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4 September 2026

10 Pages

Post-Treatment Aesthetic Perception and Facial Satisfaction After Mandibular Angle Volumization with Hyaluronic Acid: A Preliminary Prospective Clinical Study

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1
Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, Ribeirão Preto 14040-904, Brazil
2
National Institute of Science and Technology in Digital Mental Health (INCT–SMD), Porto Alegre 90035-903, Brazil
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School of Health Science, State University of Amazonas, Avenida Carvalho Leal, 1777, Manaus 69065-001, Brazil
4
Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Cafe, Ribeirão Preto 14040-904, Brazil
Oral2026, 6(5), 114;https://doi.org/10.3390/oral6050114
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Highlights

What are the main findings?
  • Subjects reported high aesthetic satisfaction and a positive perception of facial appearance 60 days after mandibular angle volumization with hyaluronic acid.
  • Three-dimensional stereophotogrammetry showed a trend toward increased mandibular volume after treatment, although volumetric changes were not statistically significant.
What are the implications of the main findings?
  • Mandibular angle volumization with hyaluronic acid appears to be a well-accepted minimally invasive procedure for improving facial aesthetics and patient satisfaction.
  • Combining objective 3D facial analysis with patient-reported outcome measures provides a comprehensive approach for evaluating the effectiveness of facial aesthetic treatments.

Abstract

Background/Objectives: Mandibular angle volumization with hyaluronic acid is used to redefine facial contours and improve the aesthetics of the lower third of the face. However, beyond the aesthetic outcomes, it is important to understand the impact of this intervention on the aesthetic perception of subjects undergoing the procedure. This preliminary prospective, non-randomized, uncontrolled clinical trial aimed to evaluate post-treatment aesthetic satisfaction and facial appearance perception in subjects who underwent mandibular angle volumization with hyaluronic acid. Methods: Ten adults (eight women and two men) with a mean age of 34.30 ± 11.20 years participated in the study. Subjects underwent injection of 2 mL of hyaluronic acid per hemiface, following the Medical Codes protocol. Volumetric analysis of the mandibular angle region was performed using the Vectra 3D imaging system. Aesthetic perception and facial self-image were assessed 60 days after the procedure using the Orofacial Esthetic Scale and FACE-Q questionnaires. Results: Volumetric analysis demonstrated descriptively higher values throughout the clinical follow-up on both sides, although no statistically significant differences were observed (p > 0.05). The questionnaires revealed high levels of aesthetic satisfaction and positive perception of facial appearance. On the Orofacial Esthetic Scale, a predominance of high aesthetic satisfaction was observed among subjects. Likewise, FACE-Q results demonstrated high levels of satisfaction related to facial appearance and self-image. Conclusions: Within the limitations of this preliminary secondary analysis, mandibular angle volumization with hyaluronic acid was associated with high post-treatment aesthetic satisfaction and favorable facial appearance perception at the 60-day follow-up. These findings are descriptive and warrant confirmation in larger controlled studies.

