Aesthetic surgery journal. Open forum最新文献

{"title":"All About Clonidine and Its Role in Preventing Hematoma Following Aesthetic Facial Surgery: A Narrative Review With Practical Guidance.","authors":"Dillon C Mobasser, Alex N Kerendi, Foad Nahai","doi":"10.1093/asjof/ojag130","DOIUrl":"10.1093/asjof/ojag130","url":null,"abstract":"<p><p>Postoperative hematoma remains the most common major complication following face and necklift surgery, with decades of literature highlighting perioperative hypertension and sympathetic surges as primary modifiable risk factors. Clonidine, a centrally acting alpha-2 adrenergic agonist, has been progressively incorporated into facelift protocols to stabilize postoperative blood pressure and blunt sympathetic activation. This narrative review examines the pharmacology of clonidine, the pathophysiology of postfacelift bleeding, and the clinical evidence supporting clonidine's role in perioperative blood pressure management. Practical dosing strategies, contraindications, and safety considerations are presented based on the available literature and the authors' clinical experience. When used in a comprehensive perioperative blood pressure management protocol, clonidine appears to be a safe and effective adjunct for hematoma prevention in aesthetic surgery, although the supporting evidence is predominantly Level IV (retrospective series and observational studies) supplemented by expert opinion. Practical dosing strategies, contraindications, and safety considerations are presented based on the available literature and the authors' clinical experience. 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":"ojag130"},"PeriodicalIF":1.9,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426261","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":"BREAST-Q Under the Microscope: A Scoping Review of Reporting Gaps in Breast Surgery.","authors":"Gabriela Fioranelli, Nicole Alvarez, Jace Boswell, Ton Doan, Leslie Christensen, Doruk Orgun, Aaron Dingle","doi":"10.1093/asjof/ojag127","DOIUrl":"10.1093/asjof/ojag127","url":null,"abstract":"<p><p>The BREAST-Q was developed to address a gap in breast surgery outcomes research as a validated, procedure-specific patient-reported outcome measure (PROM) that assesses satisfaction and health related quality of life. Despite global adoption, reporting practices remain inconsistent. This review evaluated how BREAST-Q domains are reported and compated outcomes between postmastectomy reconstruction and cosmetic breast surgery populations. Five databases (PubMed, MEDLINE, PsycINFO, Scopus, and Web of Science) were searched from January 1, 2009 to September 16, 2022. Of 6921 records, 307 studies met inclusion criteria. Eligible studies reported mean BREAST-Q scores (0-100 scale) in patients undergoing postmastectomy reconstruction, breast augmentation, or breast reduction. Studies were grouped as reconstruction (Group 1) or cosmetic (Group 2). Extracted data included publication year, country, sample size, BREAST-Q means ± standard deviation and domain coverage. Analyses were descriptive due to heterogeneity in design, populations, and follow-up The most frequently reported domains in both groups were psychosocial well-being, satisfaction with breasts, and sexual well-being (Group 1: 79.12%, 91.21%, and 77.29%; Group 2: 74.55%, 96.36%, and 83.64%). The aggregate global weighted mean BREAST-Q score was higher in Group 2 than in Group 1 (81.99 vs 74.49), Though these values represent descriptive estimates, not direct comparisons. Although widely used, BREAST-Q reporting is inconsistent, with disproportionate emphasis on select domains. This selective reporting introduces bias and limits comparability. Comprehensive reporting across all domains, or inclusion of an overall summary score, would better reflect patient satisfaction and align with the instrument's intended purpose. Level of Evidence: 3 (Therapeutic).</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag127"},"PeriodicalIF":1.9,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426208","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":"Augmentation Mastopexy With Polyurethane-Coated Implants in the Prepectoral Plane: A 24-Month Follow-Up Study.","authors":"Carmine Michele Mele, Andrea Murante, Edoardo Auriemma, Giuseppe Esposito, Luigi Castiello, Vincenzo Rullo, Santolo D'Antonio","doi":"10.1093/asjof/ojag118","DOIUrl":"10.1093/asjof/ojag118","url":null,"abstract":"<p><strong>Background: </strong>Augmentation mastopexy aims to restore breast shape and volume in patients with ptosis. Polyurethane-coated implants may enhance implant stability in augmentation mastopexy through early tissue adhesion in the prepectoral plane; however, mid-term stability and clinical outcomes remain incompletely defined, prompting the need for the present study.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the long-term aesthetic stability, complication profile, and patient satisfaction associated with augmentation mastopexy using polyurethane-coated implants placed in the prepectoral plane, with or without selective fat grafting.