Exploring Physician Salary by Specialty in Plastic Surgery: Your Guide

Understanding Physician Salary by Specialty in Plastic Surgery

Physician salary by specialty is one of the most-discussed topics among medical students and residents considering the integrated plastics match. Plastic surgery is consistently listed among the highest paid specialties, but the real story is more nuanced: compensation varies widely depending on subspecialty, practice setting, geography, and career stage.

This guide focuses specifically on plastic surgery within the broader “physician salary by specialty” conversation. You’ll learn:

• Where plastic surgery sits in the national doctor salary by specialty landscape
• How subspecialty choice (aesthetic, reconstructive, hand, craniofacial, microsurgery, academic vs private) influences income
• What compensation looks like across training milestones—resident, fellow, early attending, and late career
• How different practice models affect your earning potential and lifestyle
• Practical steps you can take now as a medical student or resident to position yourself for financial success

All numbers below are approximate and based on recent (2023–2024) compensation survey data (e.g., Medscape, MGMA, AMGA, large recruiting firms) plus real-world anecdotal ranges from practicing plastic surgeons. Exact figures vary, but the ranges and patterns are reliable enough for planning.

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Where Plastic Surgery Fits in the Physician Salary Landscape

When students look at doctor salary by specialty, they usually see cardiology, orthopedics, neurosurgery, and plastic surgery at or near the top. Plastic surgery is consistently among the highest paid specialties, often ranking in the top 3–5.

Big-Picture Comparison: Plastic Surgery vs Other Specialties

Typical annual attending compensation ranges (pre-tax, total cash compensation including bonus; approximate):

• Plastic Surgery:
  • Common range: $450,000 – $900,000+
  • Median/typical: around $550,000 – $650,000
  • Very high earners (busy aesthetic or high-volume private practice): $1M+

For context, compare with selected other specialties:

• Primary care (IM, FM, pediatrics): ~$230,000 – $320,000
• General Surgery: ~$400,000 – $550,000
• Orthopedic Surgery: ~$550,000 – $900,000+
• Neurosurgery: ~$650,000 – $1M+
• Dermatology: ~$450,000 – $700,000
• Radiology (diagnostic): ~$450,000 – $650,000
• Anesthesiology: ~$440,000 – $620,000

Plastic surgery clearly sits in the upper tier of physician salaries. But plastic surgery is not a single salary profile. The integrated plastics match can lead to very different financial outcomes depending on:

• Your subspecialty focus (aesthetic vs reconstructive vs hand)
• Whether you work in private practice, academic medicine, or a multi-specialty group
• Your geographic location
• How aggressively you develop your business, marketing, and efficiency skills

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Plastic Surgery Subspecialties and Income: How Focus Shapes Pay

Within plastic surgery, physician salary by specialty is best understood as physician salary by subspecialty and practice type. Below are common pathways and how they typically influence compensation.

1. Aesthetic (Cosmetic) Plastic Surgery

Profile:
Focus on cosmetic procedures: breast augmentation, rhinoplasty, body contouring, facial rejuvenation, minimally invasive/injectables, etc. Predominantly outpatient and self-pay.

Typical Compensation

• Early career in group practice: $450,000 – $650,000
• Established solo or partnership in a strong market: $700,000 – $1M+
• Top-tier brand, high-volume practice: $1.2M+ is possible but not the norm

Key Drivers of Income

• Payer mix: Aesthetic work is usually cash-pay, avoiding insurance hassles and low reimbursement.
• Brand and marketing: Reputation, online presence, before/after galleries, and patient reviews heavily influence volume.
• Location: Urban, high-income areas (LA, Miami, NYC, Dallas, Dubai, etc.) can be very lucrative but also highly competitive.
• Ancillary income: Skincare lines, injectables, medspa services, skincare retail, premium memberships.

Pros

• Among the highest paid subspecialties within plastic surgery
• Control over schedule, elective procedures, fewer emergencies
• Strong potential for entrepreneurial growth

Cons

• Requires good business sense and marketing; success not guaranteed
• No-shows and economic downturns can hurt volume
• High overhead (ORs, staff, marketing) for large cosmetic practices

2. Reconstructive Plastic Surgery (General Reconstruction & Microsurgery)

Profile:
Breast reconstruction, cancer reconstruction, extremity reconstruction, trauma, wound care, microsurgical free flaps.

