Abstract <p>This commentary evaluates the study by Li et al. on the use of artificial intelligence (AI) for patient selection in cosmetic surgery. While the integration of AI into aesthetic decision-making is promising, we raise concerns regarding methodological limitations, including the absence of subgroup analyses, reliance solely on surgeon judgment, and lack of outcome-based validation. Ethical considerations such as data governance, potential cognitive bias among surgeons, and the absence of psychological screening are also discussed. We advocate for future models to incorporate standardized psychometrics and patient-centered outcomes to ensure responsible and effective clinical integration.</p> No Level Assigned <p>This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>