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Plastic surgery nurse career overview
Where you’ll work: Hospitals, private physician’s offices, outpatient clinics and medical spas.
What you’ll do: Perform and assist with a variety of elective and nonelective plastic surgery and cosmetic procedures.
Minimum degree required: ADN or BSN required for licensure.
Who it’s a good fit for: Nurses that enjoy variety, helping patients improve their self-confidence and who may prefer a role with more autonomy.
Job perks: Plastic surgery nurses tend to enjoy more normal working hours compared to other specialties, particularly when working in an office setting.
Opportunities if you pursue a higher degree or certification: Nurses can become a Certified Plastic Surgical Nurse (CPSN) through the Plastic Surgical Nursing Certification Board (PSNCB), which may lead to greater job prospects and higher wages.
Median annual salary: $86,070
Plastic surgery isn’t just about elective modifications to one’s body and appearance. Although plastic surgery nurses certainly do work with these kinds of procedures, they only scratch the surface of what plastic surgery nursing entails.
Plastic surgery also reconstructs and reconfigures tissue to address certain diseases and traumatic injuries, including severe burns, congenital anomalies, amputations and much, much more. As a plastic surgery nurse, you could get the chance to help people reclaim or discover a quality of life that has otherwise been affected by various conditions.
In this Article
What is plastic surgery nursing? | How to become a plastic surgery nurse | What they do | Who should become a plastic surgery nurse? | Requirements | Certification | What to expect | Salary and job growth | Professional resources
What is plastic surgery nursing?
Plastic surgeons are tissue experts—they repair and reconfigure tissue to address a variety of concerns, from elective procedures like breast implants to facial reconstruction following a traumatic event and everything in between.
“It’s very inclusive. There isn’t one age group we don’t take care of, and we take care of every part of the body, so there’s a lot of diversity and variety in the specialty. Even within the specialty of plastic surgery, it could include dermatology, facial plastics—which falls under the umbrella of ENT (ears, nose and throat)—ocular plastics which is ophthalmology and even burns. It really is very encompassing,” said Pamela Messina, a plastic surgery nurse and member of the International Society of Plastic and Aesthetic Nurses (ISPAN) Board of Directors.
“It’s also very multidisciplinary, so you will coordinate with all the other specialties. Given that we work on every body part, there isn’t another specialty that we’re not often coordinating care with.”
Plastic surgery vs. aesthetic nurses
Plastic surgery nurses are not the same as aesthetic/cosmetic nurses, but these two specialties do share some overlap. Many aspects of aesthetic/cosmetic nursing fall under the umbrella of plastic surgery nursing, such as aesthetic injectables (e.g. Botox), laser and light therapies (e.g. laser hair reduction) and clinical skin care. However, these kinds of treatments are the entire focus of aesthetic/cosmetic nurses.
“We overlap in the non-surgical arena. All the injectables (e.g. Botox), the dermal fillers— that is an overlap. Where we differ is we do the surgery. An aesthetic nurse can take a patient up to a certain point, but they don’t do the surgical end of things,” Messina said.
How to become a plastic surgery nurse
Earn a nursing degree.
Nurses must graduate from an accredited nursing program in order to get licensed. An associate degree in nursing (ADN) or a bachelor’s of science in nursing (BSN) are the two types of degree programs that you can choose from. There are also several bridge and accelerated degree programs for people that already have some nursing experience (as a licensed practical nurse or EMT, for example) or a degree in another subject area.
Get licensed as an RN.
Nursing graduates must pass the NCLEX-RN exam to qualify for a nursing license. This test is typically taken shortly after graduation. First, you need to apply for a license with your state’s nursing regulatory body (NRB), a process which varies slightly from state to state. Check with your NRB to find out how to apply for a license and register for the NCLEX exam.
Gain experience.
You’ll need to gain experience and hone your skills before you can get certified in your specialty. In order to qualify for the plastic surgery nursing certification, you’ll need at least two years of plastic surgery nursing experience under your belt.
Get certified.
RNs that meet the experience qualifications can sit for the Certified Plastic Surgical Nurse (CPSN) exam administered by the Plastic Surgical Nursing Certification Board (PSNCB). Getting certified is a worthwhile endeavor which validates your expertise and could lead to better jobs with a higher pay within your specialty.
What do plastic surgery nurses do?
