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(1)
(2)
©The Author(s), under exclusive license to Springer Nature Switzerland AG2023 E. Tokgöz, M. A. Carro, Cosmetic and Reconstructive Facial Plastic Surgery
https://doi.org/10.1007/978-3-031-31168-0_9
Applications of Artificial Intelligence, Machine Learning, and Deep Learning on Facial Plastic Surgeries
EmreTokgöz1 and MarinaA.Carro
2
Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA The Frank H. Netter M.D. School of Medicine, Quinnipiac University, North Haven, CT, USA
MarinaA.Carro Email: Marina.Carro@quinnipiac.edu
Keywords Artificial Intelligence applications on facial plastic surgeries –
Deep learning applications on facial plastic surgeries – Machine learning applications on facial plastic surgeries
Emre Tokgöz completed two Ph.D. degrees, one in Mathematics and another one in Industrial Engineering, at the University of Oklahoma along with a master’s degree in Computer Science and two master’s degrees in Mathematics. Due to his interest in biomedical engineering applications of mathematics and engineering, he pursued an online biomedical engineering master’s degree for professionals at Johns Hopkins University. His other research interests include nonlinear optimization, game theory, deep/machine learning, financial engineering, facility allocation problems, vehicle routing problems, systems’ design and improvement, network theory and analysis, inventory systems, and Riemannian geometry.
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Marina A. Carro is a second-year medical student at the Frank H. Netter School of Medicine (Quinnipiac University). Prior to medical school, she worked as a project manager at Clínica Esperanza Hope Clinic in Providence, Rhode Island, where she organized and managed a satellite COVID-19 vaccination clinic for underserved populations in the area. Additionally, she has worked as a certified nursing assistant for 3 years in the emergency department and intensive care unit at South County Hospital in Kingston, Rhode Island. Currently, she is on the board for the Frank H. Netter Wellness Committee, ENT Surgical Interest Group, and American Medical Student Association at Netter. She hopes to continue exploring her interests in clinical procedural research, healthcare business and administration, and provide equitable healthcare for marginalized patients throughout the rest of her career.
1 Introduction
Development of algorithms allowing to make informed decisions based on patterns learned from data and mimicking human behavior by using technology has been one of the goals of researchers for real-life applications [70]. Machine learning (ML) algorithms are computer methods that can be trained to find characteristic features and patterns in data. The idea of artificial neural network (ANN) development follows the same footsteps of the physiological neural networks. A multilayer perceptron is an artificial neural network consisting of an input layer, an output layer, and several hidden layers between the input and output layers. Neurons are the building blocks in between each one of these layers that serve as computational building blocks of the network. Neurons are interconnected in subsequent layers, and output of each neuron is the product of its input with a learned set of weights that is added to a learned bias. An activation function is used for deciding whether a neuron should be activated or not. Training, testing, and validation are three steps that can be used as part of a model development in ANN. The training phase allows the model to determine/learn the weights and biases of the ANN from training data. ANN is expected to propagate a large amount of input data to properly predict the values of the output layer during the training process. The size
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of the data has an impact on the attained results. The differences between the predictions of the ANN and the desired output values are targeted to be minimized iteratively by updating the weights and biases of the network during training. A model that works at the best level is determined on the training test with the goal of using on the testing set. Training and testing sets are chosen independently for unbiasing the model’s accuracy. The validation phase is used to ensure that the developed ANN didn’t memorize the training data characteristics by attaining good results on other datasets to validate its effectiveness of application on multiple settings. ANNs can be used to automatically perform specific tasks, such as predictive outcomes after optimizing the trainable parameters attained.
Facial traumas that have been seen in emergency departments include traffic accidents, assault, and fall overs [7274]. There can be several reasons for a plastic surgery, and AI applications can be possible that associate with these reasons that include, but not limited to, the following:
Fracture repair Nerve paralysis/rehabilitation Restoration and reconstruction Septal deviation and reconstruction Obstruction, scar revisions, and anomalies Cancer reconstruction
Unidentified or untreated fractured facial bones have an important place in an individual’s health; such fractures that are not treated properly can result in complications and sequelae such as nasal canal rupture and eyeball retraction. Manual methods used for such detection are good; however, AI solutions can improve such detections through advance analytics.
Face recognition techniques have been developed by using a variety of techniques including artificial neural network (ANN) approach in deep learning as well as linear binary patterns histogram, local feature analysis, local binary patterns, speeded-up robust features, geometric features, principal component analysis, eigenface, and Fisher vector analysis [75]. Some of the optimization methods used included evolutionary-genetic algorithm (GA), particle swarm optimization (PSO) and structural similarity image maps (SSIM) that aimed to for good precision of the recognition.
Deep learning is implemented in a variety of facial plastic surgical applications, including, but not limited to, aesthetic surgeons, to assess
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gender typing following facial feminization, and perceived age changes following rhinoplasty and facelift [8184]. ANN is utilized as early as 1991 in [80] to distinguish male and female faces. Deep convolutional neural networks (CNN) are determined to be powerful tools for face detection and gender classification. Recently, a facial recognition software called DeepGestalt (FDNA, Inc., Boston, Mass.) is shown to be superior in the recognition of known genetic syndromes based on facial features to the capabilities of clinical experts [81]. Research on surgically altered face recognition and face feature reading by using a variety of DL techniques has been also studied extensively [8489].
The next section focuses on AI/ML/DL applications on facial feature recognition, which is determined to be one of the popular areas of interest in the research community.
2 Facial Feature Recognition by Using Machine Learning Applications for Facial Plastic Surgeries
Recent advancements in technology are utilized to analyze facial plastic surgical outcomes. Analysis of facial structure for pathological or dysmorphic issues is a typical part of plastic surgical procedures given that it may be a reconstructive or an aesthetic surgery. Computed tomography (CT) cephalometric radiography is used for 3D reconstruction with the help of computer programming and advancements in image quality [2024]; however, these applications are expensive with limited access to such technology. Rapid progress on technological advancement of smartphone applications is reflected onto facial recognition–related analysis after plastic surgeries. Such applications are rare to see in practice, and further development on these applications is limited to the developers’ updates on the applications [28]. Machine learning algorithms are used for craniofacial dysmorphology analysis, which focuses on diagnosis and measurement analysis [2527]. Integration of machine learning and cellular-based technology is one way to advance plastic surgical outcome analysis. Regarding facial landmark recognition, ML Kit by Google is an open­source application programing interface (API) capable of real-time facial landmark recognition and provides extensive number of facial coordinate points [19]. In the case when such an automation is not utilized, human
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