1. Introduction

Facial harmony is an important determinant of attractiveness, psychosocial well-being, and social perception. Beyond reflecting characteristics related to age, health, and identity, the face also contributes to emotional expression and interpersonal communication [1,2]. Consequently, the growing demand for orofacial harmonization has increased interest in minimally invasive procedures designed to improve facial contour, particularly in the lower third of the face [3,4].
The mandibular angle is considered an important anatomical landmark for facial aesthetic definition [5]. A well-defined mandibular angle contributes to jawline definition, facial balance, and harmony, playing an important role in the aesthetic appearance of the lower third of the face. Variations in the contour and projection of this region influence facial shape in both men and women and are commonly addressed through minimally invasive aesthetic procedures [6]. Age-related changes, including loss of bone support, reduction in fat compartments, and tissue laxity, may compromise facial definition, leading many subjects to seek minimally invasive aesthetic procedures [7].
Among the biomaterials available for facial volumization, hyaluronic acid has become one of the most frequently used because of its high biocompatibility, favorable safety profile, and capacity for tissue integration. It is a polysaccharide naturally present in the extracellular matrix, responsible for maintaining tissue hydration, elasticity, and support [8]. Its widespread application in facial aesthetics is mainly related to its ability to restore volume, improve facial contour, and provide immediate aesthetic results, while maintaining a low rate of complications and a short recovery period [9].
Although this procedure has been widely incorporated into clinical practice, evidence regarding subjects’ aesthetic perception and facial self-image after treatment remains limited. Assessment of patient satisfaction has become an important component of contemporary aesthetic procedures because treatment success depends not only on anatomical or technical outcomes but also on each individual’s subjective perception of facial appearance and psychosocial well-being [10].
In this context, validated instruments such as the Orofacial Esthetic Scale and FACE-Q have been used to measure aesthetic perception, facial satisfaction, and the psychosocial impact of aesthetic procedures. The Orofacial Esthetic Scale evaluates aspects related to satisfaction with orofacial appearance, including the mouth, teeth, lips, and face, whereas FACE-Q investigates the overall perception of facial appearance and its impact on satisfaction with facial appearance and self-image [11,12]. In addition, three-dimensional technologies such as the Vectra 3D system allow objective analysis of facial volumetric changes, enabling measurement of the modifications produced by dermal fillers [13,14].
The association between objective volumetric analysis and subjective assessment of aesthetic satisfaction represents an important tool for understanding the clinical and psychosocial effects of orofacial harmonization procedures [10]. Therefore, considering the growing demand for facial aesthetic procedures and the need to understand their impact on subjects’ individual perceptions, this study aimed to evaluate aesthetic satisfaction and facial appearance perception in subjects who underwent mandibular angle volumization with hyaluronic acid, as well as to quantify 3D changes in mandibular angle volume by stereophotogrammetry system.

2. Materials and Methods

2.1. Study Design and Sample

This preliminary prospective, non-randomized, uncontrolled clinical trial received approval from the Research Ethics Committee of the Ribeirão Preto School of Dentistry, University of São Paulo, Brazil (protocol #79298124.2.0000.5419). Before enrollment, all subjects were informed about the study objectives and provided with written informed consent. During the preparation of this work, the authors used ChatGPT (OpenAI, GPT-5 model) to support text translation.
Sample size estimation for the original prospective clinical cohort was performed using G*Power software (version 3.1.9.2; Franz Faul, University of Kiel, kiel, Germany), based on data reported by Marcus et al. [15]. An effect size of Cohen’s dz = 1.08 was estimated from these data. Assuming a statistical power of 81% and a significance level of 5%, a sample size of 10 subjects was established for the original prospective clinical cohort.
Thirty individuals were initially screened for eligibility. Following application of the inclusion and exclusion criteria, 10 participants were included in the study. The final sample comprised eight women and two men, with a mean age of 34.30 ± 11.20 years and a mean body mass index of 23.94 ± 2.35 kg/m2. Adult subjects with permanent dentition, Angle Class I dental occlusion confirmed by clinical examination performed by a single dentist, good general health, and body mass index ranging from 18.5 to 25 kg/m2 were selected. During the follow-up period, participants were instructed not to undergo surgical interventions or additional facial aesthetic procedures. Subjects presenting open skin lesions or ulcerations, cognitive impairment, neurological disorders, or inadequately controlled systemic diseases were excluded. Subjects with a history of previous facial aesthetic interventions, including dermal fillers, energy-based procedures, or facial surgical procedures, as well as those with a history of orthodontic treatment, were also excluded.
The present study is a secondary analysis of data derived from the prospective clinical cohort previously described by Bettiol et al. [4] and Romero et al. [16]. Although the participants and intervention were the same, this manuscript evaluates independent patient-reported outcomes that have not been previously analyzed or published, thereby addressing a distinct research question. Accordingly, no new sample size calculation was performed for the patient-reported outcomes investigated in this secondary analysis because the sample size had already been established for the original prospective clinical cohort.

