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AAI 85: AI Transforming Aesthetic Medicine: Experts’ Consensus

August 20, 2024

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In this episode of “Anti-Aging Insights,” Dr. Teri Fisher delves into a groundbreaking topic: the role of artificial intelligence (AI) in aesthetic medicine. Dr. Fisher highlights the recent consensus reached by experts in the field about the transformative potential of AI. This discussion underscores how technology intersects with beauty and wellness, providing both exciting opportunities and looming challenges.

Dr. Fisher revisits his five personal pillars for an aesthetic practice: safety, customized treatments, expertise, natural results, and enjoyable experiences. He explains that AI can significantly enhance these pillars, particularly in the areas of safety, customized treatments, and natural outcomes.

The episode discusses the limitations of traditional scales used for assessing appearance and treatment outcomes, which are often subject to human bias and variability. AI offers a viable alternative for more objective and reliable assessments by considering the holistic nature of the human face. This led to an international consensus meeting in February 2024, where experts discussed guidelines for the ethical and practical integration of AI in aesthetics.

Key findings from this consensus include several unanimous points:
1. AI can standardize and improve patient assessment and consultation.
2. AI can help prevent overcorrection, a critical concern.
3. There is a need for validated objective facial assessments, such as the Facial Aesthetic Index (FAI).
4. AI must consider gender and age in skin quality assessments.
5. Patients wearing makeup should be excluded from baseline AI examinations.
6. AI systems should incorporate patients’ ancestral roots into their analysis to ensure fairness and accuracy.

The consensus highlighted the importance of considering ethnic and cultural differences in AI assessments. For example, the AI model should account for unique facial features among East Asians, Indians, Europeans, Latin Americans, and Africans to ensure equitable and personalized treatments.

Dr. Fisher concludes that AI has the potential to revolutionize patient assessments and treatment efficacy, but its integration must be thoughtful, inclusive, and ethical. It’s not about replacing human touch but enhancing it to achieve more precise, natural, and satisfying results for patients.

Listeners are encouraged to visit DrTeriFisher.com for the latest updates and connect with Dr. Fisher on Instagram @DrTeriFisher.

Key Insights

  • AI can help standardize and improve patient assessments and consultations in aesthetic medicine.
  • AI contributes to preventing overcorrection, a major concern in aesthetic treatments.
  • AI should incorporate gender and age factors when assessing skin quality to ensure accurate evaluations.
  • Patients wearing makeup should be excluded from AI baseline examinations to maintain assessment accuracy.
  • AI systems must include patients’ ancestral roots in analyses to deliver equitable and personalized treatments.

Episode Transcript

Hey there and welcome to another episode of Anti-Aging Insights. As always, I’m your host, Dr. Teri Fisher. And today we are diving into a fascinating and very timely topic, the role of AI, or artificial intelligence, in the field of aesthetic medicine. Now I have done some episodes on AI in the past, but the difference here is that recently a consensus was arrived at, by a number of experts in aesthetic medicine. And I wanted to highlight to you today what came of this meeting, what came of this consensus, and what were identified as the key issues when it comes to AI and aesthetic medicine.

So as part of this podcast, we are going to explore how technology, and again specifically AI, intersects with the art of beauty and wellness. As you know, the landscape of aesthetic medicine is constantly evolving and with it comes exciting opportunities and also some challenges as well. Recently, as I mentioned, there was an industry shaping consensus among experts about how AI can revolutionize our approach to aesthetics. And that is essentially what we are discussing today.

So before we dive in, I just want to remind you that my five personal pillars, when it comes to my aesthetic practice is safety, customized treatments, expertise, natural results, and enjoyable experiences, or as I like to call them, the scene, the things that set the scene, S C E N E, and this entire discussion on AI in aesthetics ties back to these pillars, particularly enhancing the safety, improving customized treatments, and ensuring natural results. So that’s why I think this is really, really important and let’s get started.

So let’s set the stage by understanding the problem that AI aims to address in aesthetic medicine. Traditionally, we rely on validated scales for assessing appearance and treatment outcomes. What does that mean? These are specific scales that have been developed that we can use to try to give us consistent assessments of people’s skin, of people’s features, and how we can use those scales to try to keep things as objective as possible. The problem and the limitation with these scales is primarily based on the human subjectivity and the biases that can affect the consistency and that objectivity of the evaluations.

Human variability is immense. What one practitioner might see as an improvement another might see differently. And so that’s where AI enters the scene. Researchers have recognized that AI offers a promising alternative by providing more objective and reliable assessments that consider the holistic nature of the human face.

