Rebuild faces, hands and bodies after cancer, burns and accidents. Cosmetic work is only part of it.
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Pay, the path, pros and cons and the facts on one printable page. Counsellors: send it to a student from your own email in one click.
The median pay is about $414,010 a year. Across everyone in the job it runs from about $80,320 at the lower end to about $655,320 at the upper end. The source is listed under Sources at the end of this page.
14 to 16 years after high school, on the usual route.
$158,000 to $330,000 all in for tuition, fees, exams and kit. Living costs are not counted.
Yes. It is a regulated job, so you need a license or registration before you can work.
Moderate demand nationally, from government outlook data. Demand varies by region, so check your area.
Or read the whole thing here
What you earn and what it costs to get there.
Median for the group
$414,010
Bottom tenth
$80,320
Top tenth
$655,320
Be careful with these numbers. The federal wage survey has no separate line for plastic surgeons. They are counted in Surgeons, All Other, a mixed group of surgical specialties, where the 2025 median is $414,010, the bottom tenth earn $80,320 or less and the top tenth $655,320 or more. It counts only surgeons who are employees, and many plastic surgeons own their practice instead.
$71,052 to $86,292 a year
Duke University Hospital pay from the first to the sixth training year, 2026 to 2027
Residents are salaried hospital employees, so this is real income. You are also carrying medical school debt and working the longest hours of your life. Pay is set by the hospital, not by the specialty. Nationally, the AAMC (Association of American Medical Colleges) survey of 345 teaching hospitals puts the average first-year stipend at $68,166 as of July 1, 2025, and about $81,807 in the fifth year. Read from the AAMC's data, downloaded in a browser with Claude in Chrome on 6 November 2026, because aamc.org refuses our checker.
$511,420 a year or more
25% of employed surgeons in the Surgeons, All Other group earn this or more
Reconstructive work is billed to insurance at set rates. Cosmetic work is paid directly by the patient, and a surgeon in private practice carries the risk and the overhead of running a business.
Roughly, all in
$158,000 to $330,000
Tuition, fees, exams and kit. Not rent, food or travel
The low end is a cheap undergraduate route into a public medical school at in-state rates near $30,000 a year, plus the admission test, applications and the three steps of the United States Medical Licensing Examination at $695, $695 and $955. The high end is four full years of public university tuition then a private medical school, plus the board certification fees at the end. Residency and any fellowship are paid jobs, so the six or more training years after medical school add exam fees but no tuition, and those residency years count toward Public Service Loan Forgiveness if the hospital is a nonprofit or government one. Most medical students borrow heavily, so file the Free Application for Federal Student Aid every year.
File the FAFSA (Free Application for Federal Student Aid) every year. Most medical students borrow, and the debt is large. Public Service Loan Forgiveness can cancel the balance after 10 years of qualifying payments at a nonprofit or government hospital, and your residency years count toward those 10.
Malpractice insurance paid for you
While you are employed. It is expensive in this specialty, and you pay it yourself once you own a practice.
Public Service Loan Forgiveness
Academic and nonprofit hospitals qualify, and six or more years of residency count toward the 10.
The military will pay the tuition
The armed forces run a scholarship covering medical school plus a monthly stipend, in exchange for roughly a year of service per year of support.
You can own the business
Few doctors can build a practice that is not dependent on insurance rates. Plastic surgeons can.
The exact path from high school to qualified.
One of the longest trainings on this site. Fourteen years minimum after high school.
High school
Grades 11 and 12
Top grades in biology, chemistry, physics and math. Nothing here is decisive, but weak science makes every later step harder.
Bachelor's degree
4 years
Any major, as long as you finish the pre-medical science courses and keep a high GPA. Sit the MCAT (Medical College Admission Test) in your third year.
Medical school
4 years
Two years of classroom science, then two years of hospital rotations. You graduate as an MD (Doctor of Medicine) or a DO (Doctor of Osteopathic Medicine). Both routes lead here.
Residency, one of two routes
6 to 8 years
The integrated route is 6 years of combined training entered straight from medical school. The independent route is 5 years of general surgery first, then at least 3 more years of plastic surgery, all 3 at the same institution.
Board certification
After residency
A written examination and then an oral examination from the American Board of Plastic Surgery.
Biology and chemistry
Required for nearly every pre-medical program.
Physics
Tested on the MCAT (Medical College Admission Test), and useful for understanding how tissue and flaps behave.
Art, sculpture or woodwork
Not a joke. This is the one surgical specialty where shape and proportion are the outcome.
English and public speaking
You explain permanent, visible decisions to frightened people for a living.
Every state runs its own medical board and issues its own license, so moving states means a new application. The national exam is the USMLE (United States Medical Licensing Examination), taken in three steps. Board certification is separate and comes from the American Board of Plastic Surgery, which requires that your training be completed in the United States or Canada at a program accredited by the ACGME (Accreditation Council for Graduate Medical Education) or its Canadian equivalent.
The title surgeon is protected by your medical license, but in most states the phrase cosmetic surgeon is not tied to any particular training. Doctors from other specialties can and do advertise cosmetic procedures. Board certification by the American Board of Plastic Surgery is the thing that actually says you completed this training, and the American Society of Plastic Surgeons builds its whole public message around telling patients to check for it.
Things you don't need, but that help.
One extra year that narrows what you operate on.
Hand surgery
Nerves, tendons and microsurgery. The American Board of Plastic Surgery runs a separate hand surgery examination for it.
Craniofacial surgery
Cleft lip and palate, skull shape in children. Often deeply rewarding.
Burn surgery
Critical care as much as cutting. Very short of people.
Microsurgery and breast reconstruction
Moving tissue with its blood supply attached, usually after cancer.
Aesthetic surgery
The cosmetic side, and the route into private practice.
Research and publications
Integrated plastic surgery programs weigh them heavily.
Hours inside an operating room
Shadow early. Standing still for eight hours suits fewer people than expect it to.
Manual craft of any kind
Sewing, carving, model making. The dexterity is trainable but the interest is not.
A second language
Spanish especially, in busy trauma and burn centers.
Public picture, actual job. Much of plastic surgery is reconstruction: rebuilding a breast after cancer, closing a wound that will not heal, repairing a hand crushed in a machine, treating burns, fixing a cleft palate in a child. Hospitals hire plastic surgeons because nobody else can do those operations. If the only part that appeals to you is the cosmetic side, you will still spend most of your training years in the other half.
Day to day, pros and cons, where you'd work.
Two or three operating days a week and one or two clinic days. A straightforward procedure runs an hour or two, a microsurgical reconstruction can run eight or more without a break. Clinic days are consultations, photographs, measurements and long conversations about what surgery can and cannot do. Then dictation, insurance authorizations and post-operative checks. Emergency call means hand injuries and facial trauma at unsociable hours.
The good
The hard parts
Things people don't tell you.
On the independent route, after 5 years of general surgery, the American Board of Plastic Surgery has required since 2014 that all 3 years of plastic surgery training be at the same institution.
Plastic surgery, orthopedic surgery and general surgery all lead to hand surgery, and the American Board of Plastic Surgery runs a separate hand surgery examination with its own date each year. The hand is complicated enough to need its own specialty.
Plastic surgeons are counted in Surgeons, All Other, a group of about 27,500 employed surgeons in 2025. Federal projections expect average growth and about 700 openings a year across that whole group.
Every list is built from the same numbers shown above, so you can see where this career sits next to the others.
Surgeons first, then the rest of the field. See every career in health.
Last checked November 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise. How every figure on this site is sourced and checked.
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