2.2. Hyaluronic Acid Application in the Mandibular Angle

Mandibular angle augmentation was performed according to the standardized MD Codes facial mapping protocol, which served as the reference for defining the hyaluronic acid injection sites [17]. Each hemiface received 2 mL of Juvéderm® Voluma hyaluronic acid [18]. The filler was distributed as follows: 0.5 mL was injected into the mandibular angle using a cannula, 0.5 mL into the preauricular region, and the remaining 1 mL along the mandibular body. This injection protocol was selected to enhance mandibular contour definition using a standardized technique supported by scientific evidence.

2.3. 3D Image Acquisition

Three-dimensional facial analysis was conducted using the Vectra stereophotogrammetry system (Canfield Scientific, Fairfield, NJ, USA). This system uses multiple synchronized cameras to capture high-resolution surface images in milliseconds, minimizing motion artifacts while maintaining geometric accuracy. A standardized acquisition protocol was followed across all subjects to ensure reproducibility. Subjects were positioned in a controlled environment, with hair and accessories removed from the face, instructed to maintain a neutral expression with the Frankfurt plane parallel to the ground and the eyes aligned to the equipment references [19,20].

2.4. Volumetric Analysis

Anatomical landmarks were identified and marked directly on the facial surface prior to image acquisition. For volumetric assessment of the mandibular angle region, the anatomical landmarks tragion, gonion, and gnathion were identified to define the region of interest, forming a triangular area for subsequent analysis using the system’s dedicated software. Volumetric analysis was performed by comparing pre-procedure images with those obtained at 15, 30, and 60 days post-procedure. The region was selected using the software’s point-based selection tool, with image magnification applied to enhance the precision of anatomical delimitation. Volumetric measurements were expressed in cubic millimeters (mm3) to provide a more granular representation of the observed soft-tissue volumetric changes. All measurements were performed by a single operator, a dentist specialized in orofacial harmonization. Intra-observer reliability was assessed in 10 randomly selected cases by repeating the digital measurements after a 15-day interval. The intraclass correlation coefficient (ICC), calculated using the JASP (version 0.17.3.0; University of Amsterdam, Amsterdam, The Netherlands) software, was 0.945, indicating excellent intra-observer reliability.

2.5. Facial Self-Image Analysis

The analysis of oral and facial aesthetic self-perception was measured using the Orofacial Esthetic Scale (OES), consisting of eight items. The first seven items addressed specific aspects related to the face, facial profile, mouth, dental arches, tooth shape, tooth color, and gingiva, while the eighth item referred to the overall perception of the face and mouth. Subjects rated their level of satisfaction with each aesthetic aspect on a numerical scale ranging from 0 (very dissatisfied) to 10 (very satisfied). The scores of the eight items were summed, resulting in a total score ranging from 0 to 80 points, in which higher values indicated greater orofacial aesthetic satisfaction [21]. Given that some OES domains are not directly affected by mandibular angle volumization, the OES was considered a complementary measure of overall orofacial aesthetic perception rather than a treatment-specific outcome.
The FACE-Q Satisfaction with Facial Appearance Scale is a validated patient-reported outcome instrument developed to assess facial aesthetic self-perception. The questionnaire consists of 10 items that evaluate the individual’s perception of their current appearance, considering aspects such as symmetry, harmony, proportion, vitality, and facial radiance. Each item presents four response options organized on a Likert-type scale with increasing scores, resulting in raw scores ranging from 10 to 40 points. Subsequently, the sum of the raw scores is converted to a scale from 0 to 100, in which higher values indicate better aesthetic perception and greater satisfaction with facial appearance [22,23]. In the present study, the FACE-Q was considered the more directly relevant patient-reported measure of facial aesthetic satisfaction following mandibular volumization. Aesthetic perception and facial self-image were evaluated 60 days after the hyaluronic acid procedure in the mandibular angle region, without a prior baseline assessment for longitudinal comparison of the subjective scores. The questionnaires were completed independently by the subjects at the end of the data collection period, without access to the 3D stereophotogrammetric images or volumetric analysis results.

