03
Sep
2026
03
Sep
2026
Patients have always brought photographs to aesthetic consultations – celebrities, influencers, previous results and examples of the look they have in mind.
Artificial intelligence is now changing that conversation.
A recent report by ITV News highlights how some patients are using AI tools to alter images of their own faces before taking them to surgeons and asking them to recreate the results. For aesthetic practitioners, this raises important questions around patient expectations, consultation, informed consent and the limits of what cosmetic procedures can realistically achieve.
According to a British Association of Aesthetic Plastic Surgeons (BAAPS) survey cited by ITV, 15% of the 59 members who responded said they had experienced patients using AI to change their face and asking them to replicate the resulting image.¹
So, how should practitioners approach an AI-generated 'wish list' when a patient arrives with one?
AI-generated imagery can provide patients with another way to communicate what they like or what they would like to change.
However, there is a significant difference between visualising a desired aesthetic and determining what is clinically achievable.
An AI-generated image may not accurately account for:
As ITV's investigation demonstrated, AI-generated images can suggest significant facial changes that may not be achievable through cosmetic surgery.
Medical aesthetics practitioner Dr Sarah Tonks told ITV:
"This suggestion from AI is unrealistic. You can't. It's impossible. It's not alchemy. You can't do this."
She also highlighted a situation practitioners may increasingly encounter:
"Sometimes somebody will come in with a picture that is just not anatomically possible for that person to have."
For practitioners, this means an AI image should be treated as a conversation starter rather than a surgical blueprint.
Rather than simply dismissing an AI-generated image, practitioners could use it to explore what the patient is actually hoping to achieve.
What does the patient like about the image?
Is it the nose shape? The jawline? Facial proportions? Skin appearance? Or perhaps an overall perception of greater facial balance?
Breaking the image down can help move the conversation away from "make me look like this" and towards a more meaningful discussion about the patient's underlying aesthetic goals.
It also creates an opportunity to explain what can – and cannot – realistically be achieved.
BAAPS President Dr Nora Nugent told ITV that AI could help surgeons understand the outcome a patient is hoping for, but that it also highlights the importance of patient education.
She said:
"Being very honest about what we can achieve, being very honest about what about the image is totally unrealistic to achieve [is really important]."
She added:
"[Seeing] if there is an unrealistic element and really trying to manage expectations. In some AI generated images, there is a guarantee it will not match that because the procedure never could."
This is particularly important where a patient's expectations are based on an image that has been digitally created rather than a realistic representation of a potential clinical outcome.
There is another consideration for practitioners: the psychological impact of asking AI to analyse or modify a person's appearance.
AI tools can suggest changes that a patient may never previously have considered.
Dr Tonks told ITV:
"It may bring up things that people hadn't even thought about before, which could be a good or a bad thing, depending on what it was. Maybe it would just unlock a new insecurity for people, which we don't want to do."
This is an important consideration within the consultation.
A patient may arrive believing they have identified one particular concern, only to have an AI tool suggest several additional areas for modification.
Practitioners should therefore be alert to whether an AI-generated image is helping a patient articulate an established aesthetic concern or introducing new perceived imperfections.
One reason AI-generated facial images can be misleading is that they can appear remarkably realistic.
However, realism does not mean clinical accuracy.
AI expert and content creator Ghita El Haitmy explained to ITV:
"It doesn't actually see your face, it's not your surgeon, it doesn't know what your skin texture is, the depth of your muscles or the fat tissue that you have, or skin tissue."
She explained that the technology uses information from an image and the user's prompt to make mathematical predictions about how the image should be changed.
Crucially, she warned:
"Do not trust what AI is telling you. I keep repeating that it's a prediction engine. It all depends on the chat history that you've given it, the prompt you've given it, how you even positioned yourself in the image."
She added:
"It's all a mathematical prediction, so you should not really take it at face value."
For patients considering cosmetic surgery, this distinction is critical. An AI-generated image can illustrate an idea, but it cannot replace an assessment by a suitably qualified medical professional.
There is also a wider patient-safety concern.
If a qualified practitioner explains that an AI-generated result is unrealistic or potentially harmful, there is a possibility that a patient may seek treatment elsewhere from someone willing to promise that the result can be achieved.
