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    Dermatology journals among the 50 most cited for cosmetic procedures

    Thanks to the trend toward minimally invasive and noninvasive facial cosmetic procedures, in recent decades dermatologists have made inroads into publishing arenas once dominated exclusively by plastic surgeons, according to a study in the Aesthetic Surgery Journal.

    To analyze whether growth in minimally and non-invasive procedures by dermatologists, otolaryngologists and other specialists was reflected in peer-reviewed publications, researchers led by Joshua T. Waltzman, M.D., M.B.A., of Cleveland Clinic, searched the Thomson/Reuters Web of Knowledge for the top 50 cited articles for each decade from 1970 through 2014 in the following topics: facelift, brow lift, rhinoplasty and blepharoplasty. They also noted first authors' surgical specialties, journal titles and topics of interest through the decades.

    Among 250 articles for each procedure (except brow lifts, which had only 187 publications), facelift generally had the most citations in each decade. And across all procedures and time points, plastic surgery had the highest percentage of first authorship among the 50 most frequently cited papers – except for rhinoplasty between 2010 and 2014, when otolaryngology surpassed plastic surgery (48% versus 40%, respectively).

    However, a growing body of literature regarding minimally and non-invasive techniques since the 2000s corresponds with a rise in first authorship by dermatologists. From 2000-2014, dermatologist first authors accounted for around 8% of the most often-cited facelift articles and 5% or less of the top blepharoplasty articles. They also accounted for approximately 12% of the top brow lift articles from 2000-2009.

    Dermatology journals such as the Journal of the American Academy of Dermatology, Lasers in Surgery and Medicine and Dermatologic Surgery likewise have crept into the 50 most-cited publications on the topics of facelift (approximately 8%, 2000-2014), brow lift (15% through the 2000s and around 8%, 2010-2014) and blepharoplasty (10% or less, 2000-2014). Between 2000-2014, several articles by dermatologists, appearing in dermatologic journals, moreover cracked the top 5 most cited articles in the facelift and brow lift categories.

    The present study focused on facial cosmetic surgery because competition between plastic surgeons, dermatologists and other specialists is sharpest here. Regarding liposuction, Camp et al. showed that dermatologists ranked third among providers of these services, behind plastic surgeons and otolaryngologists, ahead of primary care and ophthalmologists, in Southern California. The same specialties were also the top 5 providers of hyaluronic acid injections in this study.

    Procedural trends and topics of interest through the decades also appear to favor dermatology. While facelift articles of the 1970s and 1980s highlighted anatomic concerns and complications, the 1990s witnessed the introduction of technical articles, discussing, for example, techniques related to the superficial muscular aponeurotic system (SMAS) and endoscopic procedures. "From 2000 to the present," wrote Waltzman et al., "papers have focused on minimally and noninvasive techniques for facelifting."

    During the 1990s, brow lift procedures shifted from open to endoscopic techniques, while attention in the blepharoplasty arena since the 1990s has shifted from minimizing surgical complications to preserving and repositioning fat compartments, an approach at which dermatologists excel.

    While dermatologic surgeons may not publish substantially regarding rhinoplasty and facelift procedures, the authors add, "This does not mean that they are not performing these procedures."

    Approaching the study from a plastic surgeon's perspective, analyzing purely surgical literature, confers a bias that the authors acknowledge. Additional biases include the use of a single search engine (Web of Knowledge) and the fact that authors did not incorporate the full field of practitioners in each specialty to determine publication trends on a per-capita basis.

    Finally, study authors say that while the most frequently cited papers are not necessarily the best or most frequently read papers. "Number of citations is at least one measure of quality, clinical pertinence and reader interest," they wrote.



    Waltzman JT, Tadisina KK, Orra S, Elbey H. “Who is publishing in facial cosmetic surgery? A citation analysis across specialties over five decades,” Aesthetic Surgery Journal. 2016;36(7):743-55.

    John Jesitus
    John Jesitus is a medical writer based in Westminster, CO.


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