Forward Strides in Academic Plastic and Reconstructive Surgery Gender Representation: 2025 Update.

[BACKGROUND] Although academic plastic and reconstructive surgery has trended toward dismantling gender disparities over the past decade, gaps remain within program leadership. In this study, the authors mapped gender distributions of plastic surgery chiefs and program directors in context of faculty and trainees to characterize how current leadership reflects and shapes the broader gender landscape.

[METHODS] In a national cross-sectional study, data on academic plastic surgery leaders, faculty, and trainees were extracted from program websites or social or professional media, determining gender using documented pronouns. Career metrics were collected for all leaders. Differences by gender were evaluated using chi-square or Fisher exact tests, independent-sample t tests, and analyses of covariance. Associations among female representation in program leadership, faculty, and trainees were examined.

[RESULTS] As of 2025, women comprise 26.4% of faculty and 50.9% of residents. A total of 0.1% of faculty or trainees self-identified as nonbinary. In comparison, 13.5% of department or division chiefs, 22.5% of primary program directors, and 43.1% of associate program directors are female. Associate program directors are significantly more likely than chiefs or primary program directors to be female ( P < 0.001), indicating expansion of women entering leadership positions. Analyses of qualifications and professional attainment supported gender parity in selection and advancement of program leaders. Program directors may shape trainee gender distributions: significant associations suggested greater inclusion of female residents at programs with female primary or associate program directors ( P ≤ 0.03). Female versus male leaders were associated with significantly greater female faculty representation within their programs (approximately 150% relative magnitudes; P ≤ 0.005).

[CONCLUSION] Gender inclusion has progressed throughout academic plastic surgery, and parity among trainees anticipates further shifts.