Dr Nugent told ITV:
"There are many instances, sadly, in the world of cosmetic procedures where underqualified people essentially use marketing tactics and agree to procedures without necessarily giving the accurate information in advance or having the skills to achieve a procedure, and that is the danger."
This reinforces the importance of transparent consultations and realistic expectations.
Practitioners should not feel pressured to agree to a procedure simply because a patient arrives with an AI-generated image and expects it to be replicated.
Patient safety and appropriate clinical judgement must remain the priority.
Despite these concerns, AI imagery doesn't necessarily have to be viewed negatively.
Used appropriately, it could potentially help patients communicate aesthetic preferences that they might otherwise struggle to describe.
The key distinction is between using AI as a communication aid and treating it as a prediction of a surgical outcome.
An image could prompt useful questions:
Used in this way, the image becomes part of a wider consultation rather than dictating the treatment plan.
The sophistication of AI-generated imagery means that managing expectations could become an increasingly important part of aesthetic practice.
A digitally created face has no genuine anatomy, surgical limitations, recovery period or risk of complications. It can therefore present an idealised outcome that is fundamentally different from what a real procedure can deliver.
For practitioners, the response should be neither to automatically dismiss AI nor to accept its images as realistic targets.
Instead, the consultation should focus on the patient sitting in front of you.
Listen to what they are trying to achieve. Explore why they want it. Assess whether their expectations are realistic and whether treatment is clinically appropriate. Explain the potential benefits, limitations and risks clearly.
And, importantly, be prepared to recommend against treatment when it is not appropriate.
As Dr Nugent told ITV:
"It might be a bit of fun to put in a photo and see what changes it might make, but you cannot rely on it as an accurate surgery simulation just yet."
AI is likely to become another influence on the way patients research and approach cosmetic procedures.
For clinics, this could mean:
More sophisticated expectations: Patients may arrive with highly specific digitally generated images of their desired appearance.
More consultation time: Practitioners may need to spend longer explaining the difference between an AI-generated image and a clinically achievable result.
Greater emphasis on education: Patients may need help understanding the limitations of AI as well as the limitations of the procedure itself.
A stronger focus on informed consent: Patients should understand the realistic outcome, potential risks and alternatives before deciding to proceed.
Continued vigilance around patient wellbeing: Practitioners should consider whether AI-generated images are helping patients communicate their goals or creating new concerns about their appearance.
AI is rapidly becoming part of how people research everything from skincare to cosmetic surgery.
For aesthetic practitioners, the challenge is to ensure that technology enhances the consultation rather than distorting it.
An AI-generated image may tell you what a patient thinks they want. The consultation needs to establish what they actually want, whether it is achievable, and whether treatment is appropriate.
Ultimately, the most important assessment is not made by an algorithm.
It is made by a suitably qualified practitioner assessing the individual patient in front of them.
According to a BAAPS survey cited by ITV News, 15% of the 59 members who responded said they had experienced patients using AI to modify their face and asking surgeons to recreate the resulting image.¹
No. AI-generated imagery should not be regarded as an accurate simulation or guarantee of a surgical outcome. It does not have the ability to assess an individual's anatomy, tissue characteristics, healing response or the clinical limitations of a procedure.
Not necessarily. An AI image can potentially be useful as a communication tool if it helps a patient explain their aesthetic goals. However, practitioners should make it clear that the image is not a treatment plan or prediction of the result.
The practitioner should explain clearly and honestly why the requested result may not be achievable and discuss realistic alternatives where appropriate. If treatment is unsuitable or potentially harmful, the practitioner should be prepared to recommend against it.
Potentially. As Dr Sarah Tonks highlighted in the ITV report, AI could introduce patients to perceived imperfections or changes they had not previously considered. Practitioners should remain alert to whether technology is helping patients articulate an existing concern or creating new insecurities.
Source
¹ ITV News, People are taking AI generated pictures to surgeons and asking them to recreate the results, 2 September 2026. Reporting by ITV News Producer Hannah Ward-Glenton, with George Hancorn.
Read the full ITV News report: https://www.itv.com/news/2026-09-02/people-are-tweaking-their-faces-with-ai-and-asking-surgeons-to-copy-the-results
Read it? Loved it? Want to share it?
