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Introduction Microsurgical reconstruction of the breast represents an area of continual evolution, as new autologous flaps are introduced and principles are refined. This progression can be demonstrated by bibliometric analysis of the scientific literature. Methods The top 10 plastic surgery journals were determined by impact factor (IF). Each issue of every journal from 1993 to 2013 was accessed directly, and all articles discussing microsurgery on the female breast were classified by authors' geographic location, study design, and level of evidence (LOE, I-V). The productivity index and productivity share of each geographic region was calculated based on number of articles published and IF. Results A total of 706 breast microsurgery articles were analyzed. There was a significant increase in microsurgical breast research (p < 0.01), with an average 33.6 ± 31.1 articles per year and a mean increase of 4.4 articles per year. Most research was of lower LOE, with level I constituting 0.14% and level II constituting 5.21% of all articles. United States contributed the most research with 336.4 articles, followed by Western Europe with 242.2. However, Western Europe experienced the greatest increase in productivity share, with + 0.50 ± 0.29 growth, while United States demonstrated the greatest decrease in productivity share with - 1.23 ± 0.31 growth. Among autologous flaps, transverse rectus abdominis muscle research had the greatest yearly publication volume until 2002, when overtaken by deep inferior epigastric perforator flap research. Conclusion Over the 21-year study period, the United States not only contributed the greatest volume of research on female breast microsurgery but also demonstrated the greatest decline in research productivity. Efforts should be made to increase the LOE in breast microsurgery research., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Since the advent of the operating microscope by Julius Jacobson in 1960, reconstructive microsurgery has become an integral part of extremity reconstruction and orthopaedics. During World War I, with the influx of severe extremity trauma Harold Gillies introduced the concept of the reconstructive ladder for wound closure. The concept of the reconstructive ladder goes from simple to complex means of attaining wound closure. Over the last half century microsurgery has continued to evolve and progress. We now have a microsurgical reconstructive ladder. The microsurgical reconstruction ladder is based upon the early work on revascularization and replantation extending through the procedures that are described in this article., (Copyright © 2013. Published by Elsevier Ltd.)

The often groundbreaking developments of new methods in Plastic Surgery have been published in the journal "Der Chirurg" (The Surgeon) ever since its foundation in 1928, when it was established as a journal dealing with all aspects of surgery and containing many innovations and developments. Historically this is also reflected in the establishment of Plastic Surgery initially as a subspecialty and later on as a specialty within the German Society for Surgery. The interdisciplinary character of modern reconstructive and oncological concepts, not only with other specialties but also within various surgical specialties, raises further challenges and leads to new developments in reconstruction, which will definitely induce an increasing amount of knowledge to the advantage of our patients. Scientific and clinical advances over the last 80 years give rise to the hope that similar success will be attained for reconstruction of traumatic and oncological defects and malformations or disfigurations in the future. Consolidated findings from regenerative medicine and tissue engineering will enrich the daily practice of surgical reconstruction.

A review is made of the latest developments in the field of plastic and reconstructive surgery. The subspecialty divisions are more pronounced in the modern era, but are still linked by a unified approach to soft-tissue management. Although cornerstone areas such as microsurgery have seen refinement, other fields, including aesthetic surgery, have been totally redefined by laser technology and the spread of endoscopic techniques.

The 70th birthday of Professor Kraft-Kinz, who holds the Chair of Surgery at the University of Graz, is a suitable occasion to review the development of several surgical disciplines into independent specialist fields. Plastic surgery is one such monospecialty which has been in existence as a separate entity for the past 7 years. Important personalities and events in surgery are traced back to the 18th century and described from an Austrian perspective, with particular reference to the University of Graz. The process of achieving independence since 1988, in conjunction with the application of new techniques, in particular microsurgery, has led to enormous expansion of this specialty, both regarding quantity and quality of practice. Hence, the initial divergence has changed to an overlapping convergence of the specialties and the current interdisciplinary cooperation is of great benefit to all the individual subspecialist fields. This is illustrated by means of case reports representing two distinct areas of exemplary interdisciplinary interaction in surgical management.

The development of extremity replantation and reconstructive microsurgery was initially carried out independently among the pioneering centers throughout the world. The comparative development of these techniques is outlined. With the fast growth of microsurgical procedures, many of the U.S. residency programs have incorporated microsurgery training into the curriculum.