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Open Access
CC BY 4.0 · Arch Plast Surg 2026; 53(01): 102-116
DOI: 10.1055/a-2731-4559
Clinical Practice and Education
Original Article

Coexisting in a Crowded Field: A 10-year Comparison of Procedural Volumes of Plastic Surgeons and Other Surgical Specialties in the United States

Authors

  • Ethan L. MacKenzie 

    1   Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States

  • Doruk Orgun 

    1   Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
    2   Department of Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan

  • Kasey Leigh Wood Matabele 

    1   Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
    3   Division of Plastic and Reconstructive Surgery, University of Rochester Medical Center, Rochester, New York, United States

  • Samuel O. Poore 

    1   Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
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Abstract

Background

Plastic surgery has broad overlap with other surgical subspecialties. Regarding procedures provided by both plastic surgery and other surgical specialties in the United States, the changes in plastic surgical case volume over time have not been previously investigated.

Methods

Select common procedure terminology (CPT) codes from an array of areas of practice including breast reconstruction, hand, adult craniofacial, peripheral nerve, microsurgery, and ventral hernia were extracted from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) from 2010 to 2020. Case numbers, operative times, and complication rates among surgical subspecialties were compared. Aesthetic surgery cases were excluded as they are not well captured by the NSQIP database.

Results

A total of 128,545 procedures were included. In 2010 and 2020, plastic surgeons performed 83.9% versus 89.3% of reconstructive breast (p < 0.001), 5.4% versus 4.3% of hand (p = 0.23), 33.6% versus 39.1% of adult craniofacial (p = 0.28), 36.7% versus 29.5% of peripheral nerve (p = 0.45), 9.3% versus 94.6% of microsurgical (p = 0.25), and 0.4% versus 0.4% of ventral hernia procedures (p = 0.99). Plastic surgery performed the majority of breast reconstruction and microsurgical procedures. Operative times and complication rates varied between specialties and were generally inversely proportional to the number of cases for included specialties.

Conclusion

Plastic surgical involvement did not significantly decrease for any of the included procedural categories in ACS-NSQIP over the study period. Breast reconstruction and microsurgery remain areas of particular specialization with plastic surgeons performing the highest volume. Areas of shared practice suggest opportunities for collaboration.

Keywords

specialty - procedures - surgeries - complications - tissue

Contributors' Statement

E.L.M.: conceptualization, methodology, investigation, formal analysis, visualization, writing – original draft preparation, writing – review and editing

D.O.: writing – review and editing, methodology, investigation, formal analysis, visualization

K.L.W.M.: methodology, investigation, writing – review and editing

S.O.P.: conceptualization, methodology, writing – review and editing, resources, supervision, project administration


Ethical Approval

Not required.


Note

This study was presented in part at the 2023 meeting of the American Society of Reconstructive Microsurgery.


Supplementary Material



Publication History

Received: 01 September 2025

Accepted: 19 October 2025

Accepted Manuscript online:
28 October 2025

Article published online:
30 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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