Abstract
BACKGROUND: Peru, an upper-middle-income country with approximately 500 plastic surgeons, equivalent to approximately 1.5 plastic surgeons per 100,000 population, faces substantial gaps in reconstructive surgical care. Critical areas of unmet need include congenital anomalies, burn care, trauma management, and postoncological reconstruction. METHODS: This perspective analysis draws upon the experiences of 2 plastic surgeons working within the Peruvian healthcare system in Arequipa and Lima, combined with a review of relevant literature on reconstructive surgery in Latin America. RESULTS: Key challenges for reconstructive surgery in Peru include a fragmented healthcare system, disparities between rural and urban areas, and a growing focus on cosmetic procedures driven by higher financial returns and medical tourism. Domestic strategies to address these gaps include increasing government funding, advocating for the inclusion of reconstructive surgery in national health insurance schemes, and promoting specialization in reconstructive surgery through improved residency programs and government incentives. International solutions emphasize sustainable collaborations with nonprofits and nongovernmental organizations that use diagonal service delivery models and low-cost, reproducible training opportunities that prioritize knowledge transfer, capacity building, and alignment with national health priorities, guided by principles of equity, respect, and the empowerment of local professionals. CONCLUSIONS: Peru must address gaps in reconstructive surgery through improved training, government incentives, and professional recognition, supported by sustainable international collaborations. These efforts can build local capacity, rebalance plastic surgery toward national health needs, and reduce disparities in access to essential surgical care.