This blog is for everyone. And a major point of interest in the blog is the concept of FIRE, being “Financial Independence, Retire Early.” But the simple fact remains that I am a plastic surgeon. And I am pursuing in FIRE. That’s the most specific niche that I occupy.
[Actually to be fair, I am chasing FIRE. I love what I do and plan to do it well after FI. But for the sake of argument, let’s just call it FIRE…way cooler]
I’ve gone on record and stated that becoming a plastic surgeon was NOT the best financial move that I have made
I say this despite the fact that plastic surgeons are among the most highly compensated physicians as shown here. I say this despite the fact that my starting salary was $470,000 plus $20,000 in bonuses.
(Recently, someone told me that I should not be forthcoming with my salary. They thought others may be discouraged. However, one of the core premises of my blog is to be totally transparent to help others. That is why I share this. Many make more and less than me. It’s to help all of us push for more as physicians. Let me know if you feel otherwise.)
The best financial move that I have ever made was to start learning about personal finance. This led to a financial plan which is leading me to FIRE. Without this, my high income would be cancelled out by the financial mistakes that had plagued me to that point. As we know, income does not count for anything in calculating net worth.
However, I cannot neglect or ignore a simple fact. As a plastic surgeon, I have a higher income that most physicians have or will have. There are advantages to this on the path to FIRE. I also enjoy the fact that a lot of my audience actually is composed of plastic surgeons.
So, this one is for all of you! (Actually it’s still for all of you, but I am going to generalize a little less than normal.)
What are special FIRE consideration as a plastic surgeon and for plastic surgeons?

Let’s start with some math
My salary is actually near the median salary for plastic surgeons based on recent data. I feel blessed to have secured this in my first year out of training. More on my tips for contract negotiations here.
So, for the sake of simplicity, let’s assume I am the average plastic surgeon.
I’ve said before but really tried to emphasize in this post that the path to financial freedom for a physician is easy. We don’t need to get caught in the weeds.
Simply put, save 20% of your pre-tax income. Invest in index funds. Retire in 25-30 years and enjoy a very comfortable retirement.
For a plastic surgeon, this is even more effective that the average doc.
Here is the math using me as the example:
Salary = $470,000 (let’s ignore the bonus)
20% savings or pre-tax income = $94,000
$94,000 invested in index funds averaging a modest 5% return after fees, etc = FV(5%, 25, -94000, 0, 0) = $ 4.5 million
That will give you a “salary” of $180,000 in retirement. If you can’t live an amazing and comfortable life on that in retirement (when your debts including mortgage should be paid off), you have a big time spending problem.
Remember, this is an example of you putting in absolute minimal effort to save and invest. And you will end up with a $4.5M nest egg. If your attending career starts at age 33 like me, you can retire with this next egg at age 58. I would this FIRE.
Not.too.shabby.
So, the average plastic surgeon should have no problem reaching this largesse.
What?! You want more?
Well, what if you want to retire earlier or with more money? What if you want fatFIRE?
Not surprisingly, being a plastic surgeon helps with this just the same way as it helps with regular FIRE.
But it requires a bit of a mindset shift.
Higher salary = more money coming in = more seed money
That’s right!
It doesn’t equal a cooler car or bigger house or wider watch face (why?…just why? I don’t get the big watch faces). This increase in income should be viewed as seed money.
And seed money grows. And with more seed money, the more you can grow.
You can grow it via:
- More securities (stocks/bonds/etc.) investing
- Passive real estate investing
- Active real estate investing
- Start up money to a physician side gig
- Buying into an ambulatory surgery center
- Investing in yourself via courses or coaching
There’s not enough room to go into each and every one of these. (And luckily most are covered extensively elsewhere in the blog.) However, the message is this: grow your extra income.
Once you start doing this, you can reach all kinds of fatFIRE, fastFIRE, or any other of the many coined FIRE terms.
I also encourage you to give back to others.
If it’s so easy to FIRE as a plastic surgeon, why are we even talking about this?
Put more simply, why do I even have a blog? Shouldn’t all plastic surgeons be able to do this without guidance?
That is the remarkable thing.
Despite making such high incomes, plastic surgeons often do not FIRE. Many even live paycheck to paycheck. Some work into their octogenarian years out of necessity. Many leave little to their family or others when they pass.
And the answer to why is human behavior.
The most important factor in your financial success is looking at you in the mirror. We live in a culture of consumerism. Most of us either believe or used to believe that what defines a “rich” person is what they buy. That’s why people will foreclose on their house but keep making luxury car payments. We are all susceptible to this. I was and still am. It’s a work in progress.
But, plastic surgeons are especially prone to image and consumerism
The culture of plastic surgery is one of opulence. Plastic surgeons make their offices look like a spa so patients don’t feel they are seeing a doctor. We typically wear expensive suits. Plastic surgeons in the media are always driving fancy cars and living in gorgeous mansions.
I’ll tell you, that is not the average plastic surgeon. Hell, that is definitely not someone making $400,000 a year in salary with student debt to pay off.
But! But, that is the image that so many plastic surgeons think they need to achieve to be successful. To not live and look and act like that makes us feel like an imposter, or worse unsuccessful. Even those like me who never identified with that image seek to achieve it like I once did.
This image leads plastic surgeons to be particularly bad at personal finance. All doctors certainly face this image and perception to some degree. But it is more grandiose for a plastic surgeon.
So, what is my advice for plastic surgeons interested in FIRE?
- Recognize and rehabilitate your relationship with consumerism
- View your elevated high income status as an advantage
- Establish that part of your income is not for you, it’s for future you
- Create and grow seed money
- Give back as much as you can
- And, yes…enjoy the benefits of all of the hard work you have put in. It’s absolutely ok to treat yourself. Just not at the expense of your future yourself!
What do you think? Do plastic surgeons have an unfair advantage in the FIRE game? Have you fallen victim to the “fancy” doctor perception? How are you working for your future self? Let me know in the comments!
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amazing man you are definitely not only going to be very rich/wealthy, but also utilize it the most to make you happy!
actually, I think both of us are very happy just being on the planned path to wealth. $180K a year in retirement! nice š I know it’s hard to plan for you future self, but you think you will keep working past 58? Pick up and travel like PoF?
It’s so hard to predict. I really do love what I do and consider myself very lucky to be in that situation. So I imagine I will keep working at least in some capacity for a while. But who knows!
The great thing about our specialty is that it allows one many options such as private practice (which is still very much possible), being an employee, etc. Want to retire at 58 and pursue other interests? Plastic surgery will allow you to do that. I’m 58 right now and I’m nowhere near ready to retire. I feel great and still look forward to my work after all these years. There’s nothing I want to do that I’m not already doing that I need to retire to do, but to each his own. It took me so long to finish training and start practicing that I just can’t give it up and it hasn’t become a drag to go in every day. Another thing that I feel is of paramount importance is taking care of your body. If you don’t put on a lot of weight as you age and do even a little exercise, you will not want to stop working because of illness, injuries, etc. This is just as important as saving wisely. Thanks again for such a great article!
David
Thanks David! I always love your perspectives! You are so right about staying healthy. That’s been a big goal of mine lately as I finished training and now have more time to exercise etc. Like you, I love plastic surgery and want to do it for a long time to come!
PPS