Private Equity Investment in Plastic Surgery Clinics: A Scoping Review.

[BACKGROUND] Plastic surgery is emerging as a prime target for private equity (PE) investments, driven by its increasing demand, scalability, and opportunities for insurance-independent revenue streams. This review synthesizes current literature to evaluate the effects of PE investments on plastic surgery practices.

[METHODS] Following Preferred Reporting Items for Systematic Reviews with Meta-Analyses Extension for Scoping Reviews guidelines, a search was conducted across PubMed, Cochrane Library, and Web of Science databases in November of 2024. English-language studies discussing equity-based investments in plastic surgery companies were included. Data on investment trends and operational and clinical effects were extracted and analyzed.

[RESULTS] Eight studies met the inclusion criteria after screening and full-text review, comprising 5 editorials and 3 quantitative analyses. The quantitative studies relied on PitchBook, a web-scraping investment database; however, limited methodologic transparency in these studies hindered comparability. Across the articles, key benefits included operational improvements (discussed in 6 of the 8 articles), reduced administrative burdens (3 articles), enhanced technology access (6 articles), practice expansion (4 articles), expanded services (3 articles), increased profitability (3 articles), financial stability (2 articles), and retirement benefits (2 articles). Challenges included misaligned objectives between PE firms and physicians (4 articles), aggressive cost-cutting (2 articles), compromised care quality (3 articles), increased patient costs (2 articles), loss of physician autonomy (3 articles), equity dilution (1 article), and declining morale (1 article).

[CONCLUSIONS] Although PE investments offer financial and operational advantages to plastic surgery practices, they may also threaten care quality and physician autonomy. This review underscores the ongoing expansion of PE investments in plastic surgery, highlighting the importance of standardized methodologies and longitudinal studies to evaluate and optimize the outcomes of PE investments for both patients and physicians.