Ibrahim Güler, Armin Kraus, Gerrit Grieb, Henrik Stelling
{"title":"Evaluation of Aesthetic Outcomes Following Botulinum Toxin Treatment Using Multimodal Large Language Models: A Paired Before-and-After Analysis.","authors":"Ibrahim Güler, Armin Kraus, Gerrit Grieb, Henrik Stelling","doi":"10.1093/asjof/ojag112","DOIUrl":"10.1093/asjof/ojag112","url":null,"abstract":"<p><strong>Background: </strong>Multimodal large language models (MLLMs) are increasingly applied to visual assessment tasks, yet their ability to evaluate aesthetic treatment outcomes remains unclear.</p><p><strong>Objectives: </strong>The aim of this study was to assess whether contemporary MLLMs can identify treatment state and detect region-specific aesthetic improvement following botulinum neurotoxin treatment.</p><p><strong>Methods: </strong>In this observational study, 23 paired facial image cases (46 images; 460 model evaluations) were analyzed. Four MLLMs (GPT-5.4 Pro [OpenAI, San Francisco, CA], Grok 4.1 [xAI, San Francisco, CA], Gemini 3.1 Pro [Google DeepMind, Mountain View, CA], and Claude Opus 4.6 [Anthropic, San Francisco, CA]) performed 5 independent inference runs per case. Models identified the posttreatment image and assessed regional improvement (forehead, glabella, and periorbital). Accuracy, sensitivity, specificity, balanced accuracy, Matthews correlation coefficient, and Fleiss' <i>κ</i> were calculated descriptively. Performance was compared with majority-class baselines. Exploratory outputs included aesthetic scores and apparent age estimates.</p><p><strong>Results: </strong>All models identified the posttreatment image (100% accuracy). Region-specific improvement detection frequently failed to exceed majority-class baselines (65.2%-91.3%). Gemini 3.1 Pro showed the highest performance for the forehead (74.8%) and glabella (63.5%), whereas no model reached the periorbital baseline. Inter-run reliability varied widely (<i>κ</i> -0.113 to 0.719). High reliability did not imply correctness. All models systematically overestimated improvement (62.6%-94.8% of predictions exceeded ground truth). False positives exceeded false negatives in all 12 model-task combinations. Exploratory outputs indicated perceived rejuvenation.</p><p><strong>Conclusions: </strong>MLLMs recognize the format of aesthetic change but not its clinical nuance. Bridging this gap requires more than improved accuracy: a coordinated agenda of domain-specific fine-tuning, expert-rater benchmarking, and structured outcome frameworks, supported by governance of training-data provenance and clear safeguards before any clinical or research deployment.</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":"ojag112"},"PeriodicalIF":1.9,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392578","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}
Carolyn Kim, Bhavana Thota, Vidhya Nadarajan, Anca Dogaroiu, Lauren Kim, Amor Niksic, Victoria Peters, Jennifer Barillas, John E Hoopman, Jeffrey M Kenkel
{"title":"Laser and Energy-Based Devices in Aesthetic Practice: A 10-Year Single-Surgeon Review of Treatments, Complications, and Same-Practice Surgical Crossover.","authors":"Carolyn Kim, Bhavana Thota, Vidhya Nadarajan, Anca Dogaroiu, Lauren Kim, Amor Niksic, Victoria Peters, Jennifer Barillas, John E Hoopman, Jeffrey M Kenkel","doi":"10.1093/asjof/ojag105","DOIUrl":"10.1093/asjof/ojag105","url":null,"abstract":"<p><strong>Background: </strong>The use of lasers and energy-based devices in aesthetic plastic surgery has increased substantially; yet, long-term treatment patterns and their relationship to subsequent surgery remain unclear.</p><p><strong>Objectives: </strong>To evaluate patient demographics, device utilization patterns, complications, and same-practice surgical crossover over a 10-year single plastic surgeon's experience.</p><p><strong>Methods: </strong>A retrospective review was conducted of all patients who underwent laser or energy-based treatments by the senior author between January 1, 2013 and January 1, 2023. Variables included patient demographics, device type, procedural characteristics, documented complications, and subsequent aesthetic procedures performed by the same surgeon. Treatment patterns were evaluated longitudinally by comparing device utilization at the initial, third, and final visits.