In spite of the suitability of the day surgery environment for most patients undergoing elective plastic surgery, day plastic surgery has not been universally adopted in the United Kingdom. The experience of one plastic surgeon gained in treating 5970 patients as day cases out of a total of 12 461 patients over 10 years is described, with emphasis on the organisation of the service by only the consultant surgeon in collaboration with a medical secretary. Thus, neither the trainee surgeon nor GP clinical assistant in the team have any administrative duties. Within a day surgery unit with a twin theatre and 12 beds, it was possible on 1 day each week between July 1991 and June 1992 to treat 954 patients of whom 678 were treated under local anaesthesia and 276 under general anaesthesia. Three patients required admission to the main hospital overnight. By this day of day plastic surgery an effective service is provided to patients convenient to their home while also releasing facilities in the main regional centre which is equipped and staffed to a higher level of reconstructive expertise. However, the patients themselves should also play a part in improving the service intended for them, and a failure to attend for surgery without prior warning adds an avoidable element of inefficiency.