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Foundational Papers in Body Contouring: A Bibliometric Analysis of the Past 45 Years
Luis Antezana BS1, Lucas Kruetz-Rodrigues MD2, Austin Chen MD2, Daniel Shapiro MD2, Jorys Martinez-Jorge MD2, Karim Bakri MBBS2 1Mayo Clinic Alix School of Medicine, Rochester, MN 2Division of Plastic Surgery, Mayo Clinic, Rochester, MN

Background: As the field of body contouring continues to evolve, a solid understanding of the foundational concepts that have influenced the field is important for any plastic surgery learner. The purpose of this study is to present a bibliometric review of the top 30 most cited articles related to 6 major domains of body contouring – abdominoplasty, thighplasty, brachioplasty, gluteoplasty, body lift, and liposuction. We aim to produce a repository of foundational papers for resident and fellow education.

Methods: A bibliometric analysis utilizing the Web of Science Citation Index (WoSC) was completed on January 1st, 2021 for body contouring papers published between January 1975 to December 2020. WoSC filers following use of 22 key-phrases helped narrow our search. Papers were arranged by number of citations and reviewed sequentially to compile a list of 30 papers. Exclusion criteria included non-invasive treatments, and articles pertaining to breast surgery or facial rejuvenation, fat grafting, and fillers. These latter topics have previously been published. After selection, the articles were assigned the following categorizations: country of publication based on first author, level of evidence (LoE), and type of study. Published studies on how to assign LoE articles related to plastic and reconstructive surgery guided designations.

Results: Our search yielded a total of 4,257 articles. After filters were selected, our count narrowed to 3,143 articles. A total of 336 articles were reviewed to compile our list. The mean number of citations across the articles was 114.7 +/- SD 86.1. The highest prevalence of the papers was published between 2000-2009 (n=15, 50%). The country with the highest number of contributions was the United States of America (n=22, 73%) followed by Mexico (n=3, 10%). Plastic and Reconstructive Surgery© served as the main journal of publication for these papers (n=22, 73.3%). The majority of articles were designated to clinical type studies (n=26, 86.7%) of which all but one were therapeutic. No basic science or prevalence study design papers landed a position on this list. In terms of LoE, most papers were assigned IV (n= 11, 36.7%) and III (n=7, 23.3%). Four papers utilizing survey design for data collection were not given an LoE as per referenced guidelines.

Conclusion: Our study reveals that most papers in this field are of LoE III and IV. Although plastic surgery is not well oriented for randomized controlled trials compared to medicine, this calls for higher evidence based papers in body contouring. Some recent innovations are excluded in this study, however, many of these are yet to be fully established and do not represent the foundations of the field. Moreso, many of the peer-reviewed articles in this analysis serve as the basis for both standard and innovative techniques currently in practice. This analysis provides an easy, electronic way for residents and fellows interested in body contouring to quickly access some of the most influential concepts, and to gain a foundational basis for understanding the evolution of the field.

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