2.6. Data Analysis

The volumetric data obtained through three-dimensional stereophotogrammetry were analyzed descriptively and using repeated measures ANOVA, considering the different evaluation periods (baseline/15, baseline/30, and baseline/60 days). The significance level adopted was 5% (p < 0.05). Statistical analyses were performed using SPSS software, version 20.0 (SPSS Inc., Chicago, IL, USA). The results of the Orofacial Esthetic Scale and FACE-Q questionnaires were subjected to descriptive analysis and presented as means, standard deviations, minimum and maximum values, as well as the percentage distribution of satisfaction levels. Given the exploratory nature of these outcomes and the absence of baseline or control-group comparisons, no inferential statistical testing was performed for the questionnaire data.

3. Results

The volumetric analysis of the mandibular angle region demonstrated descriptively higher values throughout the clinical follow-up on both sides after hyaluronic acid injection; however, no statistically significant differences were observed among the evaluated periods (p > 0.05) (Table 1). No major adverse events, vascular complications, infections, nodules, or persistent edema were observed during the follow-up period.
Table 1. Mean values (±standard error) of mandibular angle volumetry at the different evaluation periods after hyaluronic acid filler injection.
The assessment of orofacial aesthetic perception and facial appearance revealed high levels of satisfaction among subjects 60 days after the procedure. The scores obtained from the Orofacial Esthetic Scale demonstrated a predominance of high aesthetic satisfaction, while the FACE-Q results indicated a favorable perception of facial appearance and self-image. No participant presented low satisfaction related to the FACE-Q (Table 2).
Table 2. Aesthetic satisfaction scores obtained from the Orofacial Esthetic Scale and FACE-Q questionnaires 60 days after mandibular angle volumization with hyaluronic acid.

