[Nickshu]

They need them for mastectomy reconstructions but also in order to retain quality plastic surgeons on active duty to do skin grafts on burn victims and reconstructions on military injuries they need to allow them to do the full scope of procedures in their training wheelhouse, otherwise they will leave active duty.

Also military residency training centers must allow residents to train and do the full scope of procedures for a plastic surgeon so they can maintain accreditation and produce surgeons capable of earning board certification.

I spent 10 years working for Navy Medicine. The "just farm it out" thing has been tried (and still goes on) but it always proved to be more expensive and logistically complicated than just having in house surgeons provide the care. It still goes on but mostly for overflow/access to care reasons.