Typical Compensation

• Hospital-employed or academic: $400,000 – $600,000
• Community hospital or private group: $450,000 – $750,000
• High-volume micro/oncologic reconstruction in busy centers: can exceed $800,000, especially with productivity bonuses

Key Drivers of Income

• Case complexity and RVUs: Microsurgery and advanced recon carry high RVU values.
• Call coverage: Trauma, hand call, and microsurgery can add substantial stipends.
• Institutional support: High-volume cancer or trauma centers often support robust reconstruction practices.

Pros

• Stable demand driven by cancer, trauma, and chronic disease
• Cases are often deeply meaningful with high patient gratitude
• Good alignment with academic careers and research

Cons

• Long, physically demanding cases
• Night/weekend calls, especially in trauma or microsurgical services
• Reimbursement is insurance-based, vulnerable to payer mix and contract rates

3. Hand Surgery

Profile:
Hand and upper extremity, including trauma, tendon and nerve repair, microvascular work, elective hand, and sometimes peripheral nerve.

Typical Compensation

• Private or group practices: $450,000 – $750,000
• Academic centers: $380,000 – $550,000
• High volume + heavy call + procedures (e.g., wide-awake anesthesia) can push income higher

Key Drivers of Income

• High case volume: Many small procedures that add up in RVUs.
• Call pay: Hand call at trauma centers can be lucrative.
• Shared market: Orthopedic hand surgeons compete in the same space; market dynamics matter.

Pros

• Constant demand (trauma, overuse injuries, work-related injuries)
• Mix of clinic and OR; many procedures can be done in-office
• Shorter cases compared with big micro reconstructions

Cons

• High call burden in some hospitals
• Heavy insurance involvement and workers’ compensation complexities
• Need strong therapy and rehab partners

4. Craniofacial & Pediatric Plastic Surgery

Profile:
Cleft lip/palate, craniosynostosis, congenital anomalies, pediatric facial trauma, sometimes aesthetic facial surgery.

Typical Compensation

• Academic pediatric/craniofacial surgeons: $350,000 – $550,000
• Mixed craniofacial + aesthetic (often in private practice): $450,000 – $800,000, depending on how much cosmetic work is incorporated

Key Drivers of Income

• Institutional funding and grants (especially in academic children’s hospitals)
• Mix with adult aesthetic procedures to supplement income
• Regional referral patterns and presence of craniofacial centers

Pros

• Highly meaningful work with long-term patient relationships
• Often central to multidisciplinary teams (ENT, neurosurgery, orthodontics)
• Strong academic and research opportunities

Cons

• Pure pediatric/craniofacial work is often on the lower earning side for plastic surgery
• Call coverage and complex, long cases
• Reliance on institutional support and insurance payers

5. Academic vs Private Practice vs Employed Models

Across all subspecialties, practice model strongly shapes compensation:

• Academic Plastic Surgery

  • Range: $350,000 – $600,000
  • Lower than private practice on average, but with trade-offs: job security, benefits, protected time, prestige, research, teaching.

• Private Practice (Solo or Partnership)

  • Range: commonly $500,000 – $900,000+
  • Higher ceiling, especially in aesthetic work, but more risk, overhead, and business responsibility.

• Hospital-Employed / Large Group Practices

  • Range: $450,000 – $750,000
  • Decent stability, moderate-to-high income potential, less entrepreneurial control but less business stress.

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Training Pathway and Earnings Over Time: From Integrated Plastics Match to Attending

Your income trajectory in plastic surgery is a long game. Understanding expected earnings at each stage helps you plan debt management, lifestyle choices, and career timing.

1. Resident Salary (Integrated or Independent)

Whether you enter via integrated plastic surgery residency or complete a general surgery residency first then an independent plastics program, resident salaries are similar to other specialties and tied to PGY year.

Typical U.S. plastic surgery resident salaries (2024 ballpark):

• PGY-1: $60,000 – $68,000
• PGY-2: $62,000 – $70,000
• PGY-3: $64,000 – $72,000
• PGY-4: $66,000 – $74,000
• PGY-5: $68,000 – $76,000
• PGY-6 & 7: $70,000 – $80,000+

Add about $3,000–$7,000 more in total compensation for overtime, moonlighting (where allowed), and benefits (health, retirement match).

