvenation (or any other procedure). A sagging of facial tissues, jowl formation and neck laxity occur universally, in everyone, with time, but the exact age when this occurs varies from person to person. Normally, there isn’t enough laxity prior to the mid-40’s to warrant a facelift but I have seen patients who were in their late 50’s who I told to wait another year before considering a facelift (I did not have my facelift until I was in my mid 60’s). And conversely, I saw a 38 year old male two weeks ago who had a very significant midface groove and jowling (a “family trait” as he called it). This is unusual in someone that age, in someone who is thin and does not have a history of weight loss – he is a good candidate for a facelift, none-the-less, if he chooses to have one. I have also seen many patients in their late 30’s and early 40’s after massive weight loss who have sufficient skin laxity to expect improvement following a facelift. I have operated on patients for the very first time in their late 80’s and early 90’s who really wanted a facial rejuvenation procedure – these patients told me that doing so earlier had never occurred to them! And of course, we see many who have their first lift at the earliest signs of sagging in their forties, and who come back regularly, as long as their health holds up, for maintenance.

Just the presence of a midface groove, jowling or neck laxity is not an indication for facelift surgery in and of itself. Patients have to decide for themselves if the signs of aging bother them sufficiently to consider surgical correction. And once the desire has been demonstrated, a careful discussion of the indications for surgery, alternatives and risks are discussed with the patient and the patient must provide an informed consent to proceed.

Artificial Intelligence might be able to tell us if we have enough of a skin sag to expect improvement from a surgical procedure – but it cannot tell us if we are emotionally ready for the surgery!

This 40 year old woman consulted following massive weight loss. She is seen here before and after Dr. Bunkis’ “A-to-V facelift” and lower eyelid blepharoplasty

This is a more typical patient, who presented in her late 50’s for her first facelift, upper and lower eyelid blepharoplasty and brow lift.

This last patient was 85 years old when she first saw us and told us that she was “just tired of looking old”. Her health was otherwise fine and we did a facelift, upper and lower eyelid blepharoplasty and a brow lift to give her a look she loved.

(All actual patients of Dr. Bunkis)

If you want to see if you can have any part of your body improved, contact us for a consultation:

For CA, please call 949-888-9700 or visit
Or for MA location, call 508-755-4825 or visit

You can write to
Dr. John Compoginis at Contact Us Form
Dr. Staci Compoginis at Contact Us Form
Dr. Deborah Ekstrom at
or Dr. Juris Bunkis at Contact Us Form