Halloween Edition: 4 Firework + Pumpkin Injuries, & AI vs Real Surgeons

And if you think plastic surgery is immune, think again.

The $430 Billion Opportunity

Here’s the cold math: physician compensation represents roughly 8.6% of total healthcare spending, about $430 billion a year. Whoever cracks the code to automate that revenue stream won’t just be rich; they’ll own the most profitable slice of medicine.

AI doesn’t need to replace every surgeon. It just needs to replace enough decision-making to claim the professional fee. And for much of modern medicine, that’s already technically possible. Diagnosis, triage, post-op management: LLMs can do all of it today. The only thing stopping them is regulation.

And regulation always bends to money.

Plastic Surgery’s Blind Spot

Plastic surgery prides itself on artistry and human nuance, which are qualities we love to think are irreplaceable. But here’s the uncomfortable truth:

• Most post-op wound checks could be automated with image recognition.
• Flap viability could be tracked with AI-assisted perfusion monitoring.
• Even consultation scripts can now be generated, personalized, and delivered better than most rushed clinics.

The only domain left purely human? Touch. For now.

Our Choice: Build With It, or Be Billed By It

This isn’t a fight against technology, it’s a fight for ownership. We can either build systems that keep clinicians at the core, or watch as venture-backed platforms turn our skills into prompts.

Plastic surgery has an opportunity to lead here:

• Integrate AI to enhance — not replace — our decision-making.
• Push for ethical frameworks that preserve clinical accountability.
• Teach trainees to use AI tools fluently, so they’re not sidelined by them.

Because if we don’t define how AI fits into our profession, someone else will, and they’ll send us the invoice.

With love (and mild existential dread),
P’Fella ❤️

Fingertip Replantation Technique

This video shows a demonstration of the fingertip replantation technique.

LWW