2. Fellowship Training (Hand, Craniofacial, Microsurgery, Aesthetic)

If you pursue additional fellowship training:

• Hand, craniofacial, microsurgery, pediatric, or aesthetic fellowship stipends:
  • Typically around $70,000 – $85,000
  • Sometimes slightly higher at well-funded institutions

A fellowship delays attending-level income by 1–2 years, but can:

• Open doors to subspecialty roles and higher long-term income
• Improve marketability and negotiating power
• Enhance your academic or specialized niche profile

3. Early Attending (Years 1–5)

When you first finish training:

• Academic or hospital-employed positions:
  • Often start around $400,000 – $550,000
• Private practice jobs (employed model, joining a group):
  • Base salaries typically $350,000 – $500,000 plus bonuses and productivity-based incentives
• Pure aesthetic practices may offer lower base initially but higher upside via collections percentage or bonuses

Early attending compensation is heavily influenced by:

• Guarantee period: 1–3 years of guaranteed salary while you build your panel
• Productivity bonuses: Based on RVUs or collections once you surpass a threshold
• Call pay: Particularly in trauma, hand, or microsurgery

4. Mid- to Late-Career (Years 6+)

As you establish yourself:

• Reconstructive / academic surgeons:
  • Commonly $450,000 – $750,000
  • High volume plus leadership roles, program directorships, or administrative stipends can push higher
• Aesthetic-focused private practice:
  • Commonly $600,000 – $1M+ total compensation for successful, busy practices
• Hybrid surgeons (mix of recon + aesthetics):
  • Often land in the $550,000 – $900,000 range

By mid-career, your income is driven by:

• Case mix and payer mix
• Reputation and referral base
• Business systems (OR efficiency, staff, marketing, digital presence)
• Negotiated contracts and partnership terms if in a group

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Factors That Shape Plastic Surgery Compensation

Two plastic surgeons in the same city, same subspecialty, can earn very different incomes. Understanding the levers behind physician salary by specialty in plastic surgery can help you plan strategically.

1. Geographic Region

Broad trends (approximate multipliers relative to national median):

• High-paying but often less-desirable lifestyle markets (rural, Rust Belt, some Southern/Midwestern areas):

  • Compensation may be 10–25% higher than big coastal academic centers.

• Major coastal cities (NYC, SF, LA, Boston, DC):

  • Compensation can be 10–20% lower than national median in academic/hospital jobs
  • However, pure aesthetic practices in these areas can generate extremely high incomes with the right patient base.

• State-specific payer mix and malpractice climate:

  • States with favorable tort reforms and strong commercial insurance can support higher incomes and better job offers.

2. Practice Ownership and Business Model

• Owners/Partners usually earn more over time than employed surgeons, but:
  • Face more financial risk
  • Must manage staff, HR, leasing, marketing, and compliance
• Employed surgeons trade some upside for stability and fewer administrative burdens.

Example:

• Employed academic reconstructive surgeon:
  • $475,000 salary + modest bonus, strong benefits, retirement match, loan repayment.
• Aesthetic practice partner:
  • Collections of $2M/year, overhead 50–60%, leaving $800,000–$1M pre-tax to the surgeon.

3. Clinical Volume and Efficiency

Regardless of setting, compensation usually tracks:

• RVUs generated (in RVU-based systems)
• Collections (in percentage-of-collections models)
• OR and clinic efficiency, including turnover times, scheduling, and no-show rates

Surgeons who:

• Maintain full clinics
• Optimize scheduling (stacking smaller cases efficiently)
• Integrate physician extenders (PAs/NPs) appropriately
  often see significantly higher income.

4. Reputation, Niche, and Brand

Plastic surgery is relationship- and reputation-driven:

• For aesthetic surgeons, online reviews, social media, SEO, and before/after galleries heavily influence patient flow.
• For reconstructive surgeons, referrals from oncologists, trauma surgeons, dermatologists, and primary care providers are key.

Becoming “the go-to” person for:

• Complex breast reconstruction
• Facial trauma and craniofacial issues
• High-quality rhinoplasty or revision cases
  can support premium pricing and robust case volume.

5. Negotiation and Contract Terms

Your starting contract matters:

• Base salary vs. productivity bonus structure
• How RVUs are credited and what thresholds trigger bonuses
• Benefits package (CME, relocation stipend, sign-on bonus, call pay)
• Partnership track and buy-in terms (for private practices)

Poorly negotiated contracts can leave tens of thousands of dollars (or more) on the table annually.