So you can imagine AI as a tool that can standardize our evaluations, making them more consistent and hopefully more free from individual biases. But of course, along with that come some concerns about privacy and standardization. So to address these issues, this global consensus of experts was gathered to discuss and develop guidelines for the use of AI in this field. This is groundbreaking work and the goal was to create a framework to guide the integration of AI into our practice while addressing some of the ethical and practical concerns.

So how did this consensus come about? Well, it’s an international group of experts across multiple specialties in plastic surgery and dermatology among others. And they met and developed a series of guidelines and recommendations. They used an online survey as a starting point, gathering their initial thoughts and opinions, which were then reviewed, and refined during their meeting, which happened in February of 2024. They continued to discuss this until they reached a majority agreement. And this iterative method ensured that the final guidelines were comprehensive and reflected this collective expertise in the room.

So let’s look now at some of these key findings from the pre consensus survey. Many experts felt that AI is under utilized in the field of aesthetic medicine and they saw a significant potential for AI in treatment monitoring, identifying options, and improving efficiency. They emphasized the importance of tools for objectifying facial exams, particularly through photographs, which when combined with the provider experience, felt that that could greatly enhance patient care.

There was a unanimous agreement on several of the key points that came about during this consensus. Number one. AI can help standardize and improve patient assessment and consultation. Number two. AI can help prevent overcorrection, which is a critical concern in this field. Number three. The need for validated objective facial assessments is there, like the facial aesthetic index (FAI), facial youth index (FYI), and skin quality index (SQI). AI should consider gender and age when assessing skin quality. That was number four. Number five. Patients wearing makeup must be excluded from AI examination at the baseline. And number six, AI systems should incorporate patients’ ancestral roots into the analysis.

The last point about ancestral roots is particularly interesting and vital. The panel provided some detailed analyses of facial features across different ethnic groups, emphasizing the importance of considering these factors in AI assessments to ensure that we deliver equitable and personalized treatments. Why is this so important? Well, it’s really interesting because an AI model is trained on data, and if we’re training an AI model on a person that is not of the same ethnic descent that we’re going to use that model on it’s not relevant. It’s in fact quite biased. And so when we go to train the model that ethnic origin has to be included.

Some of the features that were identified are, for example, in east Asians, monolid eyes, square, lower face shapes, broader mid faces, flattened shorter noses, and typically retruded chins.

For Indians, prominent foreheads, brown to black hair and eyes, larger eyes, well-defined tear troughs and retruded chins.

For European, gender differentiated eyebrow shapes (more peaked for women and horizontal for men) convex foreheads, high zygomatic arches, thinner lifts and static wrinkles as a sign of aging.

For Latin Americans, skin tones from the Fitzpatrick skin types two to five, varied eye colors, smaller foreheads, bizygomatic distance equal to or smaller than the bigonial distance, and lips with greater than 20% of the lower facial width.

And for African, darker skin tones with a Fitzpatrick skin type greater than three, shorter noses, but broader than one fifth of the facial width, lips broader than one third of the lower facial third, a forehead broader than one third of the facial length in a neutral or positive canthal tilt, even in elderly patients.

So you can see that there are lots of variabilities here, and if we just trained an AI model to consider the average person then when we are going to use that model to then evaluate faces for treatment options, it would not be accurate.

So in conclusion, this consensus on AI highlights its transformative potential. By helping to standardize patient assessments and enhance treatment efficacy, aI can play a pivotal role in aligning treatments with established aesthetic standards.

However, the integration of AI must be done thoughtfully, considering gender specific algorithms, age factors, and ancestral roots to personalize treatment plans effectively. This approach not only aims to advance personalized medicine, but also to ensure that our assessments are fair and inclusive, reflecting the dynamic nature of beauty standards around the world.

So this, I personally, I think this is really exciting. Ultimately as we move closer to the future where AI and aesthetics intersect seamlessly, maintaining an ethical approach and cultural sensitivity will be paramount. It’s not about replacing the human touch, but enhancing it by providing a tool that can help us achieve more precise, natural, and satisfying results for our patients.

Thanks again for joining me today in this discussion. Feel free to reach out to me with any questions or thoughts on this episode. I’d love to hear what you have to say.

Don’t forget to check on my website for the latest updates, DrTeriFisher.com, or as always feel free to reach out to me on Instagram, DrTeriFisher

Have a wonderful week and as always, remember sculpted confidence is crafted by you with a little help from me. And I do look forward to helping you with that. I’ll talk to you again next week. Take care.

Anti-Aging Insights Podcast Cover

Anti-Aging Insights Podcast

with Dr. Teri Fisher

Weekly interviews, insights, and inspiration to navigate the world of anti-aging and aesthetic medicine.