Aesthetic surgery journal. Open forum最新文献

{"title":"Incidence and Characteristics of Delayed Inflammatory Reactions Secondary to Hyaluronic Acid Filler Injections: A Systematic Review With Meta-Analysis.","authors":"Jimyung Seo, Jonathan Kadouch, Tatjana Pavicic, Niamh Corduff, Qin Li, Ada Trindade de Almeida, Clifton Ming Tay, Wei Qi Loh","doi":"10.1093/asjof/ojag165","DOIUrl":"10.1093/asjof/ojag165","url":null,"abstract":"<p><p>Delayed inflammatory reactions (DIRs) are rare but increasingly relevant complications of hyaluronic acid (HA) fillers. The aim of this review was to examine the incidence and characteristics of DIRs secondary to HA fillers for facial aesthetic indications. The authors systematically reviewed studies published before December 3, 2024, from PubMed and Embase, using a random-effects meta-analysis model to compute pooled incidence rates of DIR with 95% CIs. Subgroup analyses were performed according to filler crosslinking technology. Case data were analyzed descriptively. The meta-analysis included 242 studies, and case data were supplemented from 71 additional reports. The pooled incidence of DIRs was 0.0005 (95% CI, 0.0002-0.0013) events per patient-years, equivalent to an event occurring for every 2000 patients with 1 year of follow-up. When analyzed by crosslinking technology, incidence rates per patient-year were 0.0044 (95% CI, 0.0006-0.0314) for SHAPE (Stabilized Hyaluronic Acid And Purification Enhancement), 0.0022 (95% CI, 0.0011-0.0043) for Vycross, 0.0007 (95% CI, 0.0003-0.0017) for NASHA (Non-Animal Stabilized Hyaluronic Acid), and 0.0006 (95% CI, 0.0002-0.0025) for HICE (High Concentration Equalized); several filler technologies, including CPM (Cohesive Polydensified Matrix)-based fillers, reported no incident DIR cases during follow-up. The median time to onset was 3 months (range, 2 weeks to 12 years), and time to resolution was 2.9 months (range, 1 day to 6 years). Common presentations included nodules, redness, swelling, and induration. The management often involved hyaluronidase, corticosteroids, and antibiotics. DIRs are rare adverse events following aesthetic HA filler treatments, exhibiting varied times to onset and resolution. Incidence rates appear to vary by crosslinking technology, and awareness of potential differences can contribute to safe and natural outcomes. <b>Level of Evidence</b>: 3 (Therapeutic).</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag165"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construct Validity of the GENDER-Q Face and Neck Scales in 4890 Transgender and Gender Diverse Adults.","authors":"Anne F Klassen, Manraj N Kaur, Charlene Rae, Caleb Haley, Fermín Capitán-Cañadas, Daniel Simon, Luis Capitán, Jens U Berli, Tim C van de Grift, Margriet G Mullender, Thomas Satterwhite, Gerhard S Mundinger, Gabriel A Del Corral, Christodoulos Kaoutzanis, Alireza Hamidian Jahromi, Michael Alperovich, Fan Liang, Danny A Young-Afat, Sylvie D Cornacchi, Andrea L Pusic, Shane D Morrison","doi":"10.1093/asjof/ojag157","DOIUrl":"10.1093/asjof/ojag157","url":null,"abstract":"<p><strong>Background: </strong>Gender-affirming facial interventions aim to align facial features of people who identify as transgender or gender diverse (TGD) with their gender identity. GENDER-Q is a comprehensive patient-reported outcome measure with 11 scales that measure satisfaction with the face overall, facial features, specific facial areas, and laryngeal prominence (Adam's apple).</p><p><strong>Objectives: </strong>The aim of the study was to examine construct validity for the face and neck scales in an international sample of people who identify as TGD.</p><p><strong>Methods: </strong>An international cross-sectional survey collected GENDER-Q data between February 2022 and March 2024. Participants were aged 18 years and older and had sought or received gender-affirming care within the past 5 years. Predefined hypotheses for expected group-level differences and correlations between GENDER-Q scales were tested using independent <i>t</i>-tests, analysis of variance, and Pearson correlation coefficients. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline was followed to establish construct validity (ie, ≥75% hypotheses confirmed).</p><p><strong>Results: </strong>A total of 4890 participants completed the GENDER-Q Face Overall scale and additional scales as relevant. The sample identified as man (33%), woman (37%), nonbinary (24%), and other gender (6%). The percentage of hypotheses that met the COSMIN criteria of evidence of construct validity ranged from 78% to 100% for the 11 scales. As hypothesized, participants who had undergone gender-affirming facial procedures reported significantly higher satisfaction with appearance scores than those who wanted surgery or required revision surgery.</p><p><strong>Conclusions: </strong>GENDER-Q scales met COSMIN criteria for hypothesis-based construct validity. GENDER-Q can be used to inform clinical care and to advance research regarding gender-affirming facial interventions.