Research Appraisalother

The Rise of Intelligent Plastic Surgery: A 10-Year Bibliometric Journey Through AI Applications, Challenges, and Transformative Potential

Aesthetic Plast SurgLiu, Yi, Deng, Kexin, Zhang, Chengwu et al.1 Mar 2026DOI

Clinical Snapshot

75CEBM
Evidence: Moderateother

PICO Framework

P — PopulationResearch literature on artificial intelligence applications in plastic surgery (235 documents from Web of Science, 2016-2024)
I — InterventionBibliometric analysis using CiteSpace and VOSviewer software with co-citation networks, keyword co-occurrence, burst detection, and cluster analysis
C — ComparatorNot applicable - descriptive bibliometric study without comparison groups
O — OutcomesResearch trends, publication patterns, institutional contributions, keyword clusters, collaboration networks, and identification of research gaps in AI-plastic surgery integration

Bottom Line

This bibliometric analysis reveals exponential growth in AI applications within plastic surgery research, dominated by US institutions but highlighting significant collaboration gaps. Key innovations span breast reconstruction, facial analysis, and automated grading systems, yet concerning biases toward Western beauty standards emerge. The study identifies critical barriers including ethical concerns, dataset diversity limitations, and overreliance on AI-driven decisions. For Australian plastic surgeons, this research provides valuable insight into global trends while emphasising the need for inclusive, transparent approaches to AI integration. The findings support cautious adoption of AI technologies with emphasis on addressing ethical considerations and ensuring diverse representation in training datasets. Future Australian initiatives should prioritise collaborative, interdisciplinary approaches to realise AI's transformative potential while mitigating identified risks through robust governance frameworks.

Evidence: Moderate

Key Findings

  • P Value: Not applicable - descriptive analysis

  • Effect Size: 235 documents analysed over 8-year period (2016-2024)

  • Primary Outcome: Exponential growth in AI-plastic surgery publications with USA, Germany, and Canada leading research output

  • Nnt Or Sensitivity: Harvard and Stanford Universities identified as dominant institutional contributors with limited cross-institutional collaboration

  • Confidence Interval: Not reported

Clinical Application

High feasibility for Australian practitioners to learn from identified trends and avoid documented pitfalls Relevant to Australian plastic surgery practice development, particularly regarding TGA regulatory considerations for AI medical devices and RACS guidelines for emerging technologies Plastic surgeons, researchers, and healthcare administrators interested in AI integration

Abstract

BACKGROUND: Driven by advancements in deep learning, surgical robots, and predictive modeling technologies, the integration of artificial intelligence (AI) and plastic surgery has expanded rapidly. Although AI shows the potential to enhance precision and efficiency, its clinical integration faces challenges, including ethical concerns and interdisciplinary complexity, which require a systematic analysis of research trends. METHODS: The CiteSpace and VOSviewer software were used to conduct a quantitative analysis of 235 documents in the core collection of Web of Science from 2016 to 2024. Co-citation networks, keyword co-occurrence, burst detection, and cluster analysis were employed to map the research trajectories. The inclusion criteria gave priority to studies that explicitly incorporated artificial intelligence into surgical designs or outcomes. The contributions of countries, institutions, and authors were evaluated through centrality indicators. RESULT: Publications related to artificial intelligence have grown exponentially, with the USA, Germany, and Canada leading research output. Harvard and Stanford Universities dominate in terms of institutional contributions, but cross-institutional collaboration remains limited. The keyword cluster highlights the innovations of artificial intelligence in breast reconstruction, facial analysis, and automated grading systems. Burst terms such as "deep learning," "risk assessment," and "attractiveness" underscore AI's role in optimizing surgical outcomes, but they also expose biases against Western-centric beauty standards. Ethical concerns, dataset diversity gaps, and overreliance on AI-driven decisions have become key obstacles. CONCLUSION: The integration of artificial intelligence in plastic surgery goes beyond the utility based on tools and into data-informed surgical engineering. The persistent gap in collaboration and dataset diversity highlights the need for global, interdisciplinary efforts to address technical and ethical challenges while advancing AI's clinical utility. Future research must prioritize transparency, inclusivity, and collaborative innovation to realize AI's transformative potential while mitigating risks. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

References

  1. 1.Liu, Y., Deng, K., Zhang, C., Yuan, Z., Zhou, J., & Liu, C. (2024). The Rise of Intelligent Plastic Surgery: A 10-Year Bibliometric Journey Through AI Applications, Challenges, and Transformative Potential. Aesthetic Plastic Surgery. https://doi.org/10.1007/s00266-024-03952-z
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