</p><p><strong>Results: </strong>A total of 632 patients underwent 1905 laser or energy-based treatments. Patients were predominantly female (85.8%) with a mean age of 52.8 years at initial presentation. Fitzpatrick skin types II-III were the most common (72.2%). Intense pulsed light was the most frequently used modality overall (47.6%) and at the initial visit (40.3%), with increasing use of ablative modalities over time. A total of 26 complications (1.4%) were documented, most commonly hyperpigmentation (n = 7). Overall, 40.5% of patients underwent subsequent aesthetic surgery, accounting for 523 procedures, with a mean time to surgery of 4.2 years.</p><p><strong>Conclusions: </strong>Lasers and energy-based treatments demonstrated a low rate of documented complications in single-surgeon practice and showed evolving patterns over time. A substantial proportion of patients underwent subsequent aesthetic surgery within the same practice, suggesting these modalities may play an important role in longitudinal patient engagement and the integration of nonsurgical and surgical care within comprehensive aesthetic care.</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":"ojag105"},"PeriodicalIF":1.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378316","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}
James Alexander Olding, Ashraf Messiha, Felix Wilhelm Karst, Nikola Kulik, Zeanab Chaer, Farhad B Naini
{"title":"The Advancement-Rotation Principle in Chin Augmentation: A Preliminary Case Series.","authors":"James Alexander Olding, Ashraf Messiha, Felix Wilhelm Karst, Nikola Kulik, Zeanab Chaer, Farhad B Naini","doi":"10.1093/asjof/ojag110","DOIUrl":"10.1093/asjof/ojag110","url":null,"abstract":"<p><strong>Background: </strong>Injectable aesthetic treatments continue to grow in popularity globally. Hyaluronic acid-based filler remains the mainstay, used to augment or restore dimensions. Treatments to advance the chin must account for additional factors that are unique to this region, including the mandibular growth pattern, dental occlusion, and soft tissues in the form of the mentalis muscle.</p><p><strong>Objectives: </strong>This preliminary report synthesizes literature from across surgery, dentistry, and aesthetic medicine to propose an integrated method for chin assessment and treatment using injectables.</p><p><strong>Methods: </strong>We present a preliminary 3 patient case series drawing on surgical and nonsurgical cases. The presented integrated algorithm for chin assessment is applicable to medical aesthetics with the use of a smartphone camera.</p><p><strong>Results: </strong>Two nonsurgical patients each demonstrate retrognathia with contrasting mandibular growth patterns; one clockwise and one counter-clockwise. One surgical patient supports the presented methodology, where severe clockwise rotation of the mandible resulting from progressive condylar resorption was treated with 2-stage surgery.</p><p><strong>Conclusions: </strong>Effective lower face treatment requires integration of concepts from across surgery, dentistry, and aesthetic medicine. Facial growth patterns can be assessed clinically, enabling practitioners to plan and execute treatments in a way that promotes facial profile harmony and moderates an individual's aging trajectory. This preliminary series highlights how the growth rotation pattern and sagittal dimensions predictably impact lower facial features, offering novel treatment strategies. This article is the first to integrate concepts from Craniomaxillofacial surgery, Orthodontics, and Aesthetic Medicine into a chin treatment algorithm that can be easily implemented in medical aesthetics practice.</p><p><strong>Level of evidence 5 therapeutic: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag110"},"PeriodicalIF":1.9,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413967","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}
Alexandre Bussy, Paul Frobert, Richard Vaucher, Simon Perez, Franck Dupuy, Emmanuel Delay
