Applications of Artificial Intelligence for Facial Aesthetic Surgery: a Systematic Review

Abstract

Artificial intelligence (AI) offers opportunities to improve assessment, visualization, and communication in facial aesthetic surgery; however, its clinical reliability remains uncertain. This study aimed to synthesize contemporary evidence on AI applications, performance, methodological quality, and clinical relevance in facial aesthetic surgery. A systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines searched PubMed/MEDLINE, SAGE Journals, ScienceDirect, EBSCO, Scopus, and Web of Science for English-language original studies published between January 2022 and August 2026. Eleven studies met the eligibility criteria and were included in the qualitative synthesis and risk-of-bias assessment using an adapted framework informed by the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. AI applications included apparent-age estimation, automated facial morphometry, rhinoplasty simulation, patient counseling, and social media analysis. AI-based systems quantified postoperative changes in perceived age and facial morphology, generated realistic surgical visualizations, and provided comprehensible patient education responses. However, visual realism did not establish patient-specific predictive accuracy, and improvements in computational performance did not necessarily translate into greater patient satisfaction or psychosocial benefits. Six studies raised some concerns regarding risk of bias, while five were judged to have a high risk of bias. Methodological heterogeneity, limited external validation, proprietary algorithms, and potential demographic biases limited the interpretation and generalizability of the findings. AI represents a promising adjunct to facial aesthetic surgery; however, prospective multicenter validation, transparent reporting, demographically diverse datasets, and patient-centered outcome assessment are needed before routine clinical integration can be recommended with confidence.