4. Discussion

Subjects reported high levels of post-treatment aesthetic satisfaction and a favorable perception of facial appearance 60 days after mandibular angle volumization with hyaluronic acid. The use of three-dimensional stereophotogrammetry enabled an objective evaluation of volumetric changes after mandibular angle augmentation, providing complementary objective information to the patient-reported outcomes. Although no statistically significant volumetric differences were observed, the descriptive trend toward increased mandibular volume is consistent with previous studies reporting volumetric enhancement following hyaluronic acid injections in this region [24].
The apparent structural changes observed may be attributed to the aesthetic relevance of the mandibular angle in orofacial harmony. The lower third of the face plays a fundamental role in the perception of symmetry, youthfulness, and attractiveness, such that modifications in this region impact the individual’s overall appearance. In this context, recent evidence has demonstrated that hyaluronic acid-based fillers promote immediate volumetric gain and contribute to greater balance of the facial profile, especially in areas such as the chin and mandible [25].
Furthermore, three-dimensional evaluations have demonstrated volumetric increases associated with a progressive lifting effect in the mandibular region, evidencing improved tissue support and reduction in facial flaccidity [26]. Similarly, the results of the present study demonstrated a descriptive trend toward increased volumetric values and improved mandibular contour appearance after hyaluronic acid injection, although without statistically significant volumetric differences, accompanied by high levels of aesthetic satisfaction and a favorable perception of facial appearance. Corroborating these findings, Muller et al. [27] also demonstrated through three-dimensional analysis that hyaluronic acid fillers promote volumetric enhancement and improvement of the mandibular contour, with safe and long-lasting results over time.
The apparent discrepancy between the absence of statistically significant volumetric changes and the high levels of patient satisfaction deserves consideration. Perception of facial attractiveness depends not only on measurable tissue volume but also on contour definition, facial proportions, symmetry, and individual expectations [28]. Consequently, relatively small structural modifications may produce clinically meaningful improvements in self-perceived facial appearance that are not fully captured by volumetric measurements alone [10].
The FACE-Q demonstrated high levels of facial aesthetic satisfaction 60 days after the procedure, while the OES provided complementary information regarding overall orofacial aesthetic perception. These findings are consistent with studies that reported high acceptance rates and improved self-esteem following facial filler procedures with hyaluronic acid [29].
The findings of this study also corroborate research that used subjective assessment instruments, such as the FACE-Q, to measure the psychosocial impacts of facial aesthetic procedures [30]. Hoffman and Fabi [31] demonstrated that minimally invasive aesthetic procedures, such as hyaluronic acid fillers and botulinum toxin, promote improvements in satisfaction with appearance, psychological well-being, and quality of life, suggesting benefits beyond objective aesthetic changes.
Another relevant aspect of this study was the association between objective three-dimensional analysis and validated subjective instruments. The combination of facial volumetry and assessment of subjects’ individual perceptions allows for a more comprehensive analysis of the clinical and psychosocial outcomes of mandibular augmentation. Three-dimensional stereophotogrammetry objectively quantifies anatomical changes, whereas FACE-Q and OES evaluate patients’ perceptions of treatment outcomes [32]. Together, these complementary approaches provide a more comprehensive assessment of treatment effectiveness. This approach has been increasingly valued in the literature, since therapeutic success in aesthetic procedures depends not only on the structural changes achieved, but also on subjects’ subjective perceptions of their own appearance [31].
Although most subjects demonstrated high levels of satisfaction, some subjects presented moderate or lower levels of aesthetic satisfaction. This variability may be related to individual factors such as personal expectations, anatomical differences, subjective self-image perception, and emotional aspects. The literature emphasizes that satisfaction with aesthetic procedures may depend on the prior alignment of therapeutic expectations and the individualization of clinical planning [33].
Patient-reported satisfaction and objective volumetric changes represent complementary outcomes that may not necessarily correlate. Indeed, patient-perceived aesthetic benefits may persist despite reductions in objectively measured filler volume [10]. In the present study, high satisfaction was observed despite non-significant volumetric changes; however, the small sample size and absence of baseline patient-reported measures preclude establishing an association between these outcomes and do not exclude expectation-related bias. Supporting this perspective, Davis et al. [34], in a prospective study of 101 subjects, combined three-dimensional volumetric analysis with FACE-Q assessments and demonstrated significant improvements in patient-reported outcomes despite variable volume maintenance across facial regions over 12 weeks. These findings further support the complementary use of objective volumetric measurements and patient-reported outcomes when evaluating the effects of hyaluronic acid fillers.
This study has limitations that should be considered when interpreting the findings. The small sample size, absence of a control group, non-randomized design, and short follow-up period limit the generalizability of the results. Consequently, the study may have been underpowered to detect small volumetric changes over time, thereby increasing the possibility of a Type II error. As the sample size was established for the original prospective clinical cohort, it was not specifically powered for the patient-reported outcomes investigated in this secondary analysis. Moreover, patient-reported outcomes were assessed only at the 60-day follow-up and not at baseline, preventing longitudinal intraindividual comparisons of aesthetic perception and satisfaction. Therefore, these findings should be interpreted exclusively as descriptive post-treatment outcomes rather than evidence of treatment-related improvement. The OES also has limited specificity for mandibular volumization because it includes dental and gingival domains not directly affected by the intervention; consequently, its findings reflect overall orofacial aesthetic satisfaction rather than treatment-specific satisfaction. Subjective assessments may also be influenced by emotional, psychosocial, and expectation-related factors that were not controlled in the present study. Finally, given the secondary nature of this analysis, which focuses on previously unpublished patient-reported aesthetic outcomes distinct from the functional and electromyographic outcomes reported in previous studies using the same cohort, the findings should be considered exploratory and hypothesis-generating.
Clinically, the findings reinforce that mandibular angle volumization with hyaluronic acid may represent a relevant minimally invasive approach for harmonization of the lower third of the face, contributing to facial contour enhancement and improved facial appearance perception. Despite its exploratory nature, this study expands the current evidence by integrating objective three-dimensional stereophotogrammetry with validated patient-reported outcome measures, providing a broader perspective on the clinical and psychosocial outcomes of mandibular angle volumization.

