Global Disparities and Artificial Intelligence in Plastic Surgery: A Narrative Review of Current Applications and Ethical Implications

Abstract

Global disparities in surgical access remain a major health challenge, with an estimated 5 billion people lacking safe and affordable care. Plastic and reconstructive surgery plays a key role in addressing this gap, particularly through the management of trauma, burns, and congenital conditions such as cleft lip and palate. Although nonprofit organizations and surgical mission trips have delivered high procedure volumes, low- and middle-income countries (LMICs) continue to face substantial unmet need. Concerns over sustainability, long-term outcomes, and reliance on foreign teams highlight the importance of building local capacity, yet workforce shortages and infrastructure limitations remain significant barriers. Artificial intelligence (AI) offers a potential avenue for innovation. In high-income countries, AI has been applied to preoperative planning, postoperative monitoring, patient education, and workforce training. These tools could benefit LMICs by reducing reliance on personnel, improving health literacy, optimizing costs, and supporting surgical training. However, challenges such as data poverty, algorithmic bias, unequal access, and weak regulatory structures raise concerns that AI may widen rather than narrow disparities if not implemented thoughtfully. In addition, ethical considerations regarding equity, inclusion, sustainability, safety, and accountability must be addressed. This narrative review synthesizes emerging evidence at the intersection of plastic surgery, global disparities, and AI. The authors outline opportunities where AI may enhance equity and where it may exacerbate inequities, as well as the ethical considerations critical for its safe and sustainable integration.

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