Plastic surgery nurses do many of the same tasks that are true of all nurses in most settings, including:
- Perform and/or assist with various non-invasive, invasive and surgical procedures
- Administer medications
- Perform pre and postoperative care
- Monitor and document patient progress
- Patient education
Just some of the types of procedures that plastic surgery nurses perform or assist with include:
- Tissue expansion
- Treating mild to severe burns, possibly with skin grafts
- Tissue reconstruction following an accident
- Breast augmentation or reduction
- Wound care
- Aesthetic injectables (Botox, dermal fillers etc.)
- Laser, light and energy-based therapies
- Clinical skin care
- Liposuction and other body contouring
- Repairing congenital abnormalities such as cleft lips or cleft palates
Messina said that every nurse’s job is going to vary a bit depending on where they work. As a nurse in a private practice office, Messina said that her job is quite different than a plastic surgery nurse working at a hospital, for example.
“Being a plastic surgery nurse in the office space setting is very unique in that you have total independence and autonomy. You answer only to the physician that you work for. You don’t have all the rules and regulations of hospital-based medicine, and you don’t have that hierarchy of leadership that people working in an institution would have,” Messina said. “Office space nursing is good for the person who really wants to be autonomous, that wants be a leader and doesn’t need a lot of direction. You’re not functioning freely of course, but you know how to take the ball and run with it.”
Where do they work?
Plastic surgery nurses can be found in many traditional healthcare settings, but they don’t usually work in all the settings that you typically find nurses in.
“You can find plastic surgery nurses in the hospital, you could find them in private offices, in clinics, you could find them in medical spas. You could find them in operating rooms, either hospital-based, office-based or ambulatory surgery centers,” Messina said. “There’s also plastic private duty nursing since a lot of the cosmetic patients want to go home with a private duty nurse. And there’s also always the role of research.”
Who should become a plastic surgery nurse?
Plastic surgery nursing can be a great fit for someone who wants to work in a specialty with a lot of variety and potentially a great deal of autonomy if you move into an office-based setting.
“I would say anybody who is highly organized, seeks independence and autonomy, is patient, compassionate, empathetic, enthusiastic, has good communication and marketing skills. Marketing is important for plastic surgery.” Messina explained that since a significant portion of the procedures they do is not covered by insurance, nurses must be able to explain what those procedures can do for someone without pressuring them to get something done that they don’t really want.
Requirements to become a plastic surgery nurse
Nurses of all kinds, regardless of intended specialty, must graduate from an accredited nursing program in order to get an RN license. Two-year associate degrees in nursing (ADN) or a bachelor’s of science in nursing (BSN), which typically takes four years to complete, are the two main options for new nurses. Associate degrees cost less because they are shorter, but bachelor’s degrees are preferred or required by some employers. Both degrees, however, are perfectly acceptable paths to licensure.
There are other degree options for people with prior nursing experience, such as licensed practical nurses (LPNs/LVNs), which take into account the skills and education they already have. For those who already have a degree in another area and who are making a career change, they may benefit from an accelerated bachelor’s of science in nursing (BSN), which awards you a BSN in less time, typically between one and two years.
Licensing
The first step in the licensing process, besides getting your education, is to check with your state’s nursing regulatory body (NRB) to find out what the application process is for registered nurses.
Typically, nursing students nearing graduation must apply for a license and then register for the NCLEX-RN exam, which nurses everywhere must pass in order to get licensed. Once you pass the exam and your NRB verifies that your application is complete—including final transcripts and any other materials they may require, such as a background check—you should get your RN license.
“If you really want to do yourself a service, as soon as you graduate from school I believe you should really go to a hospital-based setting and get some basic learning experience,” Messina said. “Get at least two years of experience in med-surg, get your feet wet. You might start in the OR doing plastics and burns, and then if you think you want to specialize in plastic surgery, then work your way into the office setting.”
Certification
All nurses should consider getting certified in a specialty area. Certification demonstrates your commitment to your specialty and the experience you’ve gained in your area of practice. On top of that, certifications are valued by employers and could lead to better jobs with higher salaries.
Plastic surgery nurses can become a Certified Plastic Surgical Nurse (CPSN) through the Plastic Surgical Nursing Certification Board (PSNCB). Nurses must pass an examination to get this certification, but they must meet the following requirements in order to sit for the exam:
- Be currently licensed as an RN in the U.S., its territories or Canada.
- Have at least 1,000 practice hours in plastic surgery nursing within two of the last three years.
