Hi Tussy,
Yours is an extremely old post, but I figured that some other users could benefit from it.
The "new" wave in Plastics is the Integrated program, which matches students right out of medical school at the PGY1 level. There are currently approximately 25 of these, but the vast majority of programs are still fellowship positions (ie, after at least 3 years of Gen Surg or Ortho Surg residency). There are a couple which are 5 years, but the majority of the Integrated are 6 years in length (with additional time if you desire further fellowship training, ie, Burn, Hand, etc.)
Most of the other students I've talked to on the interview trail this year applied to ALL (or a large majority) of the Integrated programs as well as Gen Surg programs (in the likely event that you go unmatched in Plastics). Integrated Plastics is one of the most difficult residencies to get into these days so most advisors will recommend that you also apply to Gen Surg programs, or have some other "Plan B".
Hope this helps others out there.