Are Robot Surgeons Coming? Will Plastic Surgeons Disappear or Become Stronger?

Recent statements by Elon Musk, suggesting that “robot surgeons will arrive within three years, so don’t study medicine,” have reignited this debate. While I do not believe that fully autonomous robot surgeons will enter routine clinical practice in such a short time, I follow the development of robotic technologies in surgery with both interest and optimism.

To date, the most widely used robotic systems in surgery have been robotic platforms controlled by surgeons, rather than independent decision-makers. Systems such as the Da Vinci robot have provided significant advantages, particularly in minimally invasive surgery, by improving visualization, precision of movement, and surgeon ergonomics. In plastic and reconstructive surgery, robots have also played a supportive role in selected procedures.

In fact, we have personally used robotic technologies in reconstructive surgery, and their contribution to the surgical process is undeniable. These experiences have also been shared in the scientific literature, where robotic systems were shown to function not as autonomous surgeons, but as tools executing the surgeon’s decisions.
(Özkan Ö, Özkan Ö, Çinpolat A, Arıcı C, Bektaş G, Can Ubur M. Robotic harvesting of the omental flap: a case report and mini-review of the use of robots in reconstructive surgery. Journal of Robotic Surgery, 2019.)

In such applications, robots act as an extension of the surgeon, assuming an operative role rather than a decision-making one.

The idea that an entire surgical procedure could be performed by a robot making its own clinical decisions, independent of a surgeon, remains an extreme scenario with current technology. Surgery is not merely a sequence of technical steps. It requires:
• Preoperative planning
• The ability to change strategy in unexpected intraoperative situations
• Real-time decisions based on tactile and visual feedback from tissues
• Understanding the patient’s expectations, psychology, and aesthetic perception

These aspects still rely heavily on human judgment, intuition, and clinical experience.

That said, robotic systems clearly have the potential to make substantial contributions to surgery, particularly in areas such as:
• Suturing
• Precise execution of incision boundaries
• Technical stages requiring prolonged stability and accuracy

These are repetitive and highly technical tasks where robots can significantly enhance surgical precision and reduce physical strain on the surgeon.

Plastic surgery, however, presents a unique situation. Outcomes in this field are largely individualized, and the concept of “beauty” cannot be reduced to objective measurements. A technically flawless operation may be perceived very differently by two patients. Aesthetic decisions are shaped by culture, expectations, facial expression, body perception, and the surgeon’s artistic judgment.

For this reason, I believe that plastic surgery will be among the last surgical specialties to fully integrate autonomous robotic systems. Rather than replacing plastic surgeons, robots are far more likely to become powerful tools that enhance the surgeon’s capabilities when used appropriately.

In conclusion, robots will not eliminate surgeons. They will reshape surgery. The surgeon of the future will not be defined solely by technical skill, but by the ability to plan accurately, make sound decisions, and effectively guide advanced technologies.

Assoc. Prof. Dr. Anı Çinpolat