<![CDATA[Introduction: Surgical specialities like plastic and hand surgery, which depend on precision, aesthetic, and functional outcomes, are integrating AI, creating potential and challenges. AI is rapidly transforming clinical procedures, requiring evaluation of its potential to improve clinical care and the challenges it faces. This narrative review critically evaluates the clinical applications, emerging innovations, and ethical challenges of AI in plastic and hand surgery, synthesising evidence on both its transformative potential and the challenges it presents.Method: We conducted a narrative review of peer-reviewed literature using PubMed, Scopus, and Web of Science (2018-2025). Keywords included “artificial intelligence,” “machine learning,” “deep learning,” “plastic surgery,” “hand surgery,” “microsurgery,” and “convolutional neural networks.” We included studies on clinical applications, technological innovations, and ethical considerations. This review differs from existing syntheses by providing a balanced “Potential vs Provocation” framework that systematically addresses both benefits and challenges while proposing concrete implementation strategies for clinical practice.Results: AI technologies such as convolutional neural networks and large language models classify skin lesions, evaluate aesthetics, and automate operative documentation.Conclusion: Innovations such as generative AI, mixed reality, and predictive analytics in microsurgical procedures, patient-specific simulations, and smart rehabilitation have driven tremendous advances in this field. Despite this potential, significant challenges remain, including data bias, limited AI model interpretability, and concerns about liability and privacy. AI in plastic and hand surgery has significant potential to strengthen surgeons; however, integrating it requires acceptance, education, interdisciplinary collaboration, and ethical guidelines to address the challenges of this technological evolution.]]>
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