‘You can’t control everything’: the rise in plastic surgeons asked to create ‘AI face’ | AI (artificial intelligence)

Plastic surgeons are increasingly concerned about the rise of the “AI face,” as more clients arrive at their offices with unrealistic AI-generated visions of what they want to look like.

Dr Nora Nugent, a cosmetic surgeon from Tunbridge Wells, has seen it firsthand. Clients began coming to his office with photos of themselves enhanced by AI and with the mistaken hope that these results could be achieved through surgery. She is also president of the British Association of Aesthetic Plastic Surgeons and says many colleagues have similar experiences.

“I can only predict an increase, given the speed at which AI has been integrated into every aspect of life,” she said.

People using AI chatbots to generate their ideal faces are increasingly arriving in surgeons’ offices with briefs demanding flawless skin, well-sculpted cheekbones, slim noses and near-perfect symmetry – standards that are too time-consuming, prohibitively expensive and, in many cases, physically inaccessible.

Even if AI can control every pixel, “surgery certainly doesn’t work at that level of microscopic detail”, according to Dr Alex Karidis, a surgeon based in west London.

However, for many clients, these expectations are shaped long before they meet a surgeon. Karidis and Nugent describe how AI-generated images can be psychologically effective in defining – and reinforcing – customers’ aesthetic ideals.

Nugent said: “Once you see an image, it’s connected to you. » Karidis agreed, describing the AI ​​images as being “burned” into patients’ minds, and said his colleagues had recently been inundated with them.

Surgeons are also keen to point out that the results of cosmetic surgery are far from guaranteed.

“The patient needs to understand that there are human variations in how they heal, how they age and what can be done,” Nugent said. “I tell patients in advance: what I can do in surgery is not unlimited. None of us controls everything.”

To better understand the phenomenon, I asked an AI agent to recommend cosmetic procedures and generate images for Karidis to review. As I requested more and more radical changes to my appearance, the agent ended up warning me about the feasibility of the operations I was proposing.

But Karidis says that when customers do in-depth research about cosmetic procedures, they often focus on the pictures and ignore “all the noise” around them.

“That’s the main thing for everyone. Once you show them something like that, that’s it,” he said.

Surgeons have also noticed consistencies in the aesthetics of the “AI face,” including hyper-symmetry – something that AI can generate effortlessly but is often impossible to recreate in real life.

If one of your eyes is a few millimeters higher than the other, AI can change that in seconds, according to Harley Street cosmetic surgeon Dr Julian de Silva. But rearranging pixels is not the same as rearranging anatomy.

“It is impossible to change [eye level] because it’s actually fixed in the bones and your brain is behind the eye sockets. You can’t safely change the position of the orbits,” he said.

De Silva added that when AI edits a customer’s photo, it often defaults to widely accepted beauty ideals: for women, a V-shaped jawline, an “ogean curve” along the cheekbones, and a heart-shaped face; for men, wider jaws, lower eyebrows and fuller upper eyelids.

But De Silva is also concerned about another growing trend: clinicians sharing surgery results on social media that appear surprisingly effective, but which he suspects are themselves generated by AI.

“I remember watching one last week and I watched it over and over again,” he said, recalling a video in which a patient appeared to look 30 years younger. “And then the third time I looked at it, I could see… that the hands had six fingers.”

My trip to the surgeon

After generating embellished versions of myself, I asked Karidis to share his thoughts on AI recommendations.

I told the chatbot that I was considering cosmetic surgery and asked for “some improvements” to my photo. I also asked him to explain the virtual surgeries he had performed. He performed a rhinoplasty and septoplasty on me, “refining the tip of the nose and straightening the bridge”. He also applied “a subtle blepharoplasty [eyelid lift] and the refinement of the eyebrows.

Karidis said the rhinoplasty was relatively modest and the blepharoplasty barely noticeable, but estimated the work would still cost around £25,000.

I then asked my virtual assistant to give me “hunter’s eyes and a more masculine face.” It recommended chin implants, buccal fat removal, infraorbital augmentation, another blepharoplasty, facial stubble grafts and a handful of other procedures.

“This is where things start to get a little silly,” Karidis said. “Looks like it gave you someone else’s eyes.” He says the chin implant is not necessary and that I will “pay the price” for buccal fat removal later in life, as my face has naturally become skinnier with age.

“If one were to theoretically do everything this suggests, it would easily cost over £100,000 and probably wouldn’t look like this, not to mention you would be exposed to significant potential side effects and recovery.”

“Make me look more like a child,” I then asked the chatbot. He responded with other recommendations, including a neck lift, a brow lift, two types of custom implants, and full ablative laser resurfacing to create “fresh, perfectly even skin.”

“This is where things start to look scary,” Karidis said. “What are those huge bumps along the corner of your jaw? They look like pieces of tissue have been removed.”

“As for the neck lift and brow lift, that’s frankly wrong. I don’t see any evidence of a lift in those areas. Tissues like the brows appear to have been lowered rather than raised. Your original skin tone looks much better than this.”