Plastic Surgeon Job Description

Plastic Surgery is one of the broadest surgical specialties in scope. A plastic surgeon may spend Monday morning performing a TRAM flap breast reconstruction for a breast cancer survivor, Tuesday afternoon doing rhinoplasty consults, and Wednesday on trauma call repairing a degloving injury. That breadth is what attracts surgeons to the field and what makes generalizing about the work difficult.

In hospital and academic settings, reconstructive work is the core of the caseload. Breast reconstruction after mastectomy is one of the highest-volume reconstructive procedures in the country — plastic surgeons work directly with breast oncology teams to time and coordinate reconstruction in the context of cancer treatment. Burn units rely on plastic surgeons for split-thickness skin grafting and scar management. Trauma services call plastics for soft tissue coverage of open fractures, facial lacerations, and digit replantation.

In private practice — particularly cash-pay or high-cosmetic practices — the mix shifts. Rhinoplasty, blepharoplasty (eyelid surgery), facelifts, breast augmentation, and body contouring procedures generate most of the revenue. These practices are businesses, and successful cosmetic surgeons develop strong patient communication skills, referral networks, and marketing channels alongside their technical ability.

Hand surgery is a separate subspecialty track within plastic surgery. Hand surgeons manage carpal tunnel syndrome, trigger finger, Dupuytren's contracture, tendon injuries, and microsurgical replantation of amputated digits — a specialty that sits at the intersection of plastics and orthopedic surgery.

Across all practice settings, the consultation is as important as the OR. A surgeon who can clearly explain risks, set realistic expectations, and identify patients who are poor candidates avoids the complications and dissatisfied outcomes that lead to liability exposure and reputational damage.

Education and training:

• MD or DO degree from an accredited medical school
• Plastic surgery residency: either a 6-year integrated program (most competitive) or 3 years general surgery + 3 years plastic surgery
• Optional fellowship: hand surgery (1 year, ACGME-accredited), craniofacial surgery, microsurgery, or aesthetic surgery

Board certification:

• American Board of Plastic Surgery (ABPS) written and oral qualifying exams
• Subspecialty certificate of added qualification (CAQ) in hand surgery offered jointly by ABPS and American Board of Orthopaedic Surgery

Technical skills:

• Microsurgical technique: free flap reconstruction, nerve repair, vascular anastomosis
• Tissue handling and wound closure principles across all body regions
• Implant-based and autologous breast reconstruction techniques
• Facial anatomy and rhinoplasty, orthognathic, and oculoplastic techniques
• Burn wound management and split/full-thickness skin grafting

Procedural competencies:

• Injectables and non-surgical aesthetics: Botox, dermal fillers (for surgeons offering med-spa services)
• Laser and energy-based devices for skin resurfacing and scar treatment
• 3D surgical simulation for pre-operative planning

Non-technical requirements:

• Informed consent communication under conditions of uncertainty and patient anxiety
• Managing unrealistic patient expectations without losing the patient relationship
• Business literacy for private practice: overhead management, staff supervision, marketing strategy

Plastic surgery is among the more competitive medical specialties to enter — match rates for integrated residency positions are low, and USMLE scores and research output matter significantly. But for those who complete training, the career outlook is strong.

Demographic trends are favorable on both the reconstructive and cosmetic sides. The U.S. population is aging, increasing the volume of skin cancer cases requiring reconstructive excision, post-trauma repairs, and age-related procedures. Breast cancer incidence remains high, sustaining demand for reconstruction. On the cosmetic side, cultural acceptance of aesthetic procedures has expanded across age groups and genders, and the "rejuvenation" market is growing.

Brazilian butt lift (BBL), body contouring after bariatric weight loss surgery, and gender-affirming procedures represent relatively newer and growing case categories that plastic surgeons are uniquely positioned to perform.

Private practice cosmetic surgery income is sensitive to economic cycles — discretionary procedures contract during recessions. Surgeons who diversify their practice with reconstructive hospital work or insurance-covered procedures have more stable income floors.

The workforce pipeline is constrained by the limited number of residency slots, which have not expanded proportionally with demand. That scarcity keeps compensation high relative to other specialties with comparable training length. Academic medical centers and health systems are competing aggressively with private practice to retain plastic surgeons, offering higher base guarantees and lower call burdens than was typical a decade ago.

For surgeons completing training in 2026, the combination of aging demographics, expanding cosmetic acceptance, and reconstructive volume tied to cancer care creates a durable demand picture.

Dear Dr. [Name] and Search Committee,

I am writing to apply for the Plastic Surgery faculty position at [Institution]. I completed my integrated plastic surgery residency at [Program] in June and will finish a one-year microsurgery fellowship at [Program] this July. I am board-eligible and sitting for the ABPS written examination in the fall.

My clinical focus during residency was reconstructive breast surgery and microsurgical free flap reconstruction. I performed over 120 breast reconstruction cases as primary surgeon, including DIEP flap, TRAM flap, implant-based reconstruction with ADM, and reconstruction in the setting of prior radiation. I also had significant exposure to lower extremity free flap reconstruction for traumatic and oncologic defects, and to head and neck reconstruction in collaboration with the ENT oncology service.

What draws me to [Institution] specifically is the volume and complexity of the reconstructive oncology program. I want to build a practice centered on microsurgical breast and lower extremity reconstruction, and the case mix at [Institution] supports that trajectory in a way that few programs in the region can match.

I am also interested in contributing to the residency program. I found teaching to be one of the most valuable parts of my own training, and I have mentored two medical students through their plastic surgery research projects, both of which were presented at the PSTM annual meeting.

I would welcome the opportunity to visit and discuss the position further. Thank you for your consideration.

[Your Name], MD