5. Conclusions

Within the limitations of this preliminary study, mandibular angle volumization with hyaluronic acid was associated with high post-treatment aesthetic satisfaction and favorable facial appearance perception at the 60-day follow-up.

Author Contributions

Conceptualization, N.B.B., G.D.A.R., F.A.d.C., S.C.H.R., M.d.M., S.S. and M.P.; methodology, N.B.B., G.D.A.R., F.A.d.C., S.C.H.R., S.S. and M.P.; software, N.B.B., G.D.A.R., F.A.d.C., S.C.H.R., J.F.M.-C., L.V.M. and M.P.; statistics, S.C.H.R., S.S. and M.P.; validation, S.C.H.R., S.S., J.F.M.-C., L.V.M. and M.P.; investigation, N.B.B., G.D.A.R., L.C.d.F. and F.A.d.C.; resources, N.B.B., G.D.A.R., F.A.d.C. and M.P.; data curation, N.B.B., G.D.A.R., F.A.d.C. and M.P.; writing—original draft preparation, N.B.B., G.D.A.R., M.P. and S.C.H.R.; writing—review and editing, S.S., J.F.M.-C., L.V.M. and M.d.M.; visualization, M.P.; supervision, S.C.H.R. and M.P.; project administration, N.B.B., G.D.A.R., F.A.d.C. and M.P.; funding acquisition, S.C.H.R. and S.S. All authors have read and agreed to the published version of the manuscript.

Funding

This study was supported by a grant from the FAPESP (Grant No. 2014/50891-1), CNPQ (Grant No. 312586/2021-3), CNPQ and the National Institute of Science and Technology in Digital Mental Health (INCT–SMD) (Grant No. 409148/2024-5).

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil (protocol code 79298124.2.0000.5419, date of approval: 25 April 2024).

Data Availability Statement

The data presented in this study are available on reasonable request, after the signature of a formal data sharing agreement in anonymous form, from the corresponding author because they are protected by privacy.

Acknowledgments

During the preparation of this work, the authors used ChatGPT (OpenAI, GPT-5 model) to support text translation. Following the use of this tool, the authors carefully reviewed and revised the material as needed and take full responsibility for the final version of the publication.

Conflicts of Interest

The authors declare no conflicts of interest.

Abbreviations

The following abbreviations are used in this manuscript:
BMIBody Mass Index
FACE-QFacial Assessment Questionnaire (Patient-Reported Outcome Measure for Facial Aesthetics)
JASPJeffreys’s Amazing Statistics Program
MD CodesMedical Codes
OESOrofacial Esthetic Scale
SPSSStatistical Package for the Social Sciences
Vectra 3DThree-Dimensional Stereophotogrammetry Imaging System

