← 2026 Salary Report / Plastic Surgery
Unique mix of insurance-based reconstructive and cash-pay cosmetic work. Cosmetic focus drives the highest incomes.
Training: 6 years post-medical school | 5-Year Change: +14% | Range (25th-75th): $380,000-$800,000
Plastic surgeons start at $350,000-$450,000 in mixed reconstructive/cosmetic practices. Cosmetic-focused surgeons in private practice can earn $600,000-$1M+ within 5-8 years. Reconstructive/microsurgery-focused surgeons earn $400,000-$600,000. Hand surgery subspecialists earn $400,000-$550,000. The income range is one of the widest in medicine due to the cosmetic variable.
Cosmetic surgery income is highest in affluent metro areas (Miami, LA, NYC, Dallas, Scottsdale) despite high COL. Reconstructive surgery compensation is more geographically even and follows hospital system pay scales. Florida and California lead cosmetic procedure volume.
Employed plastic surgeons doing primarily reconstructive work earn $380,000-$520,000. Private practice cosmetic surgeons earn $600,000-$1.5M+ with zero insurance hassle on cosmetic cases. The key is patient acquisition - marketing, social media, and reputation drive cosmetic practice growth. Overhead runs 50-65% but margins on cosmetic procedures are high.
Three highest-leverage actions: (1) Build a cosmetic practice with strong social media and patient reviews - cash-pay cosmetic cases have the highest margins in medicine. (2) Consider geographic arbitrage: cosmetic demand in affluent smaller markets (Scottsdale, Charleston, Austin) can match major metros with lower overhead. (3) Med spa services (injectables, lasers) add high-margin recurring revenue with mid-level delegation. Use the PhysicianWealth Salary Benchmark for a personalized comparison.
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