Plastic Surgery Leaders: The Most Vain States

The quest for youth and beauty never ends, and plastic surgeons are a powerful indicator of society's esthetic values. In this report, Healthnews delves into the states with the highest and lowest focus on physical perfection.


We ranked the 50 states in terms of how many plastic surgeons they have per 100,000 residents. Based on the member directory of the American Society of Plastic Surgeons, we counted the number of plastic surgeons in each state. This organization, representing approximately 90% of all board-certified plastic surgeons, offers a substantial database.

Some plastic surgeons practice without American Board of Plastic Surgery certification and were not included in our data.

Plastic surgery leaderboard

#1 Connecticut

The Constitution State has the highest rate, with 155 plastic surgeons for a population of 3.6 million, amounting to 1.52 surgeons per 100,000 residents.

Connecticut is known for its wealthy population and high per capita income, which currently stands at $87,300, making it one of the wealthiest states. Due to their full wallets, residents have more disposable income to spend on elective procedures like plastic surgery.

The state has a robust healthcare system with several well-regarded hospitals and medical facilities like Yale New Haven Hospital, which attract top medical professionals, including plastic surgeons.

The state’s proximity to major metropolitan areas like New York City and Boston could also contribute to surgeons settling down and opening a practice there. Surgeons may choose to practice in Connecticut to cater to a clientele that prefers more discreet locations away from large cities.

#2 Delaware

Delaware, with its mix of bustling urban areas and idyllic beach towns, has 15 plastic surgeons catering to its 1 million residents.

Being one of the smaller states in terms of geography and population, the number of 1.45 surgeons per 100,000 people can appear relatively high even with a modest absolute number of practicing surgeons.

Delaware, especially in areas like Wilmington, has a population with a relatively high median household income of $79,325. Those with more disposable income may be more likely to seek cosmetic procedures.

Also, Delaware is known for its tax-friendly policies. The absence of sales tax and favorable business tax laws make Delaware an appealing location for plastic surgeons to establish their clinics. Lower operational costs can translate into savings that can be invested back into the practice or passed on to patients. Tax savings for residents can lead to higher disposable income.

Surgeons in Delaware benefit from its proximity to major cities such as Philadelphia, Baltimore, and Washington D.C. This strategic location allows them to cater not only to the local population but also to residents from neighboring states.

#3 Florida

The Sunshine State is home to 323 plastic surgeons among its population of 22,610,726. This is nearly 1.43 plastic surgeons for every 100,000 residents. From Miami's high-octane glamour to the tranquility of the Keys, Florida's beauty culture is as diverse as its citizens.

Renowned for its large retiree population, the state ranked second in the nation in 2021, with 4.6 million adults aged 65 and older. Older adults may seek plastic surgery for age-related cosmetic enhancements like facelifts, eyelid surgeries, and other anti-aging treatments.

The robust tourism industry also contributes to a higher demand for plastic surgery services. In 2023, the state's tourism industry generated a new all-time high total economic impact of $87.6 billion, a 31% increase over 2021.

Visitors may combine vacations with cosmetic procedures in what is often referred to as ‘medical tourism.’ The state's reputation for high-quality healthcare services attracts both domestic and international patients.

Florida's no-state income tax policy can be an incentive for high-earning professionals, including plastic surgeons, to practice in the state. The warm climate encourages a lifestyle that often involves spending time at the beach and engaging in outdoor activities. A cultural emphasis on appearance and fitness can influence the demand for cosmetic procedures.

#4 New Jersey

With a population of 9.2 million, New Jersey accommodates 130 plastic surgeons, translating to approximately 1.40 surgeons per 100,000 residents. Proximity to New York City, combined with its own metropolitan areas, creates a dynamic market for those seeking cosmetic procedures.

New Jersey has the second-highest median income among U.S. states, with a median household income of $96,126. So here, as in the previously mentioned states with high vanity, residents have more disposable income to spend on elective medical procedures, including plastic surgery.

