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. 2025 Oct 15;13(10):e7144. doi: 10.1097/GOX.0000000000007144

Mentorship of Women in Plastic Surgery: Reflections on Progress and Future Directions

Caitlin M Blades *, Sharmi C Amin †, Natalie M Guzman †, Carolyn De La Cruz ‡, Paige L Myers †, Paris D Butler §, Tara L Huston ¶,✉
PMCID: PMC12528596  PMID: 41112980

Abstract

Background:

Mentorship is essential for women in plastic surgery. It significantly aids their successful entry into the field and fosters long-term career advancement. At every stage, mentorship helps overcome barriers caused by persistent gender inequities. Given its importance, assessing the current mentorship landscape and identifying areas for improvement is essential to ensure women not only enter plastic surgery but also thrive within the field.

Methods:

A narrative review of peer-reviewed articles was conducted to assess the status of mentorship, strategies, and obstacles, as well as female representation and intersectionality within plastic surgery. The review placed a strong emphasis on mentoring in plastic surgery, while also expanding beyond the existing literature within the field to include broader perspectives.

Results:

Women are increasingly represented in medical school and training programs, but significant gender disparities persist in academic plastic surgery, especially in leadership roles. Female surgeons face challenges such as slower career progression, unequal pay, harassment, and work-life balance struggles. Mentorship is crucial for boosting academic productivity, reducing burnout, and promoting diversity, yet many women lack access to adequate guidance. The scarcity of female mentors in senior positions and the absence of structured mentorship programs exacerbate these challenges.

Conclusions:

Expanding mentorship opportunities and strategies, strengthening work-life balance support, and ensuring access to essential resources for women are vital steps in promoting success and advancing equity in academic plastic surgery.

Takeaways

Question: What is the current state of mentorship for women in plastic surgery, and how does it help address the unique challenges current and incoming trainees face?

Findings: A narrative review revealed a growing presence of women within the field. However, career advancement is hindered by gender disparities, disproportionate work-life demands, and limited access to mentors. This mentorship gap is primarily due to a paucity of female mentors and the lack of well-structured mentoring programs.

Meaning: Strengthening mentorship for women in plastic surgery through structured programs and expanded access to resources is crucial for addressing gender disparities and fostering long-term professional and personal success.

INTRODUCTION

Meaningful mentorship is a powerful strategy for enhancing both the entry and retention of women in plastic surgery. Despite the persistent gender inequities within this specialty,1 having a dedicated mentor can help alleviate the barriers often faced by female surgeons.2,3 Such mentorship offers invaluable guidance and cultivates a strong sense of belonging, empowering trainees to excel and sustain long-term success in their careers.4 Mentorship is crucial at every stage of a surgical career, from medical students seeking guidance, to trainees exploring their interests with specialty mentors, to junior surgeons needing career guidance, and experienced surgeons receiving support to transition into leadership roles in academic medicine or private practice. In this review, we explore the current representation of women within plastic surgery, emphasize the importance of mentorship, and discuss effective strategies for providing it.

CURRENT LANDSCAPE OF WOMEN IN ACADEMIC MEDICINE

In the United States, women are the majority of applicants, matriculants, and graduates from medical schools, yet only 29% of full-time professors are women.4 In academic medicine, women face slower promotion rates, fewer opportunities for promotable tasks, and lower pay for comparable work.5–9 Among senior associate deans in academic medicine, women represent approximately one-third of leaders in research and clinical affairs but represent two-thirds of leaders in diversity and faculty affairs.4 However, women consistently achieve excellent patient outcomes, excel in leadership assessments, mentor students and faculty, and contribute significantly to their organizations’ success.10–13 For example, the contributions of Drs. Amanda Gosman, Andrea Pusic, and Joyce McIntyre have led to the creation of the Surgeons in Humanitarian Alliance for Reconstruction, Research, and Education Program. Supported by the Plastic Surgery Foundation, the Surgeons in Humanitarian Alliance for Reconstruction, Research, and Education Program fosters global collaboration to expand surgical capacity and improve care in underserved regions.14 Additionally, the Volunteers in Plastic Surgery Steering Committee, led by Drs. Renata Maricevich and Noopur Gangopadhyay, supports plastic surgeons volunteering abroad. Their efforts have improved surgical care, upheld patient safety, and positively impacted global healthcare outcomes.15 These initiatives highlight the vital role of female leaders in shaping the future of plastic surgery, emphasizing their innovative approaches and commitment to education and mentorship. Therefore, addressing gender disparities in leadership throughout the field is essential to promoting equality and unlocking the full potential of organizations.

