Social Media in Plastic and Reconstructive Surgery—A Bibliometric Analysis of the 100 Most Cited Articles

Aim: Social media has become an influential force in plastic surgery, shaping patient expectations, marketing strategies, and professional conduct. Despite its growing impact, the evidentiary foundation guiding digital engagement in the specialty remains poorly characterized. This study presents a bibliometric analysis of the 100 most cited publications addressing social media in plastic and reconstructive surgery, with a secondary assessment of methodological quality, to evaluate publication trends, thematic focus, and levels of evidence. Methods: The 100 most cited publications related to social media in plastic and reconstructive surgery were identified using Web of Science and Scopus (December 2024). Extracted variables included citation metrics, publication characteristics, country of origin, journal, and thematic focus. Methodological quality was assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence (LOE). Results: The 100 articles accumulated 4278 citations (range 16–180; mean 42.8 ± 32.0). Most studies were published during the 2010s (n = 63) and originated from the United States (n = 64). Dominant themes included marketing and physician behavior, with ‘Plastic and Reconstructive Surgery’ and ‘Aesthetic Surgery Journal’ as the most frequent publication venues. The literature was largely composed of low-level evidence (LOE 5, n = 26; LOE 4, n = 34; LOE 3, n = 34; LOE 2, n = 5), with only one randomized controlled trial (LOE 1). Validated patient-reported outcome measures were reported in a single study. Conclusions: Highly cited social media literature in plastic surgery demonstrates substantial visibility but limited methodological rigor. The predominance of low-level evidence and minimal use of validated outcomes highlights a disconnect between digital influence and scientific quality. Strengthening the evidence base is essential to ensure credibility, ethical practice, and alignment with evidence-based medicine.