</p><p><strong>Methods: </strong>From January 2019 to December 2023, 169 patients (338 breasts) underwent augmentation mastopexy with polyurethane-coated implants placed in the prepectoral plane. The surgical protocol included mastopexy, implant placement, and selective fat grafting, when needed, to optimize breast contour in patients with asymmetries or minimal soft-tissue coverage (eg, pinch test <2 cm). Patients were followed up at 1, 6, 12, 18, and 24 months postoperatively, with the primary endpoint being the nipple-to-jugular distance (NJD), used to assess breast stability. Patient satisfaction was assessed using a 5-point Likert scale at 12 months.</p><p><strong>Results: </strong>The average preoperative NJD was 27.4 cm, and postoperatively, a significant reduction was observed at 1 month (21.5 cm), with minimal increase over time (22.3 cm at 24 months), indicating stable breast positioning. A single case of capsular contracture was managed with implant replacement. Patient satisfaction was high, with 78% rating their results as \"very satisfied\" (Score 5).</p><p><strong>Conclusions: </strong>Augmentation mastopexy with polyurethane-coated implants placed in the prepectoral plane provides stable, long-term breast positioning and high patient satisfaction. This technique offers a reliable alternative to traditional approaches, with minimal complications and sustained aesthetic results.</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":"ojag118"},"PeriodicalIF":1.9,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714745","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":"Peristaltic Pump-Assisted Fat Harvesting and Closed-Circuit Grafting: Technique and Immediate Cell Membrane Integrity in a Case Series.","authors":"Christopher Nichols, Daniel Albershardt","doi":"10.1093/asjof/ojag122","DOIUrl":"10.1093/asjof/ojag122","url":null,"abstract":"<p><p>Autologous fat grafting outcomes are influenced by tissue handling during harvest, processing, and reinjection. Traditional vacuum-based suction systems generate variable subatmospheric pressures and may introduce turbulence and shear forces that can affect adipocyte viability. The aim of this study was to describe a reversible peristaltic pump-assisted technique alternative for fat harvest and grafting and to outline its procedural workflow and mechanistic considerations. This report describes a closed-circuit, peristaltic pump-assisted technique based on the authors' 5-year clinical experience across more than 160 aesthetic and reconstructive procedures. The technique enables bidirectional flow for controlled aspiration and reinjection without direct handling of the tissue. The technique was applied across multiple anatomic regions, including the face, breast, and body. Tumescent infiltration, aspirate, and graft volumes were adjusted based on anatomic location and procedural goals. Intraoperative handling was characterized by continuous flow, minimal air entrainment, and minimal clogging. The technique was used for both aesthetic and reconstructive operations, including breast procedures. Peristaltic pump-assisted fat harvest and grafting represent a closed-circuit, non-vacuum-based approach to autologous fat transfer and an alternative in fat grafting technique. By combining precise pressure regulation with an adaptable closed-loop architecture, this method may contribute to consistent and reproducible graft quality, reduce tissue trauma, and decrease surgeon fatigue. This descriptive report demonstrates technical feasibility and reproducible intraoperative handling characteristics. Further controlled studies are needed to evaluate clinical outcomes and comparative effectiveness. <b>Level of Evidence: 4 (Therapeutic)</b> 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":"ojag122"},"PeriodicalIF":1.9,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714737","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":"Association Between Proton Pump Inhibitor Use and Short-Term Postoperative Complications Following Abdominoplasty: A Multi-Institutional Cohort Study.","authors":"Yoram Wolf, Jonathan Zontag, Ron Skorochod, Nir Zontag","doi":"10.1093/asjof/ojag129","DOIUrl":"10.1093/asjof/ojag129","url":null,"abstract":"<p><strong>Background: </strong>Abdominoplasty is a common procedure, especially among patients with obesity, a group in which proton pump inhibitor (PPI) use is highly prevalent. Although there are growing concerns regarding PPI-related complications, there is a lack of data on their effects in aesthetic surgery.</p><p><strong>Objectives: </strong>This study aims to assess the association between preoperative use of PPIs and the risk of short-term postoperative complications after abdominoplasty.</p><p><strong>Methods: </strong>This multicenter cohort study used the TriNetX Global Collaborative Network. Individuals aged 18 years or older who had abdominoplasty were identified and categorized into 2 groups based on preoperative PPI exposure: patients with a documented prescription before surgery and those without any recorded history of PPI prescription. To reduce baseline differences between groups, propensity score matching was conducted to achieve balance in demographic and clinical characteristics. Postoperative outcomes focused on complication rates evaluated at 30, 60, and 90 days after surgery.