References

  1. Banegas, R.; Miksa, M.C.; Ko, E.A. Facial structures and their impact on visual perception of beauty and youthfulness: Parallelism. Clin. Cosmet. Investig. Dermatol. 2025, 18, 1207–1211. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  2. Little, A.C.; Jones, B.C.; DeBruine, L.M. Facial attractiveness: Evolutionary based research. Philos. Trans. R. Soc. Lond. B Biol. Sci. 2011, 366, 1638–1659. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  3. de Melo, F.; Carrijo, A.; Hong, K.; Trumbic, B.; Vercesi, F.; Waldorf, H.A.; Zenker, S. Minimally invasive aesthetic treatment of the face and neck using combinations of a PCL-based collagen stimulator, PLLA/PLGA suspension sutures, and cross-linked hyaluronic acid. Clin. Cosmet. Investig. Dermatol. 2020, 13, 333–344. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  4. Bettiol, N.B.; de Carvalho, F.A.; Siessere, S.; Romero, G.D.A.; de Menezes, M.; Martini, C.C.J.; Mazzi-Chaves, J.F.; Magri, L.V.; Regalo, S.C.H.; Palinkas, M. Assessment of orofacial function after mandibular angle harmonization with hyaluronic acid: A longitudinal observational study. Dent. J. 2026, 14, 241. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  5. Mommaerts, M.Y.; Cleymaet, R. The ideal shape of the female jaw angle: An online survey. J. Craniomaxillofac. Surg. 2023, 51, 597–602. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  6. Keaney, T.C.; Anolik, R.; Braz, A.; Eidelman, M.; Eviatar, J.A.; Green, J.B.; Jones, D.H.; Narurkar, V.A.; Rossi, A.M.; Gallagher, C.J. The male aesthetic patient: Facial anatomy, concepts of attractiveness, and treatment patterns. J. Drugs Dermatol. 2018, 17, 19–28. [Google Scholar] [PubMed]
  7. Mendelson, B.; Wong, C.H. Changes in the facial skeleton with aging: Implications and clinical applications in facial rejuvenation. Aesthetic Plast. Surg. 2012, 36, 753–760. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  8. Frank, K.; Hilton, S.; Kerscher, M.; Grablowitz, D.; Kopera, D.; Sulovsky, M.; Kursinov, L. The safety profile of a portfolio of hyaluronic acid-based soft tissue fillers manufactured using macro technology: A systematic review of clinical evidence. Life 2026, 16, 110. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  9. de Almeida Silva, L.; de Almeida, K.R.; Ortolani, C.L.F. Aesthetic and psychosocial impacts of hyaluronic acid fillers in patients with retrognathic profiles. Aesthetic Plast. Surg. 2026, 50, 762–773. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  10. Khan, S.; Habarth-Morales, T.E.; Voytik, M.; Davis, H.; Broach, R.B.; Percec, I. Short- and long-term patient perceptions relative to hyaluronic acid filler volume retention. Aesthet. Surg. J. Open Forum 2026, 8, ojag030. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  11. John, M.T.; Larsson, P.; Nilner, K.; Bandyopadhyay, D.; List, T. Validation of the orofacial esthetic scale in the general population. Health Qual. Life Outcomes 2012, 10, 135. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  12. Pusic, A.L.; Klassen, A.F.; Scott, A.M.; Cano, S.J. Development and psychometric evaluation of the FACE-Q satisfaction with appearance scale: A new patient-reported outcome instrument for facial aesthetics patients. Clin. Plast. Surg. 2013, 40, 249–260. [Google Scholar] [PubMed]
  13. Meier, J.D.; Glasgold, R.A.; Glasgold, M.J. 3D photography in the objective analysis of volume augmentation including fat augmentation and dermal fillers. Facial Plast. Surg. Clin. N. Am. 2011, 19, 725–735. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  14. De Stefani, A.; Barone, M.; Hatami Alamdari, S.; Barjami, A.; Baciliero, U.; Apolloni, F.; Gracco, A.; Bruno, G. Validation of Vectra 3D imaging systems: A review. Int. J. Environ. Res. Public Health 2022, 19, 8820. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  15. Marcus, K.; Moradi, A.; Kaufman-Janette, J.; Ablon, G.; Donofrio, L.; Chapas, A.; Kazin, R.; Rivkin, A.; Rohrich, R.J.; Weiss, R.; et al. A randomized trial to assess effectiveness and safety of a hyaluronic acid filler for chin augmentation and correction of chin retrusion. Plast. Reconstr. Surg. 2022, 150, 1240e–1248e. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  16. Romero, G.D.A.; Bettiol, N.B.; Siessere, S.; Carvalho, F.A.; Menezes, M.; Mazzi-Chaves, J.F.; Magri, L.V.; Hallak Regalo, S.C.; Palinkas, M. Electromyographic activity of the masseter and temporalis muscles following hyaluronic acid injection in the mandibular angle: A longitudinal secondary analysis of clinical data. Oral 2026, 6, 68. [Google Scholar] [CrossRef] [Scilit]
