Plastic surgeons perform reconstructive plastic surgery which restores form and function following illness or trauma. They also perform aesthetic or ‘cosmetic’ surgery which changes appearance or form.
This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.
Nature of the work
The work encompasses a wide range of conditions in different parts of the body. Plastic surgeons may work with both children and adults.
Reconstructive surgery is the main part of the job for most plastic surgeons in the NHS. The work includes:
- breast reconstruction (including after cancer)
- skin and soft tissue cancer procedures
- head and neck reconstruction
- treatment for cleft lip and palate
- burns and trauma surgery trauma includes road traffic accidents, sporting injury and violent incidents
- hand operations
Aesthetic surgery includes:
- breast augmentation and reduction
- otoplasty – surgery to treat protruding ears
- eyelid surgery (blepharoplasty)
- liposuction – to remove unwanted fat
Aesthetic or cosmetic surgery has become very popular in the UK during the last decade. 90% of these procedures are carried out on women and much of this work is done privately.
“Operations can last from around 20 minutes for something straightforward to between six and eight hours for more complex microsurgery”. Lilli Cooper, trainee plastic surgeon,Queen Victoria Hospital, East Grinstead, West Sussex.
Plastic surgeons use innovative surgical procedures and techniques including:
- microsurgery – magnification and tiny sutures are used to join very small arteries, veins and nerves to restore the blood or nerve supply to a piece of living tissue
- skin grafts – a healthy piece of skin is transferred to another area of the body where the skin is missing or damaged
- tissue expansion – this procedure allows the body to ‘grow’ extra skin by stretching surrounding tissue
- flap surgery – the transfer of a living piece of tissue from one area of the body to another, along with its blood vessel
There are various sub-specialties within plastic surgery including:
- paediatric plastic surgery
- hand surgery
- congenital –conditions treated include cleft lip and palate, facial and ear deformities, craniofacial defects, genito-urinary anomalies, upper limb anomalies and skin conditions
- breast surgery – reconstruction after cancer, congenital anomalies and cosmetic surgery
- skin – includes excision and reconstruction, management of skin cancer metastases (the spread of cancer from one part of the body to the other)
- trauma – repair of facial trauma and lower limb trauma
- cancer – including removal of malignant tumours and skin lesions, head and neck cancer and breast reconstruction
- hand and upper limb surgery – including congenital hand abnormalities, hand injuries and treatment of degenerative hand disease
It’s an exciting time to be involved in plastic surgery and research is at the forefront of this specialty. Most plastic surgery units in the UK contribute to research. Projects are always highly collaborative and topics include tissue engineering, the development of scar-free wound healing and facial and hand transplants.
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This section provides useful information about the pay for junior doctors (doctors in training), SAS doctors (specialty doctors and associate specialists) and consultants.
NHS Employers provides useful advice and guidance on all NHS pay, contracts terms and conditions.
Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.
Read about consultant and non-consultant roles in plastic surgery, flexible working and about wider opportunities.
Plastic surgery is very competitive specialty, but once you are established the career opportunities are varied and interesting.
Managerial opportunities for consultants include:
- clinical lead - lead NHS consultant for the team
- clinical director - lead NHS consultant for the department
- medical director - lead NHS consultant for the Trust
Most NHS consultants will be involved with clinical and educational supervision of junior doctors.
Here are some examples of education and training opportunities:
- director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards.
- training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training programme director. This role will be working within the HEE local office/deanery
- associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the HEE local office/deanery
SAS doctor roles
SAS surgeons (Staff, Associate Specialists and Specialty Doctors) work as career grade specialty doctors who are not in training or in consultant posts. You will need at least four postgraduate years training (two of those being in a relevant specialty) before you can apply for SAS roles.
The role of an SAS surgeon can vary greatly. Depending on your experience you might work on complex surgery or relatively minor diagnostic and outpatients work. SAS doctors will frequently participate in routine and elective surgery rather than emergency work. They may also train other staff.
Some surgeons are attracted to the SAS role as the hours are more regular than those of the consultant, and you’re paid for on-call work and overtime beyond 7am-7pm.
Other non-training grade roles
These roles include:
- trust grade
- clinical fellows
If you have trained on an academic plastic surgery pathway or are interested in research there are opportunities in academic medicine.
For those with a particular interest in research, you may wish to consider an academic career in plastic surgery. Whilst not essential, some doctors start their career with an Academic Foundation post. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum.
Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) and may progress to a Clinical Lectureship (CL). Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.
Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC).
There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine.
The Clinical Research Network (CRN) actively encourages all doctors to take part in clinical research.
You’ll usually be expected to contribute to research as part of your job, which includes collaborating with colleagues in the UK and overseas, writing papers and presenting your work at conferences. Plastic surgeons are also involved in teaching, audit and committee work.
Some UK plastic surgeons opt to travel to disaster zones to work with a charity treating victims needing reconstructive surgery following earthquakes, tsunamis or acid spillages.
There are lots of opportunities within this specialty for private work, and there is an on-going demand for cosmetic work, most of which is performed privately.
Job market information
NHS Digital regularly publish workforce statistics which show the number of full time equivalent consultants and doctors in training for each specialty: NHS Digital workforce statistics.
Competition ratios for medical specialty training places are published on Health Education England's specialty training webpage.
For information regarding Scotland, Wales and Northern Ireland please click on the links below:
Where to look for vacancies
Applications for core surgery training are made via the Core Surgery National Recruitment Office. Find out more information, including closing dates on the Surgery Recruitment website.
London and the South East (LaSE) nationally coordinates the recruitment into Core Surgery Training round one (CT1) on behalf of England, Wales and Scotland. This training programme is open to those who may want to train flexibly on a less than full-time basis (LTFT). You can request and apply for this after you have been offered the job. Restrictions apply. Find out more about LTFT
Registration and application for core surgery and specialist training is online via Oriel. Further details person specifications and application deadlines are also available on the Oriel site.
Northern Ireland has its own recruitment process. For further details please visit the Northern Ireland Medical and Dental Training Agency website.