</p><p><strong>Results: </strong>After 1:1 propensity score matching, both groups comprised 2031 patients each. At 30 days following abdominoplasty, patients who received PPIs before surgery exhibited significantly higher risks of surgical-site infections (risk ratio [RR] 2.467; 95% CI, 1.358-4.48), wound dehiscence (RR 2; 95% CI, 1.079-3.706), opioid prescription (RR 1.368; 95% CI, 1.269-1.475), and any surgical-site complications (RR 2.545; 95% CI, 1.806-3.588) compared with the control group. These risks persisted at 60 and 90 days postsurgery.</p><p><strong>Conclusions: </strong>Preoperative exposure to PPIs may increase the risk of short-term postoperative complications following abdominoplasty. Additional studies are needed to define clinical guidelines regarding the perioperative management of these medications.</p><p><strong>Level of evidence3 therapeutic: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag129"},"PeriodicalIF":1.9,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414020","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 Impact of Artificial Intelligence on Facial Aesthetic Surgery: A Systematic Review.","authors":"Aurelia-Alexandra Colceriu, Petru-Iulian Ifteni, Liliana Rogozea, Florin-Gabriel Leașu, David Stuckler","doi":"10.1093/asjof/ojag114","DOIUrl":"10.1093/asjof/ojag114","url":null,"abstract":"<p><p>Artificial intelligence (AI) has transformed medical practice, with early adopters using custom models in imaging-heavy fields. Millions of cosmetic surgeries prompt surgeons to seek better tools amid pressure for ideal outcomes. Past reviews have covered AI in facial cosmetic surgery for both reconstructive and aesthetic purposes. There remains a need to cover AI applications in a wider range of specialties while assessing clinical relevance, readiness, and, when available, comparison with standard care. This research examines AI's impact on facial cosmetic surgery by reviewing patient care stages, surgery types, AI architectures, and model sourcing. Following PRISMA 2020 guidelines and PROSPERO registration, the authors searched PubMed and Web of Science on August 25, 2025, for English studies on facial aesthetic surgery. They included studies using AI across all care stages, with at least 4 patients. Two reviewers independently screened, assessed, and extracted data. Of 1832 records, 29 met criteria. The authors used the Cochrane ROBINS-I and RoB 2 tools for risk of bias assessment. Most studies, mainly in Asia or the United States, focus on AI tool validation, development, and applicability, with few interventional studies. Most AI models use convolutional neural networks and are commercially available. In facial aesthetic surgery, AI aids treatment planning and outcome assessment, especially in facelifts, rhinoplasty, and blepharoplasty. The results highlight AI's potential and emphasize the need for standardized reporting, updated regulations, and education programs that promote collaboration where surgeons co-design AI models. <b>Level of Evidence: 4 (Therapeutic)</b>.</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag114"},"PeriodicalIF":1.9,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413953","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":"Geographic and Socioeconomic Variation in Aesthetic Plastic Surgery Pricing Across the United States: A State-Level Analysis of Income, Gross Domestic Product, and Real Economic Burden.","authors":"Ibrahim Güler, Gerrit Grieb, Armin Kraus, Henrik Stelling","doi":"10.1093/asjof/ojag125","DOIUrl":"10.1093/asjof/ojag125","url":null,"abstract":"<p><strong>Background: </strong>Aesthetic surgery represents a major sector of direct patient payments in the United States. Despite the economic significance of this patient-funded market, systematic evidence on geographic pricing patterns and their socioeconomic determinants remains limited.</p><p><strong>Objectives: </strong>The aim of this study was to characterize geographic variation in advertised prices for common aesthetic surgery procedures across US metropolitan areas and evaluate their relationship with regional economic indicators and purchasing power.</p><p><strong>Methods: </strong>Advertised prices for 6 common aesthetic procedures were analyzed across 100 US metropolitan areas, yielding 600 city-procedure observations. Price dispersion was quantified using descriptive statistics and coefficient of variation (CV). State-level mean prices were correlated with per capita personal income and gross domestic product. Nominal prices were further adjusted for regional cost of living using Regional Price Parities (RPP) to estimate real economic costs.</p><p><strong>Results: </strong>Mean advertised prices ranged from USD 6234 for liposuction to USD 14,639 for facelift procedures, with facelifts demonstrating the greatest dispersion (CV 38.8%). State-level analysis (<i>n</i> = 33) revealed a significant association between per capita personal income and procedure prices (<i>r</i> = 0.529, <i>P</i> = .0016). Adjustment for RPP altered price rankings: New York remained the most expensive state, whereas Michigan and Kentucky ranked second and third in real cost, surpassing California. The affordability gap was substantial, with a single average procedure consuming nearly 20% of annual per capita income in Kentucky compared with ∼10% to 11% in higher-income states.