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Actionable Advice for Students and Residents Targeting Plastic Surgery

Compensation should not be the sole reason you pursue plastic surgery, but it is a legitimate factor—especially with significant medical school debt. As you work toward the integrated plastics match and beyond, consider these steps:

1. Be Realistic About the Integrated Plastics Match

• Integrated plastic surgery residency is among the most competitive specialties.
• Matching requires:
  • Excellent USMLE/COMLEX scores (or strong performance on pass/fail Step 1 and strong Step 2 CK)
  • Demonstrated interest through research, sub-internships, and mentorship
  • Strong letters of recommendation

If part of your motivation is entering one of the highest paid specialties, remember that competition is intense and many excellent applicants do not match on the first try.

2. Build Financial Literacy Early

During medical school and residency:

• Learn core money management principles:
  • Budgeting, emergency funds, loan repayment strategies, basic investing
• Understand typical plastic surgery compensation structures so you recognize a fair contract.
• Consider optional reading/listening on investing and physician finance; specialty income is high, but so is the risk of lifestyle inflation and burnout.

3. Use Electives and Rotations to Explore Subspecialties

To align interests, lifestyle, and income expectations:

• Rotate with aesthetic, reconstructive, hand, and craniofacial surgeons if possible.
• Ask about:
  • Their typical week (OR vs clinic vs admin)
  • Call schedule
  • Compensation model and what they would do differently if starting over.

This grounded insight is more valuable than isolated doctor salary by specialty tables.

4. Learn the Business Side of Medicine

Particularly if you lean toward aesthetic or mixed private practice:

• Seek mentors willing to discuss:
  • Overhead, marketing, and staffing
  • OR block time negotiation
  • Pricing and contracts with surgery centers or hospitals
• During residency, consider electives in:
  • Practice management
  • Healthcare finance
  • Quality improvement and operations

Owners who understand business fundamentals are more likely to reach and sustain high income levels.

5. Protect Your Future Earning Potential

Your ability to practice is your most valuable financial asset.

• Learn and apply ergonomic and wellness strategies to avoid injuries (neck, back, hands).
• Understand malpractice risk and practice good documentation and communication.
• Maintain licensure, board certification, and continuing education; losing these can destroy income overnight.

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Frequently Asked Questions (FAQ)

1. Is plastic surgery really one of the highest paid specialties?

Yes. Among all specialties, plastic surgery consistently ranks in the top tier of physician salaries, often alongside orthopedics, cardiology, and neurosurgery. However, there is substantial variability based on subspecialty, practice type, and region. A purely academic craniofacial surgeon may earn less than a rural orthopedic surgeon, while a successful aesthetic plastic surgeon in private practice may out-earn many neurosurgeons.

2. How much does a new plastic surgeon make right after residency?

Most new plastic surgeons in the U.S. can expect:

• $400,000 – $550,000 in academic or hospital-employed settings
• $350,000 – $500,000 base in private practices, often with productivity bonuses that may increase total compensation into the $450,000 – $650,000 range within a few years as their practice matures

Highly aesthetic-focused roles may start with a lower guaranteed base but offer a higher percentage of collections and greater long-term upside.

3. Does doing a fellowship increase my salary?

Often, yes, but not always immediately. A fellowship (hand, microsurgery, craniofacial, pediatric, aesthetic) can:

• Make you more competitive for specialized positions and high-demand niches
• Support higher productivity and referral volume in reconstructive or hand surgery
• Enhance your marketability in academic centers

However, you delay attending-level earnings by 1–2 years. The long-term financial benefit depends on how you leverage the fellowship in your career.

4. Can an academic plastic surgeon still earn a high income?

Yes. While average academic salaries are lower than private practice, many academic plastic surgeons:

• Supplement income with private aesthetic cases, consulting, or speaking
• Hold leadership roles (chief, program director, division chair) with stipends
• Work in high-volume centers with robust RVU-based bonuses

It’s entirely realistic for academic plastic surgeons to earn $500,000 – $700,000+, especially at later career stages or in hybrid roles that blend academic and private practice elements.

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Understanding physician salary by specialty in plastic surgery is essential as you navigate the integrated plastics match, choose subspecialty training, and evaluate job offers. Plastic surgery offers exceptional income potential, but the path is long, competitive, and highly variable. Aligning your clinical interests, lifestyle goals, and financial priorities—and developing strong mentorship and business acumen—will position you for both professional fulfillment and financial stability in one of medicine’s most dynamic fields.