- Have at least two years of plastic surgery experience as an RN in a general staff, administrative, teaching or research capacity for at least three years prior to applying.
- Be currently working in the field of plastic surgery nursing in collaboration with a board-certified plastic surgeon.
“I am a firm believer you should be certified in whatever specialty you embark upon,” Messina said. “Get your get your certification to show that you’ve become an expert in that field. Your patients want to know it, you want to feel it. I think it helps you with your confidence in doing what you’re doing, knowing that hey, I made the grade.”
“I am a firm believer you should be certified in whatever specialty you embark upon,” Messina said.
What’s on the exam?
The PSNCB’s CPSN exam tests applicants on two broad subject areas: clinical practice areas and nursing activities.
The nursing activities section is fairly ubiquitous for all nurses and tests on universal nursing standards in assessing and monitoring patient status, planning and administering procedures and patient education.
The clinical practice areas, on the other hand, are specific to plastic surgery nursing. They are split into two main categories: reconstructive procedures and cosmetic/aesthetic procedures.
The reconstructive section tests nurses on the disease processes and traumas in the head and neck, breast, extremities and abdomen and trunk. The cosmetic/aesthetic section covers surgical and non-surgical procedures.
What to expect as a plastic surgery nurse
In addition to the sheer diversity of procedures, patient demographics and the other specialties you’ll collaborate with frequently, Messina said there are many benefits to working as a plastic surgery nurse.
“Especially in the private setting, plastics is pretty much nine-to five,” Messina said. “I think the biggest pro is that it can be completely fulfilling to know that you will have a profound effect on your patients you care for. You come in with somebody who has a horrible burn scar deformity, and you do all these reconstructive procedures, and you know you make a profound difference in their lives.”
Messina also said she enjoys an immense amount of variety in her day-to-day routine. “For me, no, two days are the same. Every day of the week I’m doing something different.”
Plastic surgery nursing also has its fair share of unique challenges, particularly in the contrast between elective and nonelective procedures.
“…it can be completely fulfilling to know that you will have a profound effect on your patients you care for.”
“The patient signing up for elective cosmetic surgery is by far more anxious than the patient who has to have surgery.” While it may seem paradoxical, Messina explained that a patient opting for elective surgery is almost always going to be more anxious because although they’re already healthy, now they’re taking on all the risks that come with surgery. On the other hand, someone who must have surgery or else they’ll be left with some kind of deformity is much more likely to say yes to a procedure without hesitation.
Plastic surgery nurses should also be aware of how to approach patients differently depending on why they are seeing them. A patient coming in for an elective procedure is healthy and well, and probably pretty happy. A patient that is there by necessity, however, may have experienced some form of trauma and intense physical and emotional distress. This is going to influence the tone of the interactions with that patient.
Salary and job growth
The U.S. Bureau of Labor Statistics (BLS) does not compile salary data on specific nurse specialties. They do report, however, that the median annual salary for registered nurses is $86,070 according to their 2023 Occupational Employment Statistics.
The BLS also estimates that the employment of RNs will grow 5.6% through 2032, about as fast as average across all occupations.
Registered Nurses
National data
Median Salary: $86,070
Projected job growth: 5.6%
10th Percentile: $63,720
25th Percentile: $75,990
75th Percentile: $104,670
90th Percentile: $132,680
Projected job growth: 5.6%
State data
| State | Median Salary | Bottom 10% | Top 10% |
|---|---|---|---|
| Alabama | $65,900 | $50,310 | $92,870 |
| Alaska | $106,410 | $82,980 | $132,090 |
| Arizona | $88,310 | $70,060 | $109,750 |
| Arkansas | $72,920 | $45,200 | $96,040 |
| California | $133,990 | $83,510 | $194,240 |
| Colorado | $86,900 | $70,790 | $112,800 |
| Connecticut | $100,620 | $78,370 | $127,150 |
| Delaware | $93,200 | $73,800 | $122,670 |
| District of Columbia | $105,220 | $75,340 | $136,120 |