{"title":"Surgical Management of Posttraumatic Breast Bisection Following Seat Belt Injury: A Series of 3 Cases and Technique Description.","authors":"Alexandre Bussy, Paul Frobert, Richard Vaucher, Simon Perez, Franck Dupuy, Emmanuel Delay","doi":"10.1093/asjof/ojag107","DOIUrl":"10.1093/asjof/ojag107","url":null,"abstract":"<p><p>Posttraumatic breast bisection secondary to seat belt injury is a rare and often unrecognized entity that may mimic breast cancer. It results from the formation of a transfixing fibrotic scar band responsible for a sharp linear deformity of the breast. Few cases have been reported in the literature, most often as isolated case reports. We report a single-center retrospective series of 3 patients who underwent surgical management in our institution for posttraumatic breast deformity following seat belt injury. Clinical, radiological, operative, histopathological, and follow-up data were analyzed. All patients presented with a transfixing fibrotic band deformity associated with imaging-confirmed fat necrosis. The delay between trauma and surgical consultation ranged from 3 to 9 months. Surgical management consisted of bilateral reduction mammoplasty with complete excision of the fibrotic tissue. Glandular reconstruction relied on the use of a posterior glandular flap, combined with lipomodeling. Postoperative courses were uneventful. Follow-up exceeded 12 months for all patients, with stable and satisfactory aesthetic outcomes and no recurrence of deformity. Posttraumatic breast bisection must be recognized to avoid confusion with breast malignancy and to ensure appropriate management. Surgical treatment is based on excision of fibrotic tissue and glandular reshaping. The posterior glandular flap, combined when necessary with lipomodeling, represents a simple, reproducible, and effective technique, providing durable aesthetic results. <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":"ojag107"},"PeriodicalIF":1.9,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622780","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}
Justin L Anderson, Joey Liang, Jackson M Cathey, Jessica Berns, Samantha J Kaplan, Ashit Patel
{"title":"From Nose Job to a Better Job: A Scoping Review of Facial Aesthetics, Attractiveness Bias, and Outcomes in the Workplace.","authors":"Justin L Anderson, Joey Liang, Jackson M Cathey, Jessica Berns, Samantha J Kaplan, Ashit Patel","doi":"10.1093/asjof/ojag104","DOIUrl":"10.1093/asjof/ojag104","url":null,"abstract":"<p><p>Facial appearance strongly influences professional and social outcomes, with individuals perceived as more attractive often receiving increased job opportunities-a phenomenon known as \"attractiveness bias.\" As facial plastic surgery becomes increasingly common, its potential impact on workplace dynamics and ethics warrants evaluation. This scoping review synthesizes current evidence examining the relationship between facial aesthetic surgery, attractiveness bias, psychosocial outcomes, and professional trajectories. A comprehensive search of the MEDLINE database via PubMed, Cochrane Library, SCOPUS, and PsycINFO was conducted (inception-September 10, 2025) according to PRISMA-ScR guidelines. Controlled vocabulary (MeSH) and free-text terms related to facial aesthetic surgery, career outcomes, and attractiveness bias were combined. Studies were included if they examined surgical facial aesthetic or reconstructive procedures and assessed self-perception, attractiveness bias, professional or socioeconomic outcomes, or appearance-related psychological distress. Sixty-one studies met inclusion criteria and were synthesized qualitatively into 3 conceptual domains. Across studies, facial aesthetic surgery consistently enhanced both self-perception and external evaluations. Postoperative images were rated as more attractive, trustworthy, competent, and intelligent than preoperative images. Patients reported improved self-esteem and social functioning, with several studies identifying career advancement as a key motivator. In contrast, individuals with facial trauma, congenital malformations, or features diverging from cultural beauty norms reported discrimination and lower levels of overall satisfaction. Rates of body dysmorphic disorder among surgical candidates ranged from 2.5% to 32%. Facial aesthetic surgery may influence professional outcomes by modifying self-confidence and how others perceive competence. Plastic surgeons should recognize workplace-related motivations during consultation and incorporate ethical counseling to ensure informed decision-making. Further longitudinal research is needed to clarify whether cosmetic enhancement leads to tangible increased earnings. <b>Level of Evidence:</b> 3 (Therapeutic).