ABSTRACT
INTRODUCTION: Artificial intelligence (AI) holds the potential to revolutionize medicine, offering vast improvements for plastic surgery. While human physicians are limited to one lifetime of experience, AI is poised to soon surpass human capabilities, as it draws on limitless information and continuous learning abilities. Nevertheless, as AI becomes increasingly prevalent in this domain, it gives rise to critical ethical considerations that must be addressed by professionals. MATERIALS AND METHODS: This work reviews the literature referring to the ethical challenges brought on by the ever-expanding use of AI in plastic surgery and offers guidelines for its application. RESULTS: Ethical challenges include the disclosure of use of AI by caregivers, validation of decision-making, data privacy, informed consent and autonomy, potential biases in AI systems, the opaque nature of AI models, questions of liability, and the need for regulations. CONCLUSIONS: There is a lack of consensus for the ethical use of AI in plastic surgery. Guidelines, such as those presented in this work, are needed within each discipline of medicine to respond to important ethical considerations for the safe use of AI. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
ABSTRACT
BACKGROUND: In plastic surgery, evaluation of breast symmetry is an important aspect of clinical practice. Computer programs have been developed for this purpose, but most of them require operator input. Artificial intelligence has been introduced into many aspects of medicine. In plastic surgery, automated neural networks for breast evaluation could improve quality of care. In this work, the authors evaluate the identification of breast features with an ad hoc trained neural network. METHODS: An ad hoc convolutional neural network was developed on the YOLOV3 platform to detect key features of the breast that are commonly used in plastic surgery for symmetry evaluation. The program was trained with 200 frontal photographs of patients who underwent breast surgery and was tested on 47 frontal images of patients who underwent breast reconstruction after breast cancer surgery. RESULTS: The program was able to detect key features in 97.74% of cases (boundaries of the breast in 94 of 94 cases, the nipple-areola complex in 94 of 94 cases, and the suprasternal notch in 41 of 47 cases). Mean time of detection was 0.52 seconds. CONCLUSIONS: The ad hoc neural network was successful in localizing key breast features, with a total detection rate of 97.74%. Neural networks and machine learning have the potential to improve the evaluation of breast symmetry in plastic surgery by automated and quick detection of features used by surgeons in practice. More studies and development are needed to further knowledge in this area.
Subject(s)
Breast Neoplasms , Surgery, Plastic , Humans , Female , Artificial Intelligence , Neural Networks, Computer , Machine Learning , Breast Neoplasms/surgery , NipplesABSTRACT
INTRODUCTION: Artificial intelligence (AI) is a milestone for human technology. In medicine, AI is set to play an important role as we progress into a new era. In plastic surgery, AI can participate in breast symmetry assessment, which until now has been mainly subjective, allowing for inconsistencies. This study aims to improve this evaluation process by integrating a novel trained neural network with the breast symmetry calculator, BAS-Calc. MATERIALS AND METHODS: We combined the BAS-Calc tool with a custom-made neural network trained to automatically detect key features of the breast. This integrated system was tested on 81 images of patients who had undergone breast reconstruction post-breast cancer treatment. Its performance was evaluated against two human observers using statistical analysis. RESULTS: Our model successfully detected 399/405 (98.51%) of landmarks. Spearman and Pearson correlation indicated a strong positive relationship while Cohen's kappa demonstrated moderate to strong agreement between human observers and AI model. Notably, the average calculation time for the AI was 0.92 seconds, 16 times faster than the 14.09 seconds for humans. CONCLUSIONS: Our AI model successfully calculated breast symmetry from images of patients who had undergone reconstructive oncological breast surgery, demonstrating high correlation with human assessments and a markedly reduced processing time. As AI continues to evolve, it is poised to become a pivotal tool in Medicine. Therefore, it is crucial for medical professionals to proactively engage in implementing AI technologies safely and effectively. Further studies are required to broaden our understanding and maximize the potential benefits in this area. Takeaway bullet points Artificial intelligence (AI) is an upcoming force to be reckoned with. AI should find its way into practical applications in plastic surgery. AI can be applied to improve patient care and evaluate aesthetic results. In this work, we present a novel AI model that automatically evaluates breast symmetry. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
ABSTRACT
This work explores the upcoming era of artificial intelligence (AI), its potential impact on societal norms and aesthetics, and the biases inherent in AI systems. With the ability to generate realistic human-like art and language, AI entities like DALL·E or Midjourney have significant cultural and economic implications, particularly in creative sectors. However, our study highlights potential biases in AI, demonstrated through a text-to-image model called Craiyon, which was found to generate oversized and sexually suggestive images of breasts when prompted with certain phrases. These results underline the influence of societal norms on AI and the risk of perpetuating harmful stereotypes or unrealistic beauty standards. We emphasize the need for vigilance in monitoring AI's learning processes and potential biases, particularly as AI starts playing a crucial role in shaping societal perceptions of beauty and self. More inclusive and diverse AI models are needed to better represent the complexity of human beauty and to avoid biases.
