America's Plastic Surgery Crisis: What 2022-2037 Projections Reveal About Workforce Vulnerabilities

This national projection study evaluates the future supply and demand of plastic surgeons in the United States through 2037 using the Health Workforce Simulation Model from the Health Resources and Services Administration. Workforce supply was modeled in full-time equivalents (FTEs), accounting for residency graduation rates, attrition, and retirement patterns through scenario-based sensitivity analysis across alternative workforce assumptions. Demand projections incorporated demographic trends, service utilization, and physician-to-population ratios. Under status quo assumptions, the national supply of plastic surgeons is projected to decline by approximately 22%, from 10,960 FTEs in 2022 to 8,540 by 2037. In contrast, demand is expected to increase by nearly 6% under baseline conditions and by more than 40% if access barriers are eliminated. This imbalance translates into a national adequacy decline from 100% in 2022 to 73% by 2037, with the most pronounced disparities in nonmetropolitan regions and in states such as Arkansas, Maine, and New Mexico, which are projected to have the lowest adequacy levels. This projected shortage represents a multifactorial challenge shaped by demographic aging, geographic maldistribution, constrained rural infrastructure, and reimbursement pressures. Addressing these trends will require coordinated, data-driven interventions supported by sound policy planning. Policy initiatives should emphasize equitable surgeon distribution, targeted financial incentives in underserved regions, protection of procedural scope, and the adoption of technological innovations to enhance equitable and sustainable access to plastic surgery care across the United States.