Although women comprise 47% of residents in surgery and surgical subspecialties, they remain underrepresented in full-time faculty roles.16 Among surgical specialties, women are least represented in full-time faculty positions in neurosurgery (8%), followed by orthopedic surgery (22%) and general surgery (29%).4,16 This contrasts with the national average, where nearly half of full-time faculty are women.4 Furthermore, only 8% of Department of Surgery Chairs are women, significantly lower than the national average of 25%.4 These numbers highlight the need for substantial strides in surgery subspecialties to improve gender representation and equity.

Women pursuing a career in surgery face unique challenges. Female surgery faculty encounter high rates of gender harassment, with 43% reporting sexual harassment in the past year.4 Studies indicate that up to 70% of female surgeons have encountered sexual harassment, including unwanted verbal or physical conduct, yet the majority do not report these incidents to their institutions.17,18 This misconduct is primarily perpetrated by attending surgeons, with residents and fellows 4 times more likely to be victims.19 Additionally, in 2020, nearly 70% of plastic surgery trainees reported microaggressions, with female, racial, and sexual minorities, as well as independent trainees showing significantly higher odds of encountering such biases.20 Furthermore, 14.1% of female surgery residents report experiencing daily symptoms of burnout.19 Factors influencing burnout include work overload, lack of autonomy, insufficient reward, community breakdown, unfairness, and values mismatch.21 Therefore, to improve burnout rates in plastic surgery, organizational-level interventions, rather than individual-level interventions, are needed.21 Interestingly, a study of plastic surgery residents found that 39% of women, compared with 4% of men, felt their gender limited case exposure and ultimately hindered their surgical training (P < 0.001).22 These statistics emphasize the need for inclusive, respectful, and equitable environments in surgery to reduce misconduct, mitigate burnout, and support the health and success of female surgeons.

FEMALE REPRESENTATION IN PLASTIC SURGERY

In 2024, women comprised 19% of the membership in the American Society of Plastic Surgeons,23 and the American Board of Plastic Surgery reported that women accounted for only 18.3% of board-certified plastic surgeons in active practice.24 A 2020 survey revealed that women represented only 25% of faculty, 22% of program directors, and 20% of program chairs within the specialty.1 In 2023, 65% of first authors at major plastic surgery research conferences and meetings were men.25 Additionally, as of 2024, only 1 woman has been awarded the Godina Fellowship, which recognizes potential leadership in young reconstructive surgeons, since its inception in 1993.26 Figure 1 illustrates the significant gender disparity in plastic surgery, showing a “leaky pipeline” effect as the representation of women decreases across advancing career stages.1,6,27,28

Fig. 1.

Fig. 1.

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Percentage representation of women in medicine and across advancing academic plastic surgery career stages. PRS, plastic and reconstructive surgery.

Despite these challenges, the field is experiencing a gradual but meaningful transformation, with increasing efforts to support and advance women’s careers. Female representation in plastic surgery residency programs has risen from 22% in 2007 to 45% in 2024.4,27 Plastic surgery is now 1 of only 2 surgical subspecialties, along with obstetrics and gynecology, to achieve gender parity in residency matching.29 Notably, between 2014 and 2018, the percentage of female first-authored abstracts at national conferences increased from 28% to 38% (P = 0.02).25 Furthermore, from 2008 to 2018, plastic surgery saw the greatest increase in female residents and surgical society leaders (17% and 19%, P < 0.05) among surgical specialties.30 This positive trend suggests that an expanding network of female mentors will be available to support and guide future medical students, residents, and faculty.

INTERSECTIONALITY IN MENTORSHIP

Underrepresentation in plastic surgery is even more pronounced among women who are racially and ethnically marginalized. Women comprise 45% of senior associate deans in academic medicine.4 However, within this group, only 12.6% are African American, 5.7% are Hispanic/Latino, and 0.6% are American Indian or Alaska Native.4 In 2019, women constituted 39% of plastic surgery trainees, whereas ethnic representation among Asian, Latinx, Black, American Indian or Alaska Native, and Native Hawaiian/Pacific Islander-Samoan persistently remained at 20%, 7.3%, 3.2%, 0.1%, and 0.8%, respectively.31

Research has shown that surgeons who are ethnically underrepresented in medicine struggle in academic careers due to a lack of guidance from senior colleagues and advocacy from influential leaders, hindering their career development.32–35 Therefore, it is essential for female plastic surgery trainees to have access to mentors with similar gender and racial backgrounds to provide support and promote retention, ultimately leading to a more inclusive and diverse environment in the field.

BENEFITS OF MENTORSHIP FOR WOMEN IN PLASTIC SURGERY

The benefits of mentorship are extensive, impacting both the mentee and the mentor. In addition to promoting professional development and career success,36 research has demonstrated that a strong mentorship relationship enhances job satisfaction, boosts academic productivity, and fosters greater diversity and inclusion.37,38 Furthermore, effective mentorship pacifies burnout rates while increasing retention rates and productivity in surgery.39–41 A survey of 624 plastic surgeons found that trainees with strong academic mentors were more likely to pursue academic surgery.39 This underscores the powerful influence of mentorship on individual career trajectories and its potential to drive broader systemic change within the field.

A recent study on the West Coast Plastic Surgery Mentorship Program, which included 19 underrepresented in medicine medical students (63.2% women), found that all participants reported increased comfort discussing how personal factors impact barriers to a career in plastic surgery (P = 0.03).42 Additionally, all students became more confident in identifying at least 3 potential mentors in plastic surgery (P < 0.01).42 These findings highlight the role of mentorship in helping students overcome barriers and navigate future career challenges. In a survey of 103 recently matched integrated residents (40.2% women), 95% of respondents reported receiving career guidance, and 91% reported receiving advice about away rotations and interviews from their mentors.43 Furthermore, 83% of trainees said their mentors’ guidance influenced their decision to pursue plastic surgery, with nearly 40% choosing the same subspecialty.43 These findings emphasize the profound impact mentorship can have on match rates and subspecialty career choices. It is essential for established plastic surgeons across all subspecialties to offer early, continuous mentorship, as it shapes emerging careers and promotes diversity of training.

During residency training, female surgeons face multifaceted challenges related to pregnancy and parenthood. These include obstetric risks associated with the physically demanding nature of the profession, societal stigma surrounding parental responsibilities, and limited or inconsistent parental leave policies.44–46 Inadequate postpartum support, including limited lactation and childcare resources, worsens these challenges. Additionally, the demands of plastic surgery training often lead female surgeons to delay starting a family, increasing the risk of infertility.47,48 Moreover, a recent study found that only 21.4% of 28 plastic surgery programs with wellness initiatives offered parental and fertility resources.49 The lack of support for residents’ parental and fertility challenges may represent gender bias in training.49 Addressing these complex issues and limited resources is easier with a mentor who provides experience-based guidance and fosters a supportive, open environment. Interestingly, a prospective study of 191 participants found that after a speed-mentoring session with female surgeons, the percentage of female medical students and first-year trainees who believed having a family would negatively impact a surgical career dropped from 46.6% to 23.0%.50 This significant shift underscores the critical role of same-gender mentorship in surgery. Therefore, although mentorship should come from a mosaic of trusted individuals, same-gender mentorship offers unique guidance and helps dismantle gender-specific barriers to female surgeons’ success.

