Gender, Obstacles, and Perspectives in the Career of Plastic Surgeons in Italy: a Survey-Based Analysis

Abstract Background The Italian plastic surgery workforce is undergoing a demographic shift, with a growing proportion of women entering the field. Despite this, little is known about gender-specific challenges such as work-life balance, discrimination, and career progression. This study aimed to compare the professional experiences of male and female Italian plastic surgeons. Methods We conducted a cross-sectional online survey of Italian board-certified plastic surgeons and residents. The questionnaire addressed demographics, work-life balance, training opportunities, burnout, and professional challenges using multiple-choice, Likert-type items, and open-ended responses. Data were analyzed descriptively and stratified by gender and age. Results A total of 430 surgeons responded (22.6% women, 77.4% men). Women were most represented in the 30–39 age group, while men predominated in the 40–49 group. Gender-based disparities emerged: 62.7% of women with children reported career-related delays in childbearing (vs. 32.7% of men), and 61.3% reported difficulties reconciling work and family life (vs. 44.1% of men). Nearly all respondents who felt excluded from career dynamics (96.7%) or experienced sexist comments (83.3%) were women. Universal stressors included burnout (64.7%), fiscal issues (59.4%), aggressive competition (63.8%), and medico-legal risks (82.5%). Young surgeons identified insufficient exposure to aesthetic surgery and limited first-operator cases as key training gaps. Conclusions Although women are increasingly represented in Italian plastic surgery, they continue to face substantial barriers in work-life balance and career advancement. Shared systemic issues, burnout, fiscal pressures, and medico-legal risks, further burden all surgeons. Targeted action by professional bodies is essential to promote equity, improve training, and strengthen professional support. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .