Aesthetic surgery journal. Open forum最新文献

{"title":"Ultrasonographic Features of Polycaprolactone Granulomatous Reactions: Case Series and a Literature Review.","authors":"Shirin Habibi, Faezeh Khorasanizadeh, Ifa Etesami, Nasim Tootoonchi, Hamidreza Mahmoudi, Kamran Balighi, Ximena Wortsman","doi":"10.1093/asjof/ojag116","DOIUrl":"10.1093/asjof/ojag116","url":null,"abstract":"<p><p>Polycaprolactone (PCL) dermal fillers are widely used to stimulate collagen production and achieve long-lasting aesthetic results. Despite a favorable safety profile, case reports have described adverse events, including granuloma formation. The authors present 4 cases of granulomatous reactions after PCL injections, characterized clinically by painless, firm subcutaneous nodules and ultrasonographically by hypoechoic lesions with surface echogenic foci and comet-tail artifacts. To raise awareness among aesthetic practitioners, the authors conducted a narrative review of the existing literature on PCL-associated granulomas. They discussed the role of ultrasound in supporting the diagnosis of granulomatous reactions following PCL injections. This review highlights the diagnostic utility of ultrasonography and summarizes reported cases to date, aiming to enhance recognition and management of this potential adverse event. Level of Evidence: 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":"ojag116"},"PeriodicalIF":1.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563981","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 Innovative Injection Technique for Treating Edematous Fibrosclerotic Panniculopathy (Cellulite): A Prospective Multicenter Clinical Investigation.","authors":"Elena Fasola, Andreea Boca, Giorgio Reggiardo, Vincenzo Nobile, Dhouha Dridi","doi":"10.1093/asjof/ojag137","DOIUrl":"10.1093/asjof/ojag137","url":null,"abstract":"<p><p>Edematous fibrosclerotic panniculopathy (EFP) affects ∼80% to 98% of postpubertal women and has a significant impact on quality of life. Its unclear etiopathology and the multifactorial origin pose a significant challenge for its clinical management. This study aimed to evaluate the efficacy and the safety of a commercially available mixture of hyaluronic acid and amino acids in an alkaline solution. A prospective multicenter clinical trial was carried out on 46 women with EFP Stage I to early Stage IV. The improvement of cellulite severity was evaluated by the modified Clinician-Reported Photonumeric Cellulite Severity Scale (CR-PCSS) and the modified Patient-Reported PCSS (PR-PCSS) before the first (T1), the second (T2), and the third injection (T3) and after 3 (T4) and 6 (T5) months of treatment. The psychological impact of cellulite was measured using the Objectified Body Consciousness (OBC) scale. The PR-PCSS revealed that 95.3% of participants reported an improvement in their appearance. These positive outcomes remained consistent up to 6 months following the initial treatment. Similarly, the CR-PCSS showed that as early as 2 weeks after the first treatment, 76.7% of participants demonstrated objective improvement based on the Global Aesthetic Improvement Scale. These improvements also remained stable for up to 6 months. Self-esteem (OBC scale) was improved. No major adverse events were reported; minor bruising occurred as expected because of injections. Sunekos Cell 15 is a possibly effective and well-tolerated treatment for cellulite, particularly in cases with pronounced fibrosis, potentially offering a minimally invasive therapeutic option. Level of Evidence: 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":"ojag137"},"PeriodicalIF":1.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714694","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":"Management Strategies for <i>Pasteurella multocida</i> Infections in Implant-Based Breast Reconstruction: Review of the Literature and a Successful Nonsurgical Salvage Case.","authors":"Melike Refia Taslipinar, Yigit Yeni, Lal Sude Gucer, Billur Sezgin","doi":"10.1093/asjof/ojag151","DOIUrl":"10.1093/asjof/ojag151","url":null,"abstract":"<p><p><i>Pasteurella multocida</i> is a rare but clinically significant zoonotic pathogen in implant-based breast reconstruction, often related to pet exposure. Although implant infections typically lead to explantation, recent evidence-including our case-suggests that nonsurgical salvage may be possible in selected scenarios under close surveillance. In this report, the authors conducted a narrative review of the literature, identifying 5 previously reported <i>P. multocida</i> breast prosthesis infections and 1 <i>Pasteurella canis</i> case reviewed separately for broader zoonotic context. Among the 5 previously reported <i>P. multocida</i> cases, 4 required explantation, whereas only one-managed surgically-achieved successful expander salvage. This case report represents an additive contribution to this literature as the first reported instance of entirely nonsurgical expander salvage in the setting of <i>P. multocida</i> infection. Early microbiological diagnosis, appropriate antibiotic therapy, adjunctive bedside irrigation, and vigilant inpatient monitoring were key elements of this approach. This report highlights a safety-focused conservative management strategy, emphasizing that early-phase infections with low-virulence, beta-lactam-susceptible organisms in immunocompetent patients may not always require immediate explantation in the absence of clinical deterioration. Nonsurgical salvage deserves further investigation as a possible alternative to explantation in carefully selected cases. <b>Level of Evidence</b>: 4 (Therapeutic).