</p><p><strong>Level of evidence 3 therapeutic: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag157"},"PeriodicalIF":1.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limited-Dissection Ligament-Preserving Facelift for Early Facial Aging: Surgical Technique and Clinical Experience.","authors":"Albert Bosch, Nabil Fakih-Gomez","doi":"10.1093/asjof/ojag155","DOIUrl":"https://doi.org/10.1093/asjof/ojag155","url":null,"abstract":"<p><strong>Background: </strong>Early facial aging is characterized by midfacial descent, loss of mandibular definition, and attenuation of retaining ligaments. Although superficial musculoaponeurotic system (SMAS)-based and deep-plane facelifts remain the gold standard, many patients seek less invasive procedures with shorter recovery.</p><p><strong>Objectives: </strong>The aim of this study was to describe a limited-dissection ligament-preserving facelift technique and evaluate its safety and clinical outcomes in patients with early facial aging.</p><p><strong>Methods: </strong>A retrospective case series of 100 patients treated between June 2021 and January 2025 was performed. All procedures were carried out under local anesthesia using limited dissection and superoposterior suspension of the SMAS-ligament complex and platysma. Outcomes included complications, revision rates, recovery time, and patient satisfaction at 1 year.</p><p><strong>Results: </strong>Mean patient age was 43.4 years (range, 34-52 years). All procedures were performed under local anesthesia without sedation. Recovery was rapid, with 96% of patients resuming normal activities within 7 days. Transient hypoesthesia occurred in 22% of patients and resolved within 8 weeks. No hematoma, infection, permanent nerve injury, or wound dehiscence was observed. Temporal alopecia occurred in 14% of patients and resolved spontaneously in most cases. Minor under-correction was observed in 6%, with an overall revision rate of 9%. At 1 year, 82% of patients reported being satisfied or very satisfied.</p><p><strong>Conclusions: </strong>Limited-dissection ligament-preserving facelift appears to be a safe and effective minimally invasive option for selected patients with early facial aging. It provides natural results and rapid recovery and may represent an intermediate approach between nonsurgical treatments and traditional facelift procedures.</p><p><strong>Level of evidence 4 therapeutic: </strong>For image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag155"},"PeriodicalIF":1.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Safety and Complication Rate of Deep Plane Facelift Under Local Anesthesia.","authors":"Sarah Novis","doi":"10.1093/asjof/ojag156","DOIUrl":"10.1093/asjof/ojag156","url":null,"abstract":"<p><strong>Background: </strong>The deep plane facelift is traditionally performed under general anesthesia or intravenous (IV) sedation. Because of demand increases among older patients and those with comorbidities, interest has grown in performing comprehensive facelift surgery under local anesthesia; however, safety data remain limited.</p><p><strong>Objectives: </strong>The objective of this study is to evaluate the complication rate associated with deep plane facelift surgery performed under local anesthesia and to compare these outcomes with established complication rates reported in the literature.</p><p><strong>Methods: </strong>A retrospective review was conducted of 142 consecutive patients who underwent primary deep plane facelift and necklift under local anesthesia with oral sedation. All procedures were performed by a single surgeon in an office-based facility with a minimum follow-up of 90 days. Major and minor complications were recorded and compared with established complication rates for deep plane facelift reported in the literature using odds ratio analysis.</p><p><strong>Results: </strong>The mean patient age was 63.5 years. There were no major hematomas, skin necrosis, or temporary or permanent facial nerve injuries. Minor complications included seroma (3.52%), minor hematoma (0.70%), and localized infection (1.40%), all resolving with conservative management. No patients required hospitalization or experienced thromboembolic events. Complication rates did not differ significantly from published data (<i>P</i> > .05).</p><p><strong>Conclusions: </strong>Deep plane facelift with necklift can be safely performed under local anesthesia with oral sedation, demonstrating complication rates in this cohort that are no higher than published benchmark rates for patients receiving general anesthesia or IV sedation.</p><p><strong>Level of evidence 4 therapeutic: </strong>For image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag156"},"PeriodicalIF":1.