A decade later: Geographic access to plastic surgery in the U.S. using the 2022 Area Health Resource File.

Abstract

Access to plastic surgery services remains unevenly distributed across the United States, particularly in rural and underserved areas. This study provides a 10-year update on the geographic distribution of plastic surgeons using 2022 data from the Area Health Resources File. Plastic surgeon density was calculated for 942 Health Service Areas (HSAs) and stratified by demographic and healthcare infrastructure characteristics. Longitudinal changes in access from 2012 to 2022 were assessed. Practice type (office-based vs. hospital-employed) was also analyzed. In 2022, 49.9% of HSAs had no plastic surgeons, leaving 25.9 million Americans without local access. National plastic surgeon density declined from 2.42 to 2.14 per 100,000 population over the decade. Forty-one HSAs lost access to plastic surgeons, while 34 gained access. Regions that lost access had lower income, greater rurality, older populations, and fewer physicians per capita. Practice types were similarly distributed across HSAs regardless of plastic surgeon density in 2022. Geographic disparities in access to plastic surgery persist, with nearly half of U.S. regions lacking local providers. These disparities are shaped more by regional sociodemographic and infrastructure factors than by practice type. Policy interventions, training reforms, and rural workforce incentives are needed to address these inequities.