SUMMARY: Plastic surgeons report amongst the highest prevalence of chronic musculoskeletal pain and fatigue in surgeons, which impacts daily life and career longevity.1 Hospital acquired occupational injuries are common, leading to some of the highest economic burdens in the industry. Poor postural awareness and ergonomic set up in the operating room represent the underlying culprit in the majority of situations.2 While a wealth of research documents the physical detriments, there remains a paucity of literature representing solutions to this problem.3–5 In this paper, we review anatomy, surgical equipment, and postural pitfalls in the operating room that lead to neck, back and shoulder pain. This paper provides an individualized template for home strengthening and conditioning exercises to target problematic muscle groups. The goal is to improve postural awareness, core strength, and surgical stamina. Self-motivated and prophylactic conditioning is a must for maintaining physical wellbeing in a surgical field which stresses mental and physical toughness. Future focus should be aimed at implementing dedicated ergonomic education and physical wellness programs early in surgical resident training. Reference Citations: 1. Capone AC, Parikh PM, Gatti ME, et al. Occupational Injury in Plastic Surgeons. Plast Reconstr Surg. 2010; 125(5):1555–1561. A 2. Soueid A, Oudit D, Thiagarajah S, Laitung G. The pain of surgery: pain experienced by surgeons while operating. Int J Surg. 2010; 8(2):118–120 A 3. Davis WT, Fletcher SA, Guillamondegui OD. Musculoskeletal occupational injury among surgeons: effects for patients, providers, and institutions. J Surg Res 2014; 189(2):207–212. A 4. Rosenblatt PL, McKinney J, Adams SR. Ergonomics in the Operating Room: Protecting the Surgeon. Journ Min Inv Gyn 2013; 20(6): 744. A 5. Rohrich, RJ. Why I Hate the Headlight a€¦ and Other Ways to Protect Your Cervical Spine. Plast Reconstr Surg. 2001; 107(4):1037–1038.