Maybe best to ask after we've matched, but here goes...
Plastics is fascinating, but as others have commented previously, it's important to make sure that you love the rest of ophthalmology too. Otherwise there are other specialty options to consider. It sounds like you've already matched though, so congratulations and you've clearly gotten this part figured out...
Each year there are roughly 24 ASOPRS spots available and easily twice that number of well qualified candidates who at least register to begin the application process. So yes, it is very competitive and deserving people do get overlooked. I'm not sure, however, that the overall rank of your program is the strongest predictor of match success. There are many, many well-known and respected plastics faculty members outside of the top 15. The most important thing is that you form close working relationships with the people at your future institution since their letters on your behalf are probably the most important factor (at least in terms of getting an interview in the first place). Give yourself 6 months to adjust, learn the basics and decide that you really do want to pursue plastics; then start doing grand rounds, case reports & research with these people. If you have extra time, it never hurts to go help out with surgical cases. If you have fellows at your program keep in mind that your working relationship with them is very important as well. Faculty members are bound to ask them what you're actually like when they're not around. You can have a rock star application, but a lousy personality or attitude will ruin you chances faster than anything.
It's also reasonably important to do well on the OKAPs since this is the only year you have to produce a score that programs will see. Like the USMLE, it isn't supposed to be used for differentiating candidates, but some programs still ask for it and use it. I'd definitely recommend hitting a review book like Chern or Trattler and a question bank like Ophthoquestions pretty hard after you've taken the first few months to get oriented to your program.
Keep in mind that there are a lot of great non-ASOPRS fellowships as well; in some cases the distinction has more to do with history and politics than with the quality of education you'll receive. They're a bit harder to find out about, though, since there's no central clearing house, so ask around. Generally speaking, ASOPRS is more important if you want to stay in academia and some employers state that they perfer it, but coming from a good non-ASOPRS program will still afford you a lot of opportunities.
