Unmasking Inequality: The Current State of Health Disparities Research in Plastic Surgery.

Abstract

Health disparities persist within plastic and reconstructive surgery (PRS), disproportionately affecting patient populations based on social determinants of health. These disparities contribute to delayed treatment, higher complication rates, and worse aesthetic and functional outcomes, ultimately affecting quality of life and patient well-being. Progress has been made in identifying these inequities, but there remains a need for targeted research to design, implement, and assess interventions that directly address these disparities. The authors conducted a scoping review of recent PRS literature to evaluate the proportion of studies focused on identifying, understanding, and addressing disparities. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, a systematic search identified national studies published since 2019 that addressed health care disparities specific to PRS. Of the 173 studies included, 81.5% focused on identifying disparities, 10.4% aimed to understand causative factors, and an additional 8.10% implemented interventions to reduce disparities. Disparities were most frequently reported in breast surgery, followed by general reconstruction and nonbreast microsurgery. People from underrepresented racial or ethnic groups, patients with lower socioeconomic status, and women experienced the greatest burden of inequity. Most studies evaluated barriers, such as treatment access, offers of care, and postsurgical complications; few studies progressed to implementing solutions to address these challenges. To achieve meaningful progress, PRS disparities research must move beyond identifying inequities to actively reducing them through evidence-based interventions, policy initiatives, and patient-centered care. Addressing these inequities can improve access to treatment, surgical outcomes, and quality of life for underserved populations. By prioritizing actionable solutions, the field of PRS can achieve more equitable health care delivery.