Mapping Mismatches in Plastic Surgery Training Capacity, Workforce Supply, and Public Interest

Background: Plastic and reconstructive surgery (PRS) training opportunities and workforce remain unevenly distributed across the United States. Several factors drive applicants, residents, and surgeons to cluster in certain regions, including the presence of home programs, limited residency positions, and the tendency for surgeons to remain where they trained. This leaves many states without local training pathways or an adequate workforce. Meanwhile, public interest in PRS is rising. This study integrates training capacity, workforce supply, and public interest to identify mismatches and highlight regions at risk of underservice. Methods: State-level data were compiled for all 50 U.S. states and the District of Columbia. Training capacity was defined as integrated PRS residency PGY-1 and independent fellowship positions per graduating medical student, workforce supply as the number of board-certified plastic surgeons per million population, and public interest as Google Trends Relative Search Volume (RSV, 2020–2025) with the surgery filter applied to searches related to breast, body contouring, and facial procedures. All variables were normalized to a 0–100 scale for comparison across domains. Bar graphs were used to visualize mismatches, and linear regression was calculated to assess associations among training capacity, workforce supply, and public interest. Data sources included residency program websites, the AAMC Student Data Report, the AAMC Physician Workforce Data Dashboard, and the U.S. Census Bureau. Results: Mismatches were observed across states. Florida, Louisiana, and Arizona demonstrated high public interest with relatively low workforce and training capacity, functioning as plastic surgery deserts. New Mexico, Utah, and Massachusetts showed disproportionately high training relative to local demand, acting as exporters. The District of Columbia, Delaware, and Texas displayed high demand and workforces but limited training capacity, representing bottlenecks in the training pipeline. Regression analysis confirmed that training capacity was not significantly associated with workforce supply (R-squared = 0.062, p = 0.079) but showed a weak association with public interest (R-squared = 0.076, p = 0.050). In contrast, public interest and workforce supply were moderately correlated (R-squared = 0.364, p < 0.001). Conclusion: Preliminary data suggest that PRS training capacity, workforce supply, and public interest are not geographically aligned. Plastic surgery workforce supply moderately reflects public interest, but training opportunities are not aligned with either workforce needs or demand. This misalignment creates three profiles: deserts where demand exceeds supply, exporters where training outpaces local need, and bottlenecks where demand and workforce exist but training lags. These findings highlight the need to consider public interest when establishing new PRS training programs to improve geographic equity in surgical care.