OBSTACLES TO EFFECTIVE MENTORSHIP

The obstacles to achieving effective mentorship in plastic surgery are complex, with 3 key themes emerging from the literature: the underrepresentation of women in senior positions, the time constraints faced by potential mentors, and the lack of structured mentorship programs. Silva et al51 noted that women can feel discouraged from pursuing surgical specialties due to the lack of female colleagues, insufficient support, and the absence of female role models. Furthermore, the underrepresentation of women in senior roles directly limits the pool of potential female mentors available for aspiring female plastic surgeons.50 However, early exposure to female mentors can address these issues by fostering a greater interest in the field and providing visibility and guidance during critical career decisions.36

The field’s demanding nature further exacerbates the shortage of female mentors in plastic surgery. Many experienced surgeons, both male and female, have saturated schedules with clinical, research, and administrative duties.52,53 Although mentors recognize the personal satisfaction and professional fulfillment that come from mentoring, they also acknowledge that the time commitment can feel like an additional burden in an already demanding career—a phenomenon Janis and Barker53 refer to as the “giving back paradox.” Addressing this issue through supporting and encouraging faculty to provide mentorship is crucial for increasing female representation within the field.

Work-life balance in surgery is further strained by issues disproportionately faced by women, including familial responsibilities, pregnancy, and childcare.29 Studies show that female surgeons more often shoulder these burdens, even when both partners work full time.29,54 Historically, residency programs have lacked adequate support for pregnancy and parental leave, making it difficult for women to balance family planning with training.55 A 2023 study found that female surgery residents were 1.17 times more likely to experience unintended attrition than male residents (P < 0.001).56 Supporting literature highlights that women in academic plastic surgery are particularly likely to leave during early career stages when family demands are highest.57 Despite progress, such as the American Board of Plastic Surgery offering an optional 12 weeks of personal leave, the literature suggests more comprehensive policies and support systems are needed.57 Increasing support for women in surgery would improve their well-being and break cycles that both limit the number of women entering the profession and remaining within it to serve as mentors.52,53

Formal mentorship programs pair mentees with mentors, provide training and resources, and offer support to help manage time constraints.52,53,58 However, a survey of 292 American Society of Plastic Surgeons members found that only 15.2% had structured mentorship systems within their institutions, often without evaluation.52 This likely contributes to reduced mentor visibility and disproportionately affects trainees from smaller programs or those with fewer female faculty, as these mentors may already be supporting many students.29,58 Without formalized support, mentorship relies on informal, often unreliable connections that are difficult to establish and subject to the initiative of the individuals involved.42,54,55 Therefore, establishing a systematic effort to build connections and encourage career development in plastic surgery would benefit female professionals across various training levels and diverse programs.43,53

MENTORING STRATEGIES FOR MEDICAL STUDENTS

Mentorship in plastic surgery is crucial for inspiring ambition, fostering growth, and building resilience in future surgeons. Medical student mentors should have a clear understanding of their background, interests, and goals while promoting an environment that encourages autonomy and leadership.59 A mentor’s primary role is to model enthusiasm, communication, patience, and compassion. They should also be approachable, available, honest, reliable, committed to their craft, and consistently exemplifying professional and ethical behavior.60,61 Additionally, surgical mentors should guide students in research, clinical etiquette, and time management, and provide constructive feedback to develop essential technical skills. These attributes are critical in setting the tone for the student’s own professional journey.

In the professional realm, mentors should help set educational goals, offer networking opportunities, provide career counseling, and introduce students to the field’s environment, customs, and luminaries.62 Strategies should also prioritize creating a safe, supportive space for students to express aspirations, concerns, and challenges. Open communication is crucial in building trust and ensuring students receive personalized guidance and opportunities. At this stage of their careers, long-term mentoring objectives should be broken down into manageable steps, with regular check-ins scheduled. Most mentees prefer frequent one-on-one interactions over less frequent or group activities, as this allows for a more focused and supportive mentoring experience.43

MENTORING STRATEGIES FOR PLASTIC SURGERY RESIDENTS

During residency, mentorship shifts toward preparing trainees for the demands of the specialty and independent practice. At this stage, a mentor should continue to provide educational support while guiding residents through the complexities of surgical practice, career development, and leadership roles within the subspecialty of their interest. A key aspect of successful mentorship for residents is guiding them through challenging clinical decisions while managing a high surgical and patient volume. Constructive feedback on clinical performance should be consistent and residents should be encouraged to gradually tackle more complex cases as they advance in their training. As residents transition toward independent practice, it is also essential for mentors to help them build their confidence and leadership abilities, preparing them to become mentors themselves.

