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

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 .

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