The number of publications on the topic of diversity, equity, and inclusion in plastic surgery has increased exponentially in the last 5 years. Numerous changes have been implemented. On June 29, 2023, the US Supreme Court ruled that affirmative action in college admissions is unconstitutional. Writing for the majority, Justice Roberts concluded that eliminating racial discrimination means eliminating all of it, and the Equal Protection Clause applies without regard to any differences of race, of color, or of nationality. Justice Thomas authored a concurrence, stating that such policies are contrary to our colorblind constitution and our nation's equality ideal. Justice Sotomayor was joined by Justice Kagan and Justice Jackson in their dissenting opinion that ignoring race will not equalize a society that is racially unequal and that students of various racial backgrounds can offer different perspectives because of that identity. The reaction was largely partisan. Michelle Steel and Young Kim, Republican Asian American Congresswomen from California, lauded the decision, along with Republican Senator Tim Scott from South Carolina. Senate Majority Leader Democrat Chuck Schumer opined that the Supreme Court decision has put a "giant roadblock in our country's march toward racial justice." Cory Booker, New Jersey Democrat, called the decision a devastating blow. President Joe Biden and former First Lady Michelle Obama also disagreed with the decision. Profound ramifications across our institutions of higher learning and in medical specialties are likely to follow. Legally, it will be difficult or impossible to defend race-based preferences going forward. This is true regardless of whether such policies were put in place with the best of intentions.