</p><p><strong>Conclusions: </strong>Pricing for aesthetic procedures in the United States demonstrates marked geographic stratification. After accounting for regional purchasing power, the real economic burden of aesthetic procedures is often greater in lower-income states, indicating that regional wealth and purchasing power play a central role in shaping access within the patient-funded aesthetic surgery market.</p><p><strong>Level of evidence 5 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":"ojag125"},"PeriodicalIF":1.9,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413950","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":"Anterior Intercostal Artery Perforator Flap for Delayed Implant Exposure Salvage After Prepectoral Breast Reconstruction.","authors":"Rossella Gioco, Francesco Caruso, Gaetano Castiglione, Mariagloria Marino, Ada Cinquerrui, Irene Cannata, Debora Simona Fichera, Nicola Francesca Musmeci, Konstantina Balafa, Marco Latino, Angelo Rosa, Giuseppe Catanuto, Dario Virzì","doi":"10.1093/asjof/ojag113","DOIUrl":"10.1093/asjof/ojag113","url":null,"abstract":"<p><p>The anterior intercostal artery perforator (AICAP) flap has emerged as a viable option in breast reconstructive surgery for salvaging implants compromised by infection or radiotherapy. However, its application in delayed implant exposure following prepectoral reconstruction remains limited in the literature. The authors report the case of a 54-year-old woman who presented with localized infection and implant exposure following nipple-sparing mastectomy and prepectoral breast reconstruction with a silicone implant. Oncologic recurrence was excluded. Conventional conservative therapy failed, and the defect was successfully managed with an AICAP flap for implant salvage. This case highlights the feasibility of this technique as a less invasive alternative to avoid implant removal and secondary reconstruction, particularly in selected patients without extensive soft tissue compromise. Level of Evidence: 5 (Therapeutic).</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag113"},"PeriodicalIF":1.9,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392557","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":"Commentary on: Toward Successful International Pooling of Breast Implant Registry Data: The Role of Dataset Uniformity.","authors":"Caroline Glicksman","doi":"10.1093/asjof/ojag120","DOIUrl":"10.1093/asjof/ojag120","url":null,"abstract":"","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag120"},"PeriodicalIF":1.9,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392608","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":"Revisiting Total Subpectoral Breast Reconstruction: Technical Refinements for Improved Outcomes.","authors":"Buse Fatma Çapkınoğlu, Ahmet Umut Yuvacı, Akın Yücel","doi":"10.1093/asjof/ojag111","DOIUrl":"10.1093/asjof/ojag111","url":null,"abstract":"<p><strong>Background: </strong>Although prepectoral direct-to-implant breast reconstruction has gained increasing popularity, it is not suitable for all patients. Subpectoral reconstruction remains necessary in selected cases, yet traditional techniques are limited by animation deformity and restricted lower-pole expansion.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the safety, reproducibility, and clinical outcomes of a refined, mesh-free total subpectoral reconstruction technique.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 119 patients (181 breasts) undergoing immediate implant-based reconstruction using a standardized subpectoral technique. Key anatomical structures-including the inframammary ligament, serratus anterior fascia, and intercostal perforators-were preserved. Controlled fascial releases and limited superior dissection were employed to optimize implant positioning and lower-pole expansion. Outcomes included complication rates, revision surgery, and BREAST-Q scores.</p><p><strong>Results: </strong>The mean follow-up was 28.1 months. Minor complications occurred in 28.6% of cases, whereas major complications were observed in 6.7%. Hematoma, infection, and implant-related complications remained within the lower range of reported literature values. Revision surgery was required in 7.6% of patients, primarily because of contour irregularities, all successfully managed with single-stage correction. Among 100 patients completing BREAST-Q assessment, the mean score was 76.6 ± 15.1.</p><p><strong>Conclusions: </strong>This refined mesh-free total subpectoral technique provides stable implant positioning, improved lower-pole projection, and reduced animation deformity. In appropriately selected patients, it represents a safe, reproducible, and cost-effective alternative to conventional submuscular approaches.</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":"ojag111"},"PeriodicalIF":1.9,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714716","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}