Abstract
BACKGROUND: Tissue expanders are widely used in both immediate and delayed breast reconstruction after mastectomy. With advances in surgical techniques and biomaterials, this field has seen continuous development. This study aimed to analyze the top 100 most-cited articles on tissue expanders in breast reconstruction to identify research trends and progress in this field. METHODS: The top 100 most cited articles were selected from the Web of Science Core Collection (WoSCC) for a systematic search. Comprehensive bibliometric analyses were conducted using VOSviewer, CiteSpace, and Bibliometrix. Additionally, clinical trial data were retrieved from ClinicalTrials.gov (https://www.clinicaltrials.gov) and the World Health Organization International Clinical Trials Registry Platform (ICTRP) (https://trialsearch.who.int). RESULTS: The top-cited articles span multiple disciplines, with the USA contributing the highest number of publications. China, Canada, and the UK ranked second in terms of publication volume. Representative institutions included the University of Michigan and Memorial Sloan Kettering Cancer Center. Key authors included Cordeiro PG and Wilkins EG. Frequent keywords were "implant", "mastectomy", "complications", and "radiotherapy". The most cited article was by Chun YS et al. [2010]. Of the clinical trials, 66 were retrieved from ClinicalTrials.gov and 37 from ICTRP. After removing duplicates, a total of 78 trials focused on tissue expanders in breast reconstruction were included. CONCLUSIONS: Research on tissue expanders in breast reconstruction focuses on surgical optimization, complication management, biomaterials, and patient-reported outcome measures (PROMs). Current trends emphasize personalized reconstruction strategies and improved postoperative care. Challenges remain in addressing patient variability and biomaterial safety. Further research is needed to refine individualized approaches and improve clinical outcomes.