Apoptosis and cell proliferation are the main mechanisms of cell homeostasis. The pathogenesis of approximately 70 % of all diseases results from an imbalance between these two counterparts. Therefore, research on apoptosis is a main target in biological and clinical fields. Many signalling pathways and proteins involved in their regulation have been characterized. In order to evaluate the relevance of apoptosis in plastic surgery, the literature was reviewed for its impact on ischemia and reperfusion concerning flap surgery as well as wound healing and angiogenesis. Furthermore, the relevance of apoptosis in ageing, allotransplantation and tumors was investigated. In all subsections of plastic surgery, a high impact was identified. More studies on the influence and regulation of apoptosis can bring further understanding on the disease patterns of plastic surgery and other specialties as well as the development of new therapeutic options. Research focusing on apoptosis is therefore an essential means for the advancement of and future trends in plastic surgery.