Plastic surgeons are expressing growing concern about the emergence of what is being termed “AI face.” Increasingly, individuals are visiting their offices with AI-generated images that set unrealistic beauty standards for their desired appearances.
Dr. Nora Nugent, a cosmetic surgeon from Tunbridge Wells and president of the British Association of Aesthetic Plastic Surgeons, has observed this trend firsthand. Many of her clients arrive with digitally enhanced photos of themselves, believing that surgical enhancements can achieve those idealized results. This experience, she notes, is not unique to her practice but is echoed by many of her colleagues in the field.
“It’s hard to see an end to this trend, considering how AI has permeated nearly every part of our lives,” Nugent stated.
Patients increasingly come equipped with specific requests for perfection, demanding features such as flawless skin, chiseled cheekbones, and ultra-symmetrical facial structures. However, these high standards may be unattainable due to the limitations of surgery, which lacks the precision offered by AI-generated imagery, as pointed out by Dr. Alex Karidis, a west London surgeon.
For these clients, the unrealistic expectations shaped by AI often precede their consultations with surgeons. Both Nugent and Karidis have highlighted the profound impact that AI-generated visuals have on clients' perceptions of beauty.
Nugent remarked, “When you see an altered image, it becomes part of your mental framework.” Karidis referred to these images as being “burned” into patients' memories, noting a concerning influx of such requests in recent months.
Surgeons stress that outcomes from cosmetic procedures are not guaranteed. “Patients must recognize the variability in healing processes and the effects of aging,” Nugent said. “I make it clear that my surgical capabilities have limits, and neither of us can control every variable in the outcome.”
To explore this phenomenon further, I consulted an AI program to generate cosmetic enhancement suggestions and accompanying visuals for Dr. Karidis’ review. During the process, as I requested increasingly drastic changes to my appearance, the AI began to nudge me toward the feasibility of the procedures.
Karidis observed that when patients conduct extensive research on cosmetic enhancements, they tend to focus solely on the images presented, often overlooking other crucial contextual information. “The moment they see an appealing image, their decision is made,” he said.
Surgeons have also noted a recurring theme within “AI face” standards, particularly the trend toward hyper-symmetry. AI can seamlessly adjust features—like elevating one eye slightly higher than the other—something that is much more challenging to achieve through surgical means. Dr. Julian de Silva, a cosmetic surgeon practicing on Harley Street, emphasized that such changes are fundamentally constrained by bone structures.
De Silva also raised concerns about the trend of practitioners showcasing their surgical results on social media, where images may appear unrealistically perfected, potentially using AI enhancements. He recounted a specific video of dramatic transformations where he noticed unsettling details, such as a patient depicted with six fingers.
After experimenting with the AI to create idealized versions of myself, I sought Karidis' insights on the changes proposed. The AI suggested procedures like rhinoplasty and subtle eyelid lift, producing a makeover that, although modest, would end up costing around £25,000 according to the surgeon.
When I pushed for more masculine features, the AI suggested various surgeries—including chin implants and buccal fat removal—raising flags for Karidis. “This advice borders on absurd,” he remarked. “The result looks entirely unlike your original features.” He cautioned that the suggested buccal fat removal could lead to an overly gaunt appearance as one ages.
Finally, I prompted the AI for a request to enhance traits associated with a more stereotypical masculine look. The AI recommended extensive procedures, such as a neck and brow lift, alongside full laser resurfacing. “This is where it starts to become alarming,” Karidis explained. “Your jawline appears unnatural, as if parts have been excessively altered. In reality, there’s no evidence of lifting; it looks more like the features have been distorted rather than enhanced. Your natural look is far more appealing.”
