Background: Conflicts of interest pose a significant risk to the integrity of clinical research. As a part of the Sunshine Act, the Open Payments Program was established to provide transparency in financial relationships between industry partners and physicians. Previous research indicates considerable disparities between industry payments self-reported by plastic surgeon authors and those disclosed by their industry partners. The goal of this study was to determine if the Sunshine Act enhances transparency regarding authors’ conflicts of interest for readers of peer-reviewed plastic surgery journals.

Methods: Articles from the Aesthetic Surgery Journal and Plastic and Reconstructive Surgery published between 2017 and 2022 were reviewed. Self-reported disclosures for plastic surgeon authors were aggregated and compared against the Open Payments database using Python scripts.

Results: 8,040 articles were reviewed. After filtering, 1,469 unique plastic surgeons and 5,987 authorships were identified. A total of 11,593 discrepancies were found, with 82% of authors having at least one discrepancy. Average total payments for authors with discrepancies were greater than for authors without discrepancies ($106,928 vs. $6,501; p<0.001). A discrepancy in self-reporting was more likely to be identified for a senior author (p<0.001).

Conclusions: Plastic surgeon authors continue to underreport their financial relationships, and the lack of oversight continues to be problematic. Plastic surgery journals may consider automated systems to assess self-reporting accuracy.