Plastic Surgery Career Path: Tips for Med Students

Medscape

26-05-2025

Plastic surgery covers a wide range of subspecialties, all of which focus on restoring physical function or appearance. In addition to reconstructive and cosmetic (or aesthetic) — which represent the two main types of plastic surgery — subspecialties include microsurgery (the reconnection of small blood vessels and nerves in transplant cases and other circumstances) and gender-affirming surgery, among others.
The American Board of Plastic Surgery, Inc., reported that as of January 2025, there were approximately 7752 actively practicing plastic surgeons in the United States. The need for more surgeons to fill certain geographic gaps in patient access and meet the rising demand for a range of procedures suggests that a plastic surgery specialty may offer plenty of opportunity for individuals interested in helping people restore their self-confidence and independence.
To offer more insight to medical students thinking of pursing a plastic surgery specialty, we turned to Scott Hollenbeck, MD, chair of the Department of Plastic and Maxillofacial Surgery, University of Virginia Health, Charlottesville, Virginia, and president of the American Society of Plastic Surgeons.
Q: When did you decide to specialize in plastic surgery, and what helped you choose that direction?
A: I decided pretty late in my training. I was a third-year general surgery resident, and I was exposed to plastic surgery during our breast oncology rotation.
There was a plastic surgeon who asked me if I wanted to help them as they did the reconstruction following a mastectomy. I did that on several occasions and found it to be very enjoyable to 'rebuild' a patient rather than deconstruct their body through surgery.
One day, he said to me: 'You should be a plastic surgeon. You have the right skills and demeanor and will have a great career.' I saw how grateful his patients were and was convinced it would be a great career for me, and it really has.
Q: What is a typical week's schedule for a plastic surgeon, and how is your time divided between surgery, office consultations, and other matters?
A: I do a lot of different things beyond surgery and clinical care, but at least that aspect of my job is about 40 hours — or 3 days a week.
I usually dedicate one day to my obligations as a department chair and the administrative work associated with that, and one day to running my research efforts.
Now, in reality, it's not that defined. These different activities usually blend into each other throughout the week and sometimes into the weekend.
Q: How do you balance a patient's expectations with realistic possibilities?
A: That is an important point. It's all about informed consent. I never try to 'sell' a patient a surgery.
Instead, I try to explain the nature of the procedure and the potential complications and describe a realistic outcome.
Sometimes, I will share pictures with them and maybe even connect them with a prior patient who has expressed interest in serving as a resource for future patients.
Many patients use social media to get information from other patients from around the country, and this, too, can be helpful in establishing realistic expectations.
Q: How has the field of plastic surgery changed in recent years, and what is on the horizon?
A: Plastic surgery is always changing. We are known as the specialty for innovation. As such, we often create a new surgical field, which, in many cases, is then adopted by another surgical field.
Did you know the first kidney transplant was performed by a plastic surgeon? In fact, Dr Joseph Murray received the Nobel Prize for this achievement.
The past few years have seen a lot of work in the use of biomaterials to rebuild the body after trauma or cancer, as well as the use of computers to plan surgeries and robotic machinery to assist the plastic surgeon in performing very delicate procedures.
Q: What should students understand about the challenges and rewards of a plastic surgery specialty?
A: It is a challenging career, both physically and emotionally, but it is exceptionally rewarding to help patients get through difficult situations.
This applies to both reconstructive and aesthetic procedures. The skills we use are related to the transfer and reshaping of tissues to achieve a result that helps the patient in both their form and function.