In addition to clinical guidance, mentors should help residents refine their career goals and offer valuable networking opportunities. This includes connecting them with fellowship program directors or leaders at institutions or private practices where they aspire to join the faculty. Such actions provide residents with valuable exposure to the plastic surgery community and support their professional growth. Additionally, engaging the mentee in social opportunities within the field fosters camaraderie and a sense of belonging. By showing the mentee that they truly belong, the mentor helps combat the well-known phenomenon of impostor syndrome early in their career.63 Furthermore, regular check-ins with the mentee are essential to ensure their progress is on track and that they feel supported in managing the many pressures of residency training.

MENTORING STRATEGIES FOR ATTENDING PHYSICIANS

For attending physicians, mentorship evolves into a more advanced level of guidance, emphasizing professional development, leadership, and the cultivation of mentoring skills within the mentee to ensure they can effectively guide the next generation of surgeons. At this stage, mentorship increasingly shifts to sponsorship, with mentors advocating for mentees, increasing their visibility by inviting them to key meetings, facilitating introductions, and nominating them for important committee positions to advance their careers. A successful mentor helps attending physicians navigate the demands of clinical work, research, teaching, and leadership. They also support long-term career planning by aligning mentorship with the mentee's goals, such as building a research portfolio, pursuing advanced training, or expanding leadership roles.

As the number of female surgeons in leadership positions remains limited, mentorship at the attending level is crucial for supporting female surgeons and promoting diversity within the field. Although there are challenges associated with mentorship by and for women, it is important to recognize that mentor–mentee pairs can be highly successful, regardless of whether they share the same sex.60 Interestingly, female plastic surgeons strongly believe that gender and race/ethnicity concordance between mentor and mentee is important, whereas their male counterparts tend to be neutral or believe it does not matter.52 Currently, 85% of board-certified plastic surgeons are men, whereas nearly 50% of trainees are women.62 Therefore, it is essential for all surgeons to embrace mentoring both women and men, as doing so promotes personal development and broadens perspectives across the field.

Finally, attending physicians should engage in “horizontal mentorship” with their peers. Peer-to-peer mentorship fosters bidirectional growth, allowing colleagues to share clinical insights, research ideas, and challenges, while promoting a collaborative work environment.64 Horizontal mentorship promotes a culture of mutual respect and lifelong learning, while allowing surgeons to refine their mentoring skills.65 Effective mentorship strategies evolve as mentees progress through their careers, from medical students to residents to attending physicians. Each stage requires tailored approaches that foster technical growth, professional development, and leadership capabilities, ensuring that the next generation of plastic surgeons is well prepared to meet the demands of the field (Fig. 2). Ultimately, a mentor’s role is to empower their mentee with the tools, confidence, and connections needed to succeed, surpassing even the mentor’s own achievements.

Fig. 2.

Fig. 2.

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A comprehensive overview of effective mentoring strategies for women in plastic surgery. Strategies are categorized into those tailored to each career stage (medical students, residents, and attending surgeons), as well as those that are universally beneficial across all stages.

CONCLUSIONS

Although women are increasingly represented in medical education and surgery, significant gender disparities remain in plastic surgery, especially at leadership levels. Female surgeons face unique challenges such as slower career progression, unequal pay, gender-based harassment, and work-life balance difficulties. Although mentorship helps women navigate these challenges, many lack access to adequate guidance due to a shortage of female mentors in senior roles and a lack of structured programs. To promote equity, efforts should focus on expanding mentorship pathways through formal programs and clear guidance on best practices to ensure women have the resources and opportunities needed for a successful and sustainable career in plastic surgery.

DISCLOSURE

The authors have no financial interest to declare in relation to the content of this article.

Footnotes

Published online 15 October 2025.

Disclosure statements are at the end of this article, following the correspondence information.

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