Global Perspectives in Plastic Surgery: View of Plastic Surgeons From Ecuador.

Background: Ecuador faces a considerable public health burden from congenital anomalies, trauma, and burns, creating a high demand for reconstructive surgery. However, this need is largely unmet despite the presence of a skilled local surgical workforce. This article aims to analyze the systemic barriers that prevent qualified plastic surgeons in Ecuador from providing essential reconstructive care and understand the role of colleagues from high-income countries. Methods: This perspective analysis is based on a review of regional health data and literature, combined with direct expert experience from surgeons practicing within the Ecuadorian healthcare system. Results: Ecuador faces a scarcity of high-technology equipment for specialties such as craniofacial surgery and microsurgery due to their cost. The reimbursement structure within the Ecuadorian healthcare system disincentivizes plastic surgeons from providing reconstructive care, as it is not usually a financially sustainable option. International partnerships may benefit Ecuadorian surgeons by modernizing educational frameworks, creating equipment donation programs, and building sustainable local capacity rather than relying on temporary mission trips from abroad. Conclusions: The failure to provide reconstructive surgery in Ecuador represents a systems failure, not a skills gap. Overcoming this requires a multistakeholder approach focused on policy reform to make reconstructive care financially sustainable, strategic investment in technology, and the development of equitable, locally led partnerships.