Background: Citation analysis provides a means to identify pivotal works within a given field. Here we use citation analysis to identify landmark articles in plastic surgery. The most frequently cited 100 articles are identified and analyzed. Comparison is made to similar reviews in other fields. Additionally, the subject matter of these articles is compared to the procedures most commonly performed by plastic surgeons, as a means to gauge the clinical relevance of these articles.

Methods: The 4 plastic surgical journals with the highest impact factor were identified and searched for the most highly cited 100 articles published between 1950 and the present. These articles were analyzed for date, journal, article type, subject matter and number of citations. Searches within these same journals were performed on the most frequently performed procedures in plastic surgery.

Results: Four journals, Plastic and Reconstructive Surgery, Clinics in Plastic Surgery, Annals of Plastic Surgery and British Journal of Plastic Surgery, were identified as the most highly ranked plastic surgery journals by impact factor. Within these, the most frequently cited 100 papers were identified, with between 676 and 132 citations. These were published between 1950 and 1997, with no clear correlation between age of the paper and number of citations. Of the 100 most highly cited papers, 34 were technique papers, 23 were basic science papers, 15 were reviews, 13 were anatomic studies, 10 were clinical trials, 3 were classification schemes and 2 were case reports. The topics of these papers had little overlap with the most frequently performed invasive plastic surgical procedures.

Conclusions: A large and self-sustaining body of plastic surgical literature has emerged in the last half-century. The citation pattern in plastic surgery reflects the field's technical and anatomic bent, with new techniques and anatomic studies forming the plurality of highly cited papers. Randomized clinical trials are notably absent. Little overlap exists between the frequently cited papers, and commonly performed procedures in plastic surgery.