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“safe, secure, and trustworthy development and use of AI.” Certain policies that may influence healthcare
AI development include the need to maintain individual privacy, to promote civil rights and equity, to
support America’s workforce, and to promote innovation. Ostensibly, this executive order suggests that
Biden’s administration views AI as a way for healthcare workers to extend their impact rather than as a
replacement. Additionally, the need to maintain citizens’ privacy may impose limitations on the data that
can be made available to train and refine AI models.

Most recently, in February 2024, the Center for Medicare and Medicaid Services issued guidance on AI
applications. It clearly mandates that insurers cannot use AI to determine patient coverage and that
hospitals cannot use AI to determine the level of admission for patients . It specifically necessitates the role
[26]
of human review in all important medical assessments. However, the guidance was somewhat vague
regarding the specific extent of human intervention. This could subject this guidance to manipulation.
Nevertheless, this narrative appears to be the most restrictive stance taken by a federal agency on AI in
healthcare to date. It explicitly scripts a role for human judgment.

CONCLUSION
Prospects of AI’s incorporation in plastic surgery appear to be exciting as well as infinite. It has the potential
to solve problems that transcend human capability, but questions persist regarding its application, ethical
considerations, and future regulation. AI may revolutionize plastic surgery through enhanced surgical
precision, data-driven diagnostics, streamlined workflow, and a strengthened patient-physician relationship.
Ultimately, it could improve patient satisfaction and outcomes. Nevertheless, it is prudent to maintain a
reasonable level of skepticism, given the potential risks to human health and the current uncertainties
surrounding AI. Issues regarding patient consent, data privacy, and the perpetuation of systematic bias
require ongoing scrutiny. We propose that plastic surgery leadership adopt a framework of cautious
optimism, one that clearly defines the problems AI is trying to solve and its role in conjunction with human
plastic surgeons.

DECLARATIONS
Authors’ contributions
Reviewed literature and made substantial contributions to the writing of the final manuscript: Treger D,
Harris G
Made substantial contributions to the conception or design of the work, revised the final manuscript, and
gave final approval of the version to be published: Thaller SR

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Thaller SR receives book royalties from Springer & Thieme Publishers. The other authors declared that
there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.