</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag151"},"PeriodicalIF":1.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13511129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835083","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":"Medial vs Central Upper Eyelid Fat: A Histological and Immunohistochemical Study of Structural and Vascular Features.","authors":"Lukas Prantl, Hanna Guice, Sophia-Theresa Diesch, Andreas Eigenberger, Christina Gottwald, Ana Cristina S R G Jorge, Rafael Loucas, Andrea Pagani, Kirsten Utpatel, Tom Schimanski","doi":"10.1093/asjof/ojag149","DOIUrl":"10.1093/asjof/ojag149","url":null,"abstract":"<p><strong>Background: </strong>The medial upper eyelid fat compartment has long been recognized clinically as being firmer, whiter, and more fibrous than the central preaponeurotic fat. Despite its surgical relevance, systematic quantitative histological characterization remains limited.</p><p><strong>Objectives: </strong>The objective of this study was to quantitatively compare the histological and immunohistochemical characteristics of medial and central upper eyelid fat compartments, with particular focus on connective tissue composition, vascularization, and stromal nuclear density.</p><p><strong>Methods: </strong>In a paired-sample design, medial and central upper eyelid fat compartments were harvested from 10 patients undergoing upper blepharoplasty. Each compartment was analyzed using hematoxylin and eosin (H&E) staining, acid fuchsin + orange G staining, and CD31 immunohistochemistry. Connective tissue proportion, capillary density, and stromal nuclear density were assessed.</p><p><strong>Results: </strong>The medial compartment demonstrated a significantly higher proportion of connective tissue compared with the central compartment (67.74 ± 5.63% vs 56.63 ± 5.56%, <i>P</i> < .001). In contrast, capillary density was significantly reduced in the medial compartment (1.60 ± 0.54% vs 3.04 ± 1.14%, <i>P</i> = .002). Stromal nuclear density was also lower in medial fat compared with central fat (0.85 ± 0.66% vs 1.76 ± 1.06%, <i>P</i> = .004). Across all parameters, the central compartment consistently showed higher stromal nuclear density and vascularization, whereas the medial fat exhibited increased fibrous density.</p><p><strong>Conclusions: </strong>The medial upper eyelid fat compartment differs histologically from the central compartment by an increased connective tissue content and reduced vascular and stromal cell density. These findings provide a structural basis for its clinically observed firmness and potentially altered regenerative behavior.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag149"},"PeriodicalIF":1.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622674","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":"Improving Midcheek Deficiency and Tear Trough Deformity Using a Hammer-Shaped Orbital Fat Transposition: A Single-Center Review of 523 Patients.","authors":"Haoan Tang, Yutian Xiao, Kawai Ng, Yongjie Wang, Dingyu Wu, Pengju Fan","doi":"10.1093/asjof/ojag147","DOIUrl":"10.1093/asjof/ojag147","url":null,"abstract":"<p><strong>Background: </strong>Tear trough deformity and midcheek flatness frequently coexist, particularly in East Asian patients. Conventional orbital fat repositioning techniques often provide limited midcheek projection and may be technically demanding through a transconjunctival approach.</p><p><strong>Objectives: </strong>The authors describe and evaluate a modified technique combining hammer-shaped orbital fat reconstruction with Z-shaped semi-fixation to simultaneously correct tear trough deformity and midcheek deficiency.</p><p><strong>Methods: </strong>A retrospective case series of 523 consecutive patients undergoing transconjunctival lower blepharoplasty using this technique was performed. Clinical outcomes were assessed using the Barton grading system and patient-reported satisfaction, with a mean follow-up of 8.5 months.</p><p><strong>Results: </strong>All patients demonstrated improvement of at least 1 Barton grade postoperatively. Overall aesthetic satisfaction was rated as good by 89.1% of patients. Complications were uncommon and self-limited, with no cases of lower eyelid malposition or scleral show.</p><p><strong>Conclusions: </strong>In this retrospective series, hammer-shaped orbital fat repositioning with Z-shaped semi-fixation was associated with improvement in tear trough severity and patient-reported aesthetic satisfaction, with a low short-term complication rate. This approach may represent a practical option for selected patients with tear trough deformity and midcheek deficiency, although objective volumetric assessment and longer-term comparative studies are needed.</p><p><strong>Level of evidence 4 therapeutic: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag147"},"PeriodicalIF":1.