Nonfungible Tokens in Plastic Surgery

What Are Nonfungible Tokens?

Nonfungible tokens (NFTs) are exploding in popular culture. NFTs have been used to commodify anything from basketball highlights to recent music albums, with the latter generating $2 million USD in sales.^1,2 Undoubtedly, these digital tokens have generated exorbitant amounts of interest, but what is the future of this technology for plastic surgeons?

NFT Applications

On a fundamental level, NFTs are units of data stored on an electronic record known as a blockchain.³ These “blocks” contain unique information, including timestamps and transaction data, which can be used to verify transactions within the blockchain. When creating or “minting” an NFT, the minter effectively ties a form of media (ie, image file, music file) to one of these trackable blocks. This allows one to prove undisputed ownership and authenticity of virtual goods.

Art

Plastic surgeons are creative by nature and may generate artistic elements at work. NFTs have proved to be applicable in the art world, with NFTs of collectible digital characters (known as “CryptoPunks”) having been sold for upwards of 10 million USD per character.⁴ As proof of concept, our team created the first-ever published NFT in plastic surgery (Fig. 1). (See Video 1 [Online], which displays old surgical glasses NFT.)

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Fig. 1.: Image file of old surgical glasses our team has artistically interpreted and turned into an NFT. This and Figure 2 are the two first-ever published NFTs in the field of plastic surgery.

Patient Photographs

Photographs are an essential element to the field of plastic surgery, whether it be for patient documentation or education. However, with a growing use of pre- or postoperative photographs on social media, ownership of patient images has become vague. Creating an NFT with patient photographs would provide both the surgeon and patient undisputed ownership, preventing theft or forgery.

Significant Moments

Occasionally, images capture a moment or interaction that becomes increasingly significant with time. Examples might include an image of Paul Tessier evaluating a skull or a surgeon performing a first ever procedure. Images such as this are ubiquitous in plastic surgery and are prime candidates for creating NFTs.

Career Achievements and Validation of Training

Validated credentials are critical to physicians. The current model to demonstrate career achievement is through documentation on a curriculum vitae (CV), membership into an organization, or simply a piece of paper framed on a wall. NFTs may be useful in this arena, providing incontrovertible evidence of having passed an examination, graduated from school, or being inducted into a society. This model is also well suited for verification of postgraduate courses, many of which are centered around new technologies or innovative skill sets (Fig. 2). (See Video 2 [Online], which displays Duke Flap Course completion token NFT.)

Fig. 2.: Image file of a Duke Flap Course completion token our team has turned into an NFT. This, in concept, can be used as incontrovertible evidence that one has completed the Duke Flap Course. This and Fig 1 are the two first-ever published NFTs in the field of plastic surgery.

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What Does the Future Hold?

Although NFTs are undoubtedly a hot commodity, they have come under some criticism. One consideration is the energy cost associated with the computing process in blockchain technology.⁵ Additionally, it is difficult to say whether the monetary value currently assigned to NFTs is market-based or simply speculation. It remains to be seen which medical paradigm will adopt the NFT concept and what types of information will be most intriguing to those wishing to digitally enshrine an experience. Like other areas, plastic surgeons are well positioned to innovate in this exciting new field.

DISCLOSURE

The authors have no financial interest to declare in relation to this content of this article.