| Florida | $80,960 | $63,520 | $105,580 |
| Georgia | $83,620 | $63,450 | $124,330 |
| Hawaii | $129,210 | $81,070 | $145,940 |
| Idaho | $80,130 | $62,210 | $105,300 |
| Illinois | $82,470 | $63,900 | $105,140 |
| Indiana | $78,530 | $61,710 | $103,710 |
| Iowa | $71,570 | $61,250 | $90,800 |
| Kansas | $75,780 | $58,760 | $94,900 |
| Kentucky | $77,830 | $61,520 | $101,770 |
| Louisiana | $76,650 | $60,720 | $101,650 |
| Maine | $81,610 | $64,600 | $107,240 |
| Maryland | $89,340 | $66,880 | $114,440 |
| Massachusetts | $99,730 | $74,010 | $166,100 |
| Michigan | $81,710 | $67,450 | $101,610 |
| Minnesota | $97,300 | $73,050 | $120,420 |
| Mississippi | $69,370 | $54,580 | $100,160 |
| Missouri | $77,190 | $56,690 | $99,330 |
| Montana | $79,170 | $64,530 | $104,970 |
| Nebraska | $78,100 | $61,770 | $99,410 |
| Nevada | $96,210 | $77,160 | $132,010 |
| New Hampshire | $86,620 | $66,620 | $109,930 |
| New Jersey | $100,160 | $77,700 | $127,750 |
| New Mexico | $83,970 | $68,120 | $124,800 |
| New York | $104,570 | $69,450 | $136,780 |
| North Carolina | $79,580 | $62,980 | $104,190 |
| North Dakota | $74,930 | $63,920 | $95,680 |
| Ohio | $79,940 | $64,480 | $105,380 |
| Oklahoma | $78,760 | $61,360 | $101,390 |
| Oregon | $110,940 | $86,730 | $136,950 |
| Pennsylvania | $82,780 | $64,820 | $109,740 |
| Rhode Island | $94,840 | $69,350 | $116,510 |
| South Carolina | $78,380 | $60,780 | $98,980 |
| South Dakota | $67,030 | $54,780 | $85,400 |
| Tennessee | $76,200 | $55,510 | $98,090 |
| Texas | $85,110 | $64,580 | $115,740 |
| Utah | $79,790 | $64,950 | $102,000 |
| Vermont | $81,900 | $65,390 | $110,680 |
| Virginia | $84,100 | $63,710 | $115,120 |
| Washington | $107,720 | $82,630 | $139,390 |
| West Virginia | $78,730 | $50,650 | $99,440 |
| Wisconsin | $83,300 | $69,240 | $105,110 |
| Wyoming | $79,970 | $62,400 | $105,800 |
Source: U.S. Bureau of Labor Statistics (BLS) 2023 median salary; projected job growth through 2032. Actual salaries vary depending on location, level of education, years of experience, work environment, and other factors. Salaries may differ even more for those who are self-employed or work part time.
Frequently asked questions (FAQ)
What is the importance of patient education and counseling in the role of a plastic surgery nurse?
Like other nurses, plastic surgery nurses are expected to educate patients about procedures, including their benefits, risks and other alternatives. Nurses must also answer any questions the patient may have. Patient education also consists of giving patients various resources and further reading, instructions for at-home care and more.
What are the latest advancements and technologies in the field of plastic surgery nursing?
The American Society of Plastic Surgeons (ASPS)has a directory of plastic surgeons and acollection of resourcesall about the latest procedures and advancements in plastic surgery.
What strategies do plastic surgery nurses employ to minimize the risk of scarring and promote optimal wound healing after plastic surgery?
One strategy that plastic surgery nurses and physicians use to treat scarring is a procedure calledtissue expansion, in which patients “grow” additional skin that can be used for reconstruction on other parts of the body. Messina also said that hypertrophic or keloid scars often need steroid injections to manage them and promote healing.
What are some of the ethical considerations and dilemmas that plastic surgery nurses may encounter in their practice, and how do they navigate them?
Since many procedures that plastic surgery nurses deal with are elected by the patient and are not imperatively necessary, plastic surgery nurses may encounter ethical issues surrounding informed consent. It is essential that plastic surgery nurses and physicians provide patients with all relevant information pertaining to a procedure so that the patient can make a completely informed decision.
ISPAN’s position on informed consent states that they, “recognize the importance of protecting the legal rights of patients and maintaining the ethics of healthcare through the practice of informed consent. Informed consent is ‘a process by which a patient or participant voluntarily confirms his or her willingness for a proposed medical treatment or non-treatment after having been informed of all aspects of the plan that are relevant to the participant’s decision to participate.’”
Published: July 24, 2023
Written and reported by:
Kendall Upton
Staff Writer
With professional insight from:
Pamela Messina, RNFA, CPSN, CANS
Member of the ISPAN Board of Directors