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714677","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 18-Month Prospective Evaluation of a Novel Hyaluronic Acid Filler (YYS 720) for 3-Dimensional Nasal and Chin Augmentation.","authors":"Minjeong Son","doi":"10.1093/asjof/ojag146","DOIUrl":"10.1093/asjof/ojag146","url":null,"abstract":"<p><p>Hyaluronic acid (HA) fillers typically require frequent reinjections. Next-generation fillers, like the Y-phasic YVOIRE^® Y-solution (YYS) 720, require extended clinical validation to confirm their long-term performance and safety. This study evaluated 18-month clinical outcomes, safety, and satisfaction of YYS 720 for nasal and chin augmentation. In this prospective, single-arm study, 16 Korean patients received YYS 720 for the nose (<i>n</i> = 12) and chin (<i>n</i> = 7). Efficacy was evaluated through practitioner-assessed Global Aesthetic Improvement Scale (GAIS), patient-reported FACE-Q™ questionnaires, and objective 3-dimensional morphometric analysis. Safety was monitored through adverse event reporting and visual analog scale (VAS) pain scores. The GAIS responder rate was 100% through Month 12 and 84.21% at Month 18. FACE-Q scores significantly increased until Month 18 for the nose (80.67 ± 24.35, <i>P</i> = .0015) and Month 6 for the chin (86.00 ± 18.43, <i>P</i> = .0156). Three-dimensional analysis showed significant long-term improvements, with 1.73 ± 1.11 mL chin volume at Month 18 (<i>P</i> = .0061) and a 3.99 ± 2.81° nasofrontal angle increase at Month 12 (<i>P</i> = .0015) compared with baseline. The mean VAS score was low (1.69 ± 1.40). Only transient swelling and tenderness occurred in 4 patients, with no long-term delayed or serious adverse events. This pilot study provides preliminary evidence supporting the 18-month efficacy and safety of YYS 720. Given its pilot nature, these findings do not constitute claims of long-term reliability or durability, which were not formally assessed. Level of Evidence: 4 (Therapeutic).</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag146"},"PeriodicalIF":1.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655092","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":"Artificial Intelligence in Plastic Surgery: A Bibliometric and Visual Analysis of the 100 Most-Cited English-Language Publications.","authors":"Jonathan Mokhtar, Meera Hallak, Michel Gabriel Cazenave, Lucas Kreutz-Rodrigues, Krishna S Vyas, Curtis L Cetrulo, Alexandre G Lellouch","doi":"10.1093/asjof/ojag148","DOIUrl":"10.1093/asjof/ojag148","url":null,"abstract":"<p><p>Artificial intelligence (AI) is fundamentally transforming the landscape of plastic surgery, yet the structural architecture of its most influential scholarship has not been systematically characterized. This study presents a bibliometric and visual analysis of the 100 most-cited English-language AI publications in plastic surgery. Scopus was searched from database inception through January 15, 2026. Eligible articles underwent dual independent screening in Covidence, and the 100 most-cited publications were analyzed using R (v4.4.1) and VOSviewer (v1.6.18) for citation metrics, authorship networks, geographic and institutional contributions, journal distribution, and thematic categorization. Of the 3827 retrieved records, 357 met the full inclusion criteria, and the top 100 were identified. These articles collectively received 2701 citations (average: 27.01 ± 22.19), with a marked post-2022 publication surge accounting for 79% of the studies, with 2024 contributing to 34% of that share. Patient education and large language model-based consultation constituted the dominant thematic cluster (35%), followed by ethical and governance considerations (17%) and outcomes prediction and risk modeling (13%). Aesthetic surgery represented the most prolific specialty (34%), with craniofacial and breast reconstruction each contributing to 21%. Aesthetic Plastic Surgery (<i>n</i> = 16) and the Aesthetic Surgery Journal (<i>n</i> = 10) led journal representation. The United States dominated global scholarly output, whereas Peninsula Health in Australia emerged as the most impactful institution, with Rozen and Seth jointly leading the analysis as top authors. This analysis demonstrates the intellectual topography of AI scholarship in plastic surgery, identifying prevailing thematic concentrations and underexplored domains, and offering a contemporary framework for future research priorities and international collaboration. Level of Evidence: 3 (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":"ojag148"},"PeriodicalIF":1.9,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655019","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":"<i>Mycobacterium fortuitum</i> Infection in Breast Implant and Rib Osteomyelitis: A Case Report and Review of Literature.","authors":"Paola Andrea Kafury Goeta, Mauricio Zuluaga Botero, Federico Reina Ramírez","doi":"10.1093/asjof/ojag119","DOIUrl":"10.1093/asjof/ojag119","url":null,"abstract":"<p><p>Breast implant-associated <i>Mycobacterium fortuitum</i> infections with presumed rib osteomyelitis are exceedingly rare, with fewer than 7 cases reported globally. We report the first documented case from Latin America, identified through systematic review of PubMed and SciELO databases. A 25-year-old woman with no predisposing comorbidities underwent mastopexy and breast augmentation with a retropectoral silicone implant. She developed a persistent left breast wound unresponsive to conventional treatment at an outside institution and was referred to our center ∼14 months postoperatively with a