</p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag104"},"PeriodicalIF":1.9,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371048","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":"Early Performance of a Multifilament Resorbable Synthetic Mesh in Aesthetic Breast Surgery: A 206 Patient Experience.","authors":"Renee M Burke, Charalambos K Rammos","doi":"10.1093/asjof/ojag109","DOIUrl":"10.1093/asjof/ojag109","url":null,"abstract":"<p><strong>Background: </strong>Increasing evidence supports the role of soft-tissue reinforcement in enhancing outcomes and longevity in breast surgery. Maintenance of lower pole shape, soft-tissue support and implant position often requires use of mesh in aesthetic procedures. The authors describe their experience utilizing a fully resorbable multifilament scaffold (TIGR® Matrix, Novus Scientific, Uppsala, Sweden) as an alternative to biologic and synthetic meshes.</p><p><strong>Objectives: </strong>To assess early safety and performance outcomes when TIGR Matrix is utilized in primary and revision cosmetic breast surgery.</p><p><strong>Methods: </strong>We began routinely utilizing TIGR matrix in aesthetic breast surgeries in 2023 and retrospectively reviewed all patients who underwent primary or revision elective cases with the mesh. Indication for use and examination of product performance was performed via a retrospective review.</p><p><strong>Results: </strong>TIGR matrix was used in 206 patients (407 breasts), mean age 42.6 years, with mean follow-up of 9.2 months. Mean BMI was 24.2 with 30 patients (14.6%) having a history of massive or major weight loss. One hundred fourteen cases (55.3%) were primary procedures, 92 (44.7%) were revisions. Mesh was placed in the subfascial position in 97 (47.1%) cases and submuscular in 109 (52.9%). Ten patients (4.9%) required postoperative intervention; 5 seromas in 4 patients (1.9%) required mesh removal and implant exchange and 6 patients required revision surgeries due to animation deformity (5) and implant displacement (1).</p><p><strong>Conclusions: </strong>Use of TIGR matrix demonstrated early safety and effectiveness, achieving consistent clinical outcomes in both primary and revision aesthetic breast surgeries.</p><p><strong>Level of evidence 3 therapeutic: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag109"},"PeriodicalIF":1.9,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413955","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}
Narendra Kumar, Guilherme Olavo Olsen de Almeida, Amit Luthra, Shaheen Amna Kashif, Serge Dahan, Jean D A Carruthers
{"title":"Use of High-Intensity Focused Ultrasound in the Periorbital Rejuvenation: A Systematic Review.","authors":"Narendra Kumar, Guilherme Olavo Olsen de Almeida, Amit Luthra, Shaheen Amna Kashif, Serge Dahan, Jean D A Carruthers","doi":"10.1093/asjof/ojag099","DOIUrl":"10.1093/asjof/ojag099","url":null,"abstract":"<p><strong>Background: </strong>Periorbital aging represents one of the earliest manifestations of facial aging, resulting from structural changes across cutaneous, adipose, and muscular layers of the periocular region. Although high-intensity focused ultrasound (HIFU) is increasingly used for noninvasive rejuvenation, evidence on periorbital outcomes remains scarce.</p><p><strong>Objectives: </strong>To synthesize the effectiveness and safety of HIFU technologies for periorbital rejuvenation in adults.</p><p><strong>Methods: </strong>A systematic review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO. MEDLINE/PubMed, Scopus, Cochrane CENTRAL, and Google Scholar were searched for studies published between January 2015 and November 2025. Randomized trials and prospective or retrospective cohort studies evaluating HIFU applied to the periorbital region were included. Outcomes included wrinkle severity, skin elasticity, texture, lifting effects, patient satisfaction, and adverse events. Risk of bias was assessed.</p><p><strong>Results: </strong>Ten studies involving 10 to 191 participants were included. Across included studies, HIFU demonstrated significant improvements in periorbital wrinkle severity, biomechanical skin elasticity (Cutometer R2, R5, and R7), surface topography (PRIMOS Ra and Rz), and eyebrow or eyelid contour. Greater improvement was observed with multiple treatment sessions. Adverse events were generally mild and transient, including erythema, edema, and pain; rare complications (<1%) occurred without permanent sequelae.</p><p><strong>Conclusions: </strong>High-intensity focused ultrasound appears to be a safe and effective noninvasive option for periorbital rejuvenation. However, the certainty of evidence is very low due to nonrandomized designs and heterogeneity, highlighting the need for well-designed randomized controlled trials with standardized protocols.</p><p><strong>Level of evidence 3 therapeutic: </strong></p>","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag099"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450793","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}
