These days, what constitutes beauty seems to be an ever-moving target. I grew up in time when airbrushing in magazines was the distorted standard we often held ourselves up to when we looked in the mirror. Now, with AI-generated images flooding our feeds, unrealistic has taken on a whole new meaning. While it’s an exciting time for the field of aesthetic medicine where consumers can address a variety of skin and body concerns with a wide array of technological options (many which are non-invasive), it also poses some ethical questions. For example, what is considered too far, who is setting the boundaries for patients, and what responsibilities do medical professionals providing these services have?
Dr. Steven Williams
To answer these questions, I turned to three highly regarded medical professionals to get their thoughts on the matter including two plastic surgeons and board-certified nurse practitioner. For the plastic surgeons, I tapped Dr. Steven Williams, who is a Board-Certified plastic & reconstructive surgeon, President of The American Society of Plastic Surgeons (ASPS), founder of Tri Valley Plastic Surgery in San Francisco in addition to Dr. Jennifer Levine, who is a double Board-Certified facial plastic surgeon who has both her own practice and is an attending plastic surgeon at Manhattan Eye, Ear, and Throat Hospital at Lenox Hill Hospital. I also reached out to Alexa Maestrone, FNP-BC who for several years worked along New York City’s most prestigious plastic surgeons and who now specializes in aesthetic medicine, for her perspective.
When I ask Williams, who has a background in tech, what he thinks is the biggest impact technology will have on medicine, either good or bad he explains to me that the biggest positive impact will be the ability to accelerate and improve analyzing research. “It’s already clear that artificial intelligence has the ability to consume and analyze large quantities of data and create new associations or insights that aren’t immediately visible to the human eye. This will change how healthcare is delivered and impact the lives of everyone.”
The biggest downside of technology as he sees is it how social media is being used. “AI can make smart filters and images not based in reality like looking like their avatar or not wanting to age at all. AI can be used to create advertisements and algorithms to promote these images. The is getting a lot of attention in the medical community. I would say that a lot of people are trying to make safeguards to protect and inform patients on realistic expectations. As AI gets smarter, it could get around the safeguards we set up. But it isn’t all doom and gloom.”
Dr. Jennifer Levine
Levine, who specializes in delivering symmetrical results for her patients tells me that her office currently uses many devices in her practice that incorporate AI to offer precise and controlled treatments. “AI has the ability to help us stay looking our most youthful by making small changes that are done precisely and regularly that will alter the way we age. We are able to curate customized aesthetic treatment plans that combine invasive and noninvasive procedures to provide our patients with the best result with as little downtime and pain as possible.” The downside she sees echoes Williams’ sentiment—that AI generated photos are problematic. “We’re being exposed to highly altered images and people are beginning to view these as beauty standards. I think that in the future more people will be calling out these images and hopefully not allowing them to be used.”
“Physicians have an obligation to address body dysmorphia or unrealistic expectations. These are very important conversations. But we have to balance that with peoples’ autonomy,” Williams tells me when I ask what the expectation should be of doctors. “Sometimes patients are frustrated when we point out the limitations, but most understand that safety must come first and that not everything they see online is real. In the future, I think we will see an increase in unrealistic expectations of eternal beauty, perfect form and figures on social media that becomes a part of our society’s fabric.”
When I ask Maestrone how she addresses patients who have unrealistic expectations she tells me, “Patients are surprised when I say ‘no’ to unnecessary treatments. I will not drastically alter appearances as this detracts from their unique essence. When overdone, the result is the homogenized ‘beauty’ we so often see.” Maestrone takes a direct and honest approach with her clients. “I emphasize realistic outcomes and educate them on the risks and limitations of treatments. In the medical community, responsible practitioners play a pivotal role in setting ethical standards. Collaboration, ongoing education, and promoting authenticity over trend-driven transformations are key to ensuring that aesthetic procedures prioritize the well-being of patients rather than conforming to fleeting ideals.”
Alexa Maestrone, FNP-BC
Levine shares that she feels very fortunate that most of her patients have realistic expectations, but there have been a few instances where they will show a picture of results that are unattainable for that individual or inconsistent with their anatomy. “I try to set realistic expectations from the beginning. Prior to initiating any treatment, we always review patients' photos with them to determine the best plan. Our goal as a medical community overall is to deliver a natural result that enhances the patients’ individual beauty, results should not be trending.”
It will be interesting to see how this will play out. I spoke to very reputable medical professionals, so it isn’t a surprise that they approach this pragmatically seeing both the good and bad aspects of technology in aesthetics. But doctors and other medical professionals are humans too, which means there may be some who don’t hold themselves up to the same standards as these folks do. It is huge industry that continues to grow exponentially with many specialties wanting a piece of the pie—all of which to say that it comes down to the patient really being proactive in doing their due diligence.