chronic fistula and rib exposure. A multidisciplinary approach (plastic surgery, orthopedic surgery, and infectious disease) was employed. Serial surgical debridement with vacuum-assisted closure therapy was performed. Cultures confirmed <i>M. fortuitum</i> sensitive to clarithromycin and doxycycline; combination therapy with clarithromycin and moxifloxacin was administered for 6 months. Wound closure was achieved with epigastric and thoracoabdominal pedicle flaps, followed by bilateral autologous fat grafting for breast reconstruction. At 8-year follow-up, the patient reported satisfaction with the aesthetic result. This case emphasizes the importance of maintaining clinical suspicion for nontuberculous mycobacterial infection in chronic nonhealing wounds following breast implant surgery, even in immunocompetent patients without identifiable risk factors. 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":"ojag119"},"PeriodicalIF":1.9,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622671","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":"One Procedure, Multiple Nerves, Diverse Pain Phenotypes: A 4-Patient Case Series of Trigeminal Neuropathic Pain Following Facial Hyaluronic Acid Injections.","authors":"Ortal Nachum, Shachar Zion Shemesh, Paz Kelmer, Itay Goor Aryeh, Lior Ungar","doi":"10.1093/asjof/ojag145","DOIUrl":"10.1093/asjof/ojag145","url":null,"abstract":"<p><p>Facial hyaluronic acid (HA) injections are widely performed in aesthetic procedures, and their vascular complications are well recognized. In contrast, nonvascular neuropathic pain syndromes involving peripheral trigeminal nerve branches have received limited attention. In this study, the authors report a retrospective 4-patient case series of individuals evaluated at a tertiary headache and facial pain clinic for persistent facial pain or headache temporally associated with facial HA injections. Clinical assessment included injection history, symptom timing and evolution, anatomical pain distribution, focused neurologic examination, imaging when indicated, exclusion of alternative etiologies, and response to individualized treatment. The cases demonstrated heterogeneous peripheral trigeminal neuropathic phenotypes involving the infraorbital, infratrochlear, and supratrochlear nerve territories. Presentations included persistent trigeminal neuropathic pain, focal headache syndromes, and trigeminal neuralgia-like paroxysms. Two patients had infraorbital nerve involvement but distinct clinical manifestations, illustrating that injury or irritation of the same peripheral nerve may produce different pain phenotypes. All patients reported clinical improvement after individualized peripheral nerve-directed or local interventions, including hyaluronidase, targeted nerve blocks, pulsed radiofrequency, botulinum toxin, and neuropathic pain medications. These observations do not establish prevalence, causality, or treatment efficacy. However, they highlight the importance of careful procedural history, anatomical localization, exclusion of dental, otolaryngologic, central, and neurovascular causes, and early referral when symptoms persist. Prospective studies using standardized pain measures and targeted imaging are needed to define diagnostic criteria and management pathways. <b>Level of Evidence: 4 (Therapeutic)</b>.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag145"},"PeriodicalIF":1.9,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714761","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":"Nonshaven Follicular Unit Extraction with Pretrimming Method and a Large-Session Hair Transplantation: Experience of a Brazilian Surgical Team.","authors":"Maria Angélica Muricy, Dário Júnior de Freitas Rosa, Fabia Oppido Schalch","doi":"10.1093/asjof/ojag144","DOIUrl":"10.1093/asjof/ojag144","url":null,"abstract":"<p><strong>Background: </strong>Androgenetic alopecia is a prevalent condition, with advanced cases often requiring surgical intervention. The nonshaven follicular unit extraction (nonshaven FUE) technique, combined with a large-session hair transplantation, has emerged as a strategy to optimize aesthetic outcomes and reduce social stigma.</p><p><strong>Objectives: </strong>The aim of this study was to describe the technique of nonshaven FUE with large-session hair transplantation using the pretrimming method.</p><p><strong>Methods: </strong>A retrospective analysis of medical records was conducted on patients who underwent hair transplantation using nonshaven FUE with individualized pretrimming of donor hairs. All procedures were performed by the same surgical team between May 2015 and October 2023.</p><p><strong>Results: </strong>The retrospective analysis was conducted on 236 patients (91.95% male; mean age 44.17 ± 10.12 years). A large-session hair transplantation (>2500 grafts) was successfully performed in all patients, with efficient donor harvesting and implantation in both men and women.</p><p><strong>Conclusions: </strong>Nonshaven FUE with pretrimming method and a large-session hair transplantation represent a safe and effective approach for advanced androgenetic alopecia.</p><p><strong>Level of evidence 4 therapeutic: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag144"},"PeriodicalIF":1.9,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690292","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}