Mina Pashaei Ghezeljeh, Amirreza Jabbaripour Sarmadian
{"title":"Response by Jabbaripour Sarmadian to \"Autologous Fat Grafting Combined With Platelet-Rich Plasma in the Treatment of Female Genitourinary Aging: A Retrospective Study\" by Ren et al.","authors":"Mina Pashaei Ghezeljeh, Amirreza Jabbaripour Sarmadian","doi":"10.1093/asjof/ojag108","DOIUrl":"10.1093/asjof/ojag108","url":null,"abstract":"","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag108"},"PeriodicalIF":1.9,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370966","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 Online Landscape of Brazilian Butt Lift Information: Readability, Quality, and Traffic Analysis.","authors":"Elisa Bertulla, Edoardo Raposio","doi":"10.1093/asjof/ojag106","DOIUrl":"10.1093/asjof/ojag106","url":null,"abstract":"<p><strong>Background: </strong>The Brazilian Butt Lift (BBL) has become increasingly popular yet remains one of the highest-risk aesthetic procedures. As patients frequently use online sources to understand medical procedures, clear and reliable web-based information is essential.</p><p><strong>Objectives: </strong>This study evaluates the readability, understandability, quality, and visibility of online BBL resources.</p><p><strong>Methods: </strong>A Google search for \"Brazilian Butt Lift Procedure\" was conducted using Startpage to reduce bias. The first 10 eligible English-language websites were analyzed. Extracted text was evaluated using 6 readability indices. Understandability was assessed with the Patient Educational Material Assessment Tool (PEMAT), overall quality with the JAMA (Journal of the American Medical Association) Benchmark Criteria. Website visibility was measured using SpyFu estimates of monthly organic traffic. Spearman's correlation was used to explore the relationship between readability and traffic.</p><p><strong>Results: </strong>Readability for all websites exceeded the recommended sixth-grade level (mean readability score 21.68), indicating complex content. Sixty percentage of the websites scored 83% in PEMAT due to long sentences and limited explanation of technical terms; the remaining 40% websites met all understandability criteria. Journal of the American Medical Association assessment revealed deficiencies in transparency, with few sites providing references, author credentials, or publication dates. The correlation between readability and organic traffic was weakly positive (ρ = .176), indicating that frequently visited websites were not necessarily easier to read.</p><p><strong>Conclusions: </strong>In this review, online BBL information was generally difficult to understand and often lacks essential quality indicators. The weak relationship between readability and traffic suggests that popular websites may not provide accessible content. Improving linguistic clarity, structure, and transparency is needed to ensure patients receive reliable, comprehensible guidance on this high-risk procedure.</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":"ojag106"},"PeriodicalIF":1.9,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392615","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":"Response by Kayaalp to \"Iatrogenic Liver Perforation During Liposuction: A Case Report and In-depth Review of Clinical Presentation, Management, and Lessons Learned\" by Jaafrian et al.","authors":"Cuneyt Kayaalp","doi":"10.1093/asjof/ojag081","DOIUrl":"10.1093/asjof/ojag081","url":null,"abstract":"","PeriodicalId":72118,"journal":{"name":"Aesthetic surgery journal. Open forum","volume":"8 ","pages":"ojag081"},"PeriodicalIF":1.9,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201362","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}