Background National procedural volume summaries are commonly used to describe plastic surgery activity and may inform workforce planning and training exposure. However, the distribution of reported volume across practice categories and the extent of within-category concentration are not well characterized, which limits the interpretation of procedural counts. Methods A cross-sectional descriptive secondary analysis of American Society of Plastic Surgeons (ASPS)-reported procedural data for the calendar year 2024 was conducted. Procedures were grouped into three practice categories: cosmetic surgical, minimally invasive, and reconstructive. The total procedural volume was calculated for each category and expressed as a proportion of the overall ASPS activity. Within each category, procedures were ranked by 2024 volume. Concentration was assessed using the Top-5 concentration ratio (CR5), with supplementary analyses using the Top-3 concentration ratio (CR3) and the Herfindahl-Hirschman Index (HHI). Results In 2024, the total ASPS procedural volume across cosmetic surgical, minimally invasive, and reconstructive practice categories was 30,877,819 procedures. Minimally invasive procedures accounted for 28,243,407 procedures (91.5% of the total volume), compared with 1,585,878 cosmetic surgical procedures (5.1%) and 1,048,534 reconstructive procedures (3.4%). Minimally invasive volume exceeded cosmetic surgical volume by 26,657,529 procedures and reconstructive volume by 27,194,873 procedures. The five highest-volume procedures accounted for 69.4% of cosmetic surgical volume, 83.6% of minimally invasive volume, and 80.3% of reconstructive volume. Supplementary concentration metrics showed the same pattern, with CR3 values of 52.1%, 67%, and 69.9% and HHI values of 0.1212, 0.1960, and 0.1929, respectively. Conclusions The ASPS procedural volume in 2024 was dominated by minimally invasive procedures and was highly concentrated within practice categories. These findings support interpreting procedural totals alongside case mix and within-category concentration rather than relying on procedure counts alone.
Saleh Alhotan (Fri,) studied this question.