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unusual Iatrogenic Complication of Botulinum Toxin: Forearm Flexor Weakness Following a Nonstandard Intradermal Sensitivity Test.","authors":"Ahmad Fayez Ahmad","doi":"10.1093/asjof/ojag132","DOIUrl":"10.1093/asjof/ojag132","url":null,"abstract":"<p><p>Botulinum toxin (BoNT) type A is widely used in aesthetic and functional medicine and is generally considered safe when administered at appropriate doses and using proper techniques. However, rare and unusual complications may occur, even in patients with no previous neurological or allergic history. The author reports the case of a 24-year-old female who developed an unexpected neuromuscular complication characterized by progressive weakness of the forearm flexor muscles following a nonstandard intradermal sensitivity test of BoNT performed on the volar aspect of the forearm. The procedure was carried out by a nonspecialist practitioner. The patient subsequently developed reduced grip strength and functional limitation of hand movements within days, without systemic symptoms or clinical evidence of an allergic reaction. Clinical evaluation suggested a pharmacological neuromuscular effect rather than an immunologically mediated hypersensitivity reaction. No cutaneous signs of allergy, such as urticaria or angioedema, were observed. The temporal relationship and anatomical distribution of weakness were consistent with possible local toxin diffusion or unintended neuromuscular junction blockade. The patient was managed conservatively; a gradual improvement in muscle strength was observed over time. This case highlights a rare and atypical complication associated with the nonstandard use of BoNT and emphasizes the importance of adherence to evidence-based injection protocols performed by qualified specialists. It also raises concerns regarding the practice of intradermal \"sensitivity testing,\" which lacks scientific validation and may lead to unintended neuromuscular effects, particularly when performed by nonspecialists. Further studies are needed to clarify the safety implications of nonstandard applications and to distinguish true hypersensitivity reactions from pharmacologic diffusion-related effects. Level of Evidence: 5 (Therapeutic) For image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag132"},"PeriodicalIF":1.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of a Portable Nonfixed Stereophotogrammetry System for Facial Imaging.","authors":"Marcelo Germani, Ana C N Carnevali, Pietra Roschel de Borba, Gabriela Giro, Victor R M Munoz-Lora","doi":"10.1093/asjof/ojag078","DOIUrl":"10.1093/asjof/ojag078","url":null,"abstract":"<p><p>Stereophotogrammetry (3D-SQ) provides a precise alternative for the assessment of facial aesthetic procedures. Nevertheless, its accuracy could be influenced by the operator when a nonfixed device is used. The objective of the present observational study was to evaluate the reliability of a portable nonfixed 3D-SQ device. Three operators took two 3-dimensional (3D) image captures of 3 distinct volunteers using a portable nonfixed 3D-SQ device. The acquisition of images was performed at 2 different time points (F1 and F2) with a 60 min interval between each capture for each volunteer. No external lights or tripod were utilized, as recommended by the manufacturer. The photographs were processed through specialized software to generate 3D models, and a specific region of the face was analyzed to assess the reliability of the method. Interclass correlation coefficients (ICCs) of the area, perimeter, and volume of the selected region were calculated. The results demonstrated a high intraoperator consistency at all 3 obtained values (volume ICCs = 0.829; area ICCs = 0.828; perimeter ICCs = 0.673). However, a low reliability in all values across different operators was found (ICCs < 0.5). These results suggest that variations in the captures may differ among different operators. These results may be attributed to factors such as the operator height, differences in reference points, or equipment stability. The study concluded that the reliability in facial stereophotogrammetry using a nonfixed device can be influenced by the operator, exhibiting high intraoperator reliability but significant variations between different operators. <b>Level of Evidence</b>: 4 (Therapeutic) For image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag078"},"PeriodicalIF":1.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid-Sparing Options in Perioperative Pain Management: An Expert Video Roundtable Discussion.","authors":"Al Aly, Rodney J Rohrich, Nicholas Haddock, Sam Jejurikar","doi":"10.1093/asjof/ojag153","DOIUrl":"https://doi.org/10.1093/asjof/ojag153","url":null,"abstract":"","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag153"},"PeriodicalIF":1.