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BACKGROUND: Almost three times as many board-certified female plastic surgeons are single compared to their male colleagues. The purpose of this study is to determine why women in plastic surgery are less likely to be married than their male counterparts. We propose there is a diminishing pool of available mates, and as unmarried female plastic surgeons progress in their career, a shift occurs from hypergamy toward hypogamy.

METHODS: A 52 question survey was sent to female members of the American Society of Plastic Surgeons. The questions focused on type of training and practice; marital status and age at marriage; spousal education, financial, and professional status; relational goals, values, and satisfaction. A total of 736 questionnaires were sent via e-mail, and responses were anonymous.

RESULTS: The response rate was 34% (n=250). Participants ranged in age from 26 to over 70 years. 64% of respondents were married, 2% engaged to be married, 11% in serious relationships, and 23% single or dating. The most frequently cited reason for being single was a perceived lack of desirable partners (45%), job constraints (14%), and personality differences (13%). Of unmarried women, 56% wanted to marry in the future, while 44% did not wish to be married at this time. 52% of all respondents would prefer not to marry someone whose income was less than their own, and 73% would prefer not to marry someone less educated, whereas 29% reported they would not marry someone who would agree to be the homemaker. Female surgeons who married at an earlier age (<36 years) were more likely to select a spouse who attained a higher level of education and earned a higher annual income compared to those who married later. Respondents’ assessment of spousal professional status did not change with later marital age. Of unmarried respondents, 19.6% were divorced. When presented with the hypothetical situation of re-marriage, 88% of divorced women would prefer to marry a non-medical professional in comparison to 76% of non-divorced participants.

CONCLUSIONS: With an aging population and the trend of women outnumbering men in higher education, the mating pool of eligible partners diminishes as female plastic surgeons complete their training, and gain professional and financial success. This phenomenon appears to alter traditional patterns of selecting a mate. Given the shrinking number of potential suitors, a shift occurs, and women who marry later make educational level, financial, and professional success lesser priorities in their choice of partner. Others consider alternative means to fulfill their biological incentive to raise children. Our findings may not be unique to plastic surgery, and likely apply to other surgical specialties and professional fields.