Voices of Leadership: Challenges Faced by Female Facial Plastic Surgeons and Considerations for Future Generations

CLINICAL QUESTION

What challenges do female facial plastic surgeons in leadership positions encounter, and what considerations may help support future generations of women leaders in the specialty?

BOTTOM LINE

Female facial plastic surgeons in leadership roles continue to face gender bias, impostor syndrome, mentorship burden, work–life imbalance, and institutional barriers despite increasing representation in surgery. The authors emphasize the importance of honest mentorship, structural change, purposeful leadership, and sustainable career models to support future generations of female surgeon leaders.

BACKGROUND: Women are increasingly entering surgical subspecialties and leadership positions in facial plastic and reconstructive surgery. Despite progress in gender equity, barriers persist in academic advancement, leadership development, compensation, mentorship expectations, and work–life integration. Understanding these experiences may help guide future institutional and cultural change within the specialty.

STUDY DESIGN: Qualitative thematic analysis of reflections from female facial plastic surgeons in national and institutional leadership positions regarding leadership challenges, mentorship, and future considerations for women in the field.

SETTING: Academic and national leadership environments within facial plastic and reconstructive surgery

SYNOPSIS: This viewpoint article synthesizes reflections from female facial plastic surgeons serving in leadership roles, including departmental vice chairs, division chiefs, residency and fellowship directors, medical directors, and presidents of national organizations. Several recurring themes emerged regarding challenges encountered throughout leadership development.

Participants described the persistent tension between assertiveness and likability, noting that women in surgery often feel pressure to display traditionally “masculine” leadership traits while simultaneously meeting societal expectations for warmth and emotional availability. Impostor syndrome and self-doubt were also frequently cited, particularly in academic settings and national meetings, where women may hesitate to pursue speaking or leadership opportunities despite qualifications.

Work–life imbalance represented another dominant theme. Respondents described competing demands from clinical practice, administration, research, mentorship, family responsibilities, and household labor, often accompanied by guilt and emotional exhaustion. Mentorship burden—or “mentorship tax”—was also emphasized, with relatively few senior women supporting growing numbers of female trainees and junior faculty, frequently without institutional recognition or compensation.

The authors additionally highlighted structural barriers within academic medicine, including productivity-based compensation systems, uncompensated leadership roles, and promotion models that may disadvantage women during childbearing years. Social media and evolving beauty standards were identified as emerging pressures unique to facial plastic surgery, influencing both patient expectations and surgeons’ personal branding responsibilities.

Despite these challenges, the surgeons emphasized leadership as deeply meaningful and purpose-driven, offering opportunities to influence institutional culture, advocate for equity, mentor future generations, and expand professional impact beyond operative care.

CITATION: Lyford-Pike S, et al. Voices of leadership: challenges faced by female facial plastic surgeons and considerations for future generations. Facial Plast Surg Aesthet Med. 2026;28(1_suppl):6S-9S. doi:10.1177/26893614251394696.

COMMENT: This qualitative study of interviews with female facial plastic surgeons holding leadership positions offers incredible insights into challenges faced by female surgeons—not just facial plastic surgeons—and insights into how some of these challenges can be lessened as we move into the future. It is a must read for everyone!—Matthew Q. Miller, MD