Increasing Private Equity Investments in Plastic Surgery Practices in the United States: Analysis of Trends and Consolidation.

Background: Private equity (PE) investment in healthcare has expanded rapidly, particularly in plastic surgery, where rising demand for aesthetic procedures presents attractive financial opportunities. While PE backing may enhance operational efficiencies, concerns exist regarding its potential impact on care quality, patient outcomes, and healthcare costs.

Objectives: This study examines PE acquisitions of U.S. plastic surgery practices, identifying trends in investment growth, geographic distribution, and the financial models adopted by PE-backed practices.

Methods: This cross-sectional study analyzed PE acquisitions of U.S. plastic surgery practices from January 1, 2000, to July 1, 2024. Data were obtained from PitchBook, verified through practice websites and follow-up inquiries. The analysis focused on acquisition trends, insurance acceptance policies, and the geographic distribution of PE-backed practices.

Results: Between 2000 and 2023, PE-backed acquisitions in plastic surgery grew by 4300% in practice volume and 7630% in capital investment. Acquisitions were concentrated in states such as Texas, Florida, and New York. PE investment was prominent in general, facial, and oculoplastic surgery practices, with a preference for cash-only models, particularly in specialized fields. Many practices employed few plastic surgeons, relying instead on aesthetic clinicians.

Conclusions: PE consolidation in plastic surgery is expanding rapidly, driven by demand for elective procedures. While PE investment brings financial and operational advantages, it raises concerns about healthcare quality and equity. Further research comparing PE and non-PE-owned practices is necessary to guide policies ensuring patient care quality and access.