What’s better: authenticity or so-called perfection?
A growing number of people are turning to chatbots for advice on cosmetic procedures, then bringing AI-generated images of their own “dream face” to surgeons and asking them to recreate the look. That’s according to cosmetic surgeons who say they’re seeing this trend crop up more and more in consultations.
Aiming for AI-generated perfection is becoming incredibly popular.
According to a survey by the British Association of Aesthetic Plastic Surgeons, 15% of the 59 members who responded said patients have already walked in clutching AI-altered images of themselves, expecting surgeons to mirror the digital tweaks in real life. It’s a trend that’s raising serious eyebrows across the industry, putting consultants in the tricky position of having to explain where digital fantasy stops and basic human anatomy begins.
One reporter put chatbots to the test.
To see exactly what these tools produce, a reporter tested the two most widely used AI chatbots in the UK, uploading a photo and asking each one what changes might be suggested. One chatbot didn’t hold back, generating a full collage of “recommended procedures” including chin enhancement, under-eye corrections, jawline enhancement, skin optimisation, nose refinement, and lip adjustments, with only the last two flagged as “optional.”
It added a disclaimer explaining it couldn’t say what someone “should” change, only point out features that stood out and suggest procedures people commonly consider based on them, while noting the results weren’t exact predictions. It also recommended going conservative, since subtle changes tend to age better and look more natural over time.
The second chatbot took a notably more cautious approach, opening by stating it couldn’t offer recommendations for specific medical or cosmetic procedures, since these are significant decisions requiring a consultation with a qualified medical professional who can assess someone’s unique facial structure and talk through the benefits and risks involved. It did acknowledge that some people explore treatments to define the jawline, reshape the nose, or reduce fine lines, but was clear that any images it generated were strictly for illustrative purposes only.
Are these AI-generated results even achievable in real life?
The real question is whether what these chatbots produce is possible to recreate through surgery. According to one medical aesthetics practitioner, the answer is often simply no. Looking at the more dramatically altered version of the reporter’s face, she was blunt that the suggestion was unrealistic and simply not achievable, describing it as anatomically impossible for some people to attain the results shown, no matter what procedure they underwent.
She also raised a separate concern, that uploading a photo for AI critique could surface insecurities people hadn’t previously considered at all, something that could work against a person’s wellbeing depending on what the AI happened to flag.
What this means for surgeons and patients
The president of the British Association of Aesthetic Plastic Surgeons said that while AI can help surgeons understand exactly what outcome a patient is hoping for, it also highlights just how important patient education has become before any procedure goes ahead.
Being honest with patients about what’s achievable, and equally honest about which parts of an AI-generated image are completely unrealistic, matters enormously. In some cases, an AI-generated image essentially guarantees disappointment from the outset because the procedure being imagined was never possible to begin with.
There’s a real risk of turning to unqualified practitioners.
There’s also a real worry that if a qualified surgeon turns down a patient because their AI-generated image is unrealistic or potentially unsafe to pursue, that patient might instead seek out an unqualified practitioner willing to promise the same result.
According to the association’s president, there are unfortunately plenty of examples within cosmetic procedures of underqualified individuals using aggressive marketing tactics, agreeing to procedures without giving patients accurate information beforehand, or without having the skill required to deliver what’s being promised. She said it’s fine to treat these AI tools as a bit of fun, uploading a photo just to see what changes might come back, but stressed they absolutely shouldn’t be relied upon as an accurate simulation of real surgery just yet.
How do these AI tools generate the images?
It’s important to understand that AI chatbots don’t “see” a photo the way a person does. According to an AI expert and content creator, these systems are essentially calculators that convert an image into a string of numbers, then use whatever prompt they’re given to generate an entirely new string of numbers in response.
The AI doesn’t actually see someone’s real face, isn’t their surgeon, and has no understanding of their skin texture, muscle depth, or underlying fat and skin tissue. Instead, it makes predictions based on things like a person’s apparent race and estimated age, factoring in lighting conditions within the uploaded photo, before generating its best guess at what to edit based on the prompt it was given.
Crucially, she stressed that AI should never be trusted for advice around cosmetic surgery. She described these tools as prediction engines, with outputs shaped entirely by prior chat history, the specific prompt used, and even how someone happened to be positioned in their photo. Since it’s all fundamentally a mathematical prediction, she said, the results shouldn’t be taken at face value.
What the company behind one chatbot has said
OpenAI, which owns and operates ChatGPT, said that hundreds of millions of people search the internet for health information every single day. The company said it believes AI can improve that experience by helping people find clearer answers and better prepare for conversations with professionals, but stressed that ChatGPT is not a clinician, and should never be used as a substitute for professional medical care and advice.