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Proposal in the Approach to Brachial Remodeling: The Melfa-Anastasia Arm Laxity System (MAALS).","authors":"Melfa Fabrizio, Anastasia Dafne, Ciranna Gabriele, Melfa Sonia, Nicoletti Giovanni","doi":"10.1093/asjof/ojag150","DOIUrl":"10.1093/asjof/ojag150","url":null,"abstract":"<p><strong>Background: </strong>Current diagnostic tools for upper arm laxity assessment-including the pinch test and two-dimensional photographic scales-fail to characterize the underlying tissue composition, leading to inappropriate treatment selection and preventable complications.</p><p><strong>Objectives: </strong>To introduce the Melfa-Anastasia Arm Laxity System (MAALS), a precision medicine framework integrating high-frequency ultrasound (HFUS) biometry with a cylindrical geometric model for objective, compositional assessment of brachial architecture.</p><p><strong>Methods: </strong>MAALS employs a noncontact stand-off technique (HFUS, 18-22 MHz) to measure superficial adipose tissue thickness (SAT) and triceps muscle thickness (M) at the mid-brachial sentinel point. Two dimensionless indices are derived: the adipose saturation percentage (%SAT = SAT/Rtot × 100) and the muscle filling ratio (MFR = M/Rtot), where Rtot is the total brachial radius calculated from arm circumference.</p><p><strong>Results: </strong>Based on preliminary anatomically rational thresholds, MAALS defines five phenotypes (0-4): normotrophic (0), adipose hypertrophy (1), mixed morphology (2), pure cutaneous ptosis with critical vascular risk zone (%SAT < 20%, SAT < 4-5 mm; liposuction contraindicated) (3), and sarcopenic/atrophic (4). Each phenotype carries specific therapeutic indications ranging from prevention to regenerative strategies.</p><p><strong>Conclusions: </strong>MAALS is presented as a conceptual precision medicine framework requiring prospective validation, not as an established clinical standard. By providing objective compositional characterization of brachial architecture, it offers a structured basis for safer, more individualized treatment planning, future multicenter validation studies, and integration with AI-based segmentation technologies.</p><p><strong>Level of evidence 5 therapeutic: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag150"},"PeriodicalIF":1.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 Receptor Agonists in Aesthetic Surgery: An Expert Video Roundtable Discussion.","authors":"Ryan E Austin, Daniel J Gould, Renee Burke, Kye Higdon","doi":"10.1093/asjof/ojag152","DOIUrl":"https://doi.org/10.1093/asjof/ojag152","url":null,"abstract":"","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag152"},"PeriodicalIF":1.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Postoperative Complications After Superomedial Pedicle Reduction Mammaplasty.","authors":"Alexandra Boric, Bo Hyun Kong, Ravi Dhawan, Gabriela García Nores, Albert Losken","doi":"10.1093/asjof/ojag141","DOIUrl":"10.1093/asjof/ojag141","url":null,"abstract":"<p><strong>Background: </strong>The superomedial pedicle (SMP) is a widely used reduction mammaplasty technique, but patient-specific risk factors may influence complications.</p><p><strong>Objectives: </strong>The aim of this study was to quantify postoperative complication rates and identify independent predictors after bilateral SMP breast reduction.</p><p><strong>Methods: </strong>In this study, the authors retrospectively reviewed 643 consecutive patients undergoing bilateral SMP breast reduction for macromastia from January 2004 to December 2024. Complications were classified as minor (delayed healing, infection, seroma, hematoma, and necrotic events) or major (readmission and/or reoperation). Logistic regression identified predictors, adjusting for age, BMI or obesity class (BMI <30, Classes I-III), smoking, hypertension, and diabetes.</p><p><strong>Results: </strong>The mean age was 39.3 years (range, 14-74 years), and the mean BMI was 32.5 kg/m² (range, 18.9-58.2 kg/m²). The overall complication rate was 22.2% (15.4% minor, 6.8% major). The mean follow-up was 5.5 years. All obesity classes predicted minor complications and delayed healing. Only Classes II to III predicted any complication (all <i>P</i> ≤ .008) and infection (all <i>P</i> ≤ .025). In continuous BMI models, higher BMI (per 1 kg/m² increase) predicted any complication (<i>P</i> = .011), minor complications (<i>P</i> = .002), and delayed healing (<i>P</i> = .001). Smoking predicted major complications (<i>P</i> = .007) and reoperation (<i>P</i> = .033), whereas hypertension predicted any complication (<i>P</i> = .023) and readmission (<i>P</i> = .039). Total resection weight (per 100 g) was not a predictor of most complications, except nipple necrosis (<i>P</i> = .001).</p><p><strong>Conclusions: </strong>The superomedial reduction technique is safe and reproducible even in high-risk patients. Postoperative complications are driven predominantly by patient physiologic risk factors rather than resection volume.</p><p><strong>Level of evidence 3 therapeutic: </strong>For image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag141"},"PeriodicalIF":1.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}