New Jersey is also the most densely populated state in the U.S. High population density often correlates with a greater number of medical professionals, including plastic surgeons, to meet the demand for services.

#5 Kansas

Kansas breaks stereotypes by hosting 41 plastic surgeons for its population of 2.9 million people, resulting in 1.39 surgeons per 100,000 residents. Even in the heart of the Midwest, cosmetic enhancements have a growing presence.

Kansas is home to several prominent medical schools and training hospitals, like Wesley Medical Center, the University of Kansas School of Medicine, and Via Christi Health. These institutions not only train new plastic surgeons but can also be a factor in retaining them in the state upon completion of their residencies.

In addition, Kansas has initiatives to improve healthcare in rural areas, like the Kansas Bridging Plan, which might include incentives for specialists, including plastic surgeons, to practice in less densely populated areas.

The state’s central location might make it an appealing place for medical professionals who wish to serve a broad region, especially for specialized services like plastic surgery that might not be as readily available in surrounding rural or underserved areas.

Compared to coastal states, Kansas generally has a lower cost of living and cost of doing business, which can be attractive for medical practitioners starting or relocating their practices.

#6 California

The Golden State secures the sixth spot in the rating, with 537 plastic surgeons serving its vast population of almost 39 million. This equates to about 1.38 surgeons per 100,000 residents.

California has a renowned status as a trendsetter in beauty and lifestyle. The state's major urban centers, like Los Angeles and San Francisco, are hubs for the entertainment and fashion industries, where the demand for cosmetic procedures is consistently high.

Comprehensive medical infrastructure and institutions, like Cedars-Sinai Medical Center or Stanford Health Care-Stanford Hospital, contribute to its high ranking, attracting top-tier plastic surgeons and patients.

#7 New York

New York ranks seventh, hosting 265 plastic surgeons for its nearly 20 million residents. That's 1.35 surgeons per 100,000 people.

As a global epicenter of fashion, culture, and finance, New York, especially New York City, naturally cultivates a market for plastic surgery, catering to both locals and a global clientele. The state's world-class medical facilities, like NewYork-Presbyterian Hospital, along with its reputation for high-quality healthcare, further solidify its position in the top 10.

Rounding out the top 10 are Hawaii, Maryland, and Virginia, ranking eighth, ninth, and tenth, respectively. Hawaii, with its population of 1.5 million, has 19 certified plastic surgeons (1.32 per 100,000 people). The state's unique geographical location and its reputation as a paradise for tourists make it an attractive spot for medical tourism.

Maryland follows closely, with 81 surgeons serving more than 6 million residents (1.31 per 100,000 people). Its proximity to the nation's capital and its affluent suburbs contribute to a high demand for cosmetic services.

Lastly, Virginia, with its rich history and robust economy, hosts 113 plastic surgeons for almost 9 million residents (1.29 per 100,000 people).

At the other end of the spectrum

While the leading states showcase high numbers, it's equally important to recognize those where plastic surgery is less common. Wyoming (0.17), Alaska (0.55), and West Virginia (0.62) sit at the opposite end of the scale.

These states have lower population densities compared to others. In Alaska, the remote nature of many communities and the logistical challenges can influence the demand and feasibility of offering plastic surgery. Economic factors in West Virginia, combined with a generally rural and dispersed population, might contribute to lower demand for elective medical services.

The healthcare priorities set by state governments could also influence the distribution of medical specialties. States might prioritize primary care, emergency care, and other services over specialties like plastic surgery.

The verdict on vanity

As American esthetic standards evolve, these numbers may change. A growing focus on body positivity and advancements in non-surgical treatments are a few factors that may influence future trends.

With Connecticut leading the charge, followed closely by Delaware and Florida, America's landscape of plastic surgery is rich and varied. Yet, the vanity rankings tell only part of the story, merely scratching the surface of a nation's complex relationship with appearance and self-image.

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