ABSTRACT
Desde que hicieron aparición los registros centralizados de implantes mamarios en varios países del mundo, la implantación y evolución de estos ha sido desigual. Desde el Comité de Registros de Implantes de Federación Ibero Latinoamericana de Cirugía Plástica (FILACP) lanzamos un estudio para conocer el estado actual de este tipo de bases de datos en los países de la Federación mediante una encuesta en línea.El cuestionario fue remitido de forma correcta por 20 de los 22 países de FILACP. Solamente 1 país (España) posee un registro nacional plenamente funcionante, mientras que 4 países más (20%) cuentan con sistemas de notificación de complicaciones o registros privados de los fabricantes de prótesis. En el 35% de los países no hay intención de poner ningún registro nacional en marcha.Exponemos también en el trabajo las peculiaridades de cada país. (AU)
Since the appearance of centralized registries of breast implants in several countries around the world, the implantation and use of each registry has been uneven. From the FILACP (Ibero Latin American Federation of Plastic Surgery) Implant Registrations Commi- ttee we launched a study to evaluate the current status of this type of databases. The study was carried out in the countries of the Federation and consisted of an online survey.It was answered by 20 of the 22 countries. Only 1 country (Spain) has a fully functional national registry, while 4 more countries (20%) have a compilation reporting systems or private registries of prosthesis manufactu- rers. In 35% of countries there is no intention to start any national registry.We also review in the work the aspects of the system in each country. (AU)
Subject(s)
Humans , Breast Implants , Surgery, Plastic , Mammaplasty , Surveys and Questionnaires , Latin America , Professional Review OrganizationsABSTRACT
La miositis osificante es una osificación heterotópica, autolimitada, que afecta a cualquier grupo de edad y suele presentarse en la musculatura de las extremidades, en su variante más frecuente, en zonas de traumatismo por su relación íntima con la lesión mecánica. Es considerada benigna y si la identificación por imágenes es clara, su tratamiento consiste en seguimiento clínico. Sin embargo, cuando existen dudas diagnósticas, conviene realizar biopsia para definir el tratamiento quirúrgico. Presentamos una paciente con tumoración dolorosa en región lumbar, a nivel del triángulo de Petit, de 18 meses de evolución. La biopsia de partes blandas era sugerente de tumor fibromixoide osificante cuyo análisis postoperatorio reveló miositis osificante. Se realizó extirpación local amplia y reconstrucción con malla biológica sin tensión y cierre por planos, ya que se han descrito hernias espontáneas y también secundarias a través del triángulo de Petit. Estas últimas, en su mayoría, son hernias postincisionales
Myositis ossificans is a heterotopic self-limited ossification that affects every age. It usually appears in limb musculature, commonly in exposed areas due to its intimate relationship with mechanical trauma. It is considered a benign disease and, if clinical and radiological identification results obvious, suggested treatment is clinical follow-up. But if there is a diagnostic doubt, a biopsy must be performed in order to define surgical treatment. We present a case report of a patient with an 18 month-evolution painful tumour in the lumbar area, at the level of Petit triangle. The initial biopsy of the soft tissue mass suggested fibromyxoid ossificans tumour, but after postoperative analysis, diagnosis of myositis ossificans was stated. Surgical treatment consisted of a wide local resection and immediate reconstruction with a biological mesh, achieving a non-tension closure in order to avoid spontaneous and secondary hernias, which are described specifically in the triangle of Petit triangle. These hernias are usually post-incisional
Subject(s)
Humans , Female , Adult , Myositis Ossificans/diagnostic imaging , Myositis Ossificans/surgery , Fibroma/diagnostic imaging , Biopsy , Surgical Mesh , Diagnosis, DifferentialABSTRACT
No disponible
