On March 8, 2019, we celebrated International Women’s Day, a global day, which honors social, economic, cultural, and political achievements of women while simultaneously turning our attention toward the continued lack of gender balance present in today’s world. The Balance for Better campaign theme prompted a closer look at diversity within our plastic surgery specialty. Gender balance has improved with many organizational efforts and laws enacted in the United States. Unfortunately, despite these institutions, statistics show the trend toward financial and career success still favors men. Within the field of medicine, a similar trend has been observed. Though women constitute 50% of medical school graduates, the majority still enter fields outside of surgical subspecialties. In comparison to other surgical subspecialties, women are most represented in plastic surgery. Unfortunately, significant gender discrepancies remain in post-graduate practice including academic practice rank, societal board membership, invited speaker opportunities, and compensation, to name a few. The “leaky pipeline” of women describes a precipitous decline in women at each progressive step of the professional ladder. We explore the multi-faceted nature of this phenomenon and highlight contributing factors limiting female growth within the plastic surgery profession. We also emphasize the continued growth of female plastic surgeon presence in all sectors despite these existing obstacles. We submit that continued leadership, mentorship, and sponsorship provided by both male and female physicians in the field will facilitate future leadership, advance gender parity, and cultivate a sense of belonging within the plastic surgery community, allowing brilliant minds to flourish and the profession to thrive.