  17. de Maio, M. MD Codes™: A methodological approach to facial aesthetic treatment with injectable hyaluronic acid fillers. Aesthetic Plast. Surg. 2021, 45, 690–709. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  18. Ho, D.; Jagdeo, J. Biological properties of a new volumizing hyaluronic acid filler: A systematic review. J. Drugs Dermatol. 2015, 14, 50–54. [Google Scholar] [PubMed]
  19. Andrade, L.M.; Rodrigues da Silva, A.M.B.; Magri, L.V.; Rodrigues da Silva, M.A.M. Repeatability study of angular and linear measurements on facial morphology analysis by means of stereophotogrammetry. J. Craniofac. Surg. 2017, 28, 1107–1111. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  20. de Menezes, M.; Rosati, R.; Ferrario, V.F.; Sforza, C. Accuracy and reproducibility of a 3-dimensional stereophotogrammetric imaging system. J. Oral Maxillofac. Surg. 2010, 68, 2129–2135. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  21. Campos, L.A.; Marôco, J.; John, M.T.; Santos-Pinto, A.; Campos, J.A.D.B. Development and psychometric properties of the Portuguese version of the Orofacial Esthetic Scale: OES-Pt. PeerJ 2020, 8, e8814. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  22. Rivers, J.K.; Bertucci, V.; Muhn, C.; Humphrey, S.; Solish, N.; Carruthers, J.; McGillivray, W.; Bhogal, M.; Garcia, J.K.; Sangha, S.; et al. Canada harmony study: Improvements in patient satisfaction with facial appearance and psychological impact of combined aesthetic treatment. Aesthet. Surg. J. Open Forum 2025, 7, ojae130. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  23. Albuquerque, M.C.P.; Guerra, J.M.; Aguiar, M.T.; Caetano, C.F.F.; Borges, M.M.F.; Cetira Filho, E.L.; Silva, P.G.B.; Sousa, F.B. Analysis of a Brazilian cross-cultural adaptation of the FACE-Q SFAOS in facial harmonization in dentistry. Braz. Oral. Res. 2022, 36, e050. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  24. Alcantara, A.; Vassoler Guerrero Puccia, É.; Perrella de Rezende, C.; Ho Kim, J.; Viana, R. Optimizing dermal filler for chin and jawline definition as an advanced approach for natural results: A prospective case series with ultrasonographic and 3d facial imaging evaluation. Cureus 2025, 17, e99477. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  25. Go, B.C.; Frost, A.S.; Friedman, O. Using injectable fillers for chin and jawline rejuvenation. World J. Otorhinolaryngol. Head Neck Surg. 2023, 9, 131–137. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  26. Queiroz, T.P.; Lucatelli, S.R.; Jellmayer, J.A.; Dos Santos, P.L. Analysis in 3D of hybrid injectable combining hyaluronic acid and calcium hydroxyapatite: Prospective study. Aesthetic Plast. Surg. 2026, 50, 2714–2722. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  27. Müller, D.; Prinz, V.; Sulovsky, M.; Cajkovsky, M.; Moellhoff, N.; Cotofana, S.; Frank, K. Longevity and subject-reported satisfaction after minimally invasive jawline contouring. J. Cosmet. Dermatol. 2022, 21, 199–206. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  28. Hatch, C.D.; Wehby, G.L.; Nidey, N.L.; Moreno Uribe, L.M. Effects of objective 3-dimensional measures of facial shape and symmetry on perceptions of facial attractiveness. J. Oral Maxillofac. Surg. 2017, 75, 1958–1970. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  29. Demesh, D.; Cristel, R.T.; Gandhi, N.D.; Kola, E.; Issa, T.Z.; Dayan, S.H. Effects of hyaluronic acid filler injection for non-surgical rhinoplasty on first impressions and quality of life (FACE-Q scale). J. Cosmet. Dermatol. 2022, 21, 3351–3357. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  30. Klassen, A.F.; Cano, S.J.; Scott, A.; Snell, L.; Pusic, A.L. Measuring patient-reported outcomes in facial aesthetic patients: Development of the FACE-Q. Facial Plast. Surg. 2010, 26, 303–309. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  31. Hoffman, L.; Fabi, S. Look better, feel better, live better? The impact of minimally invasive aesthetic procedures on satisfaction with appearance and psychosocial wellbeing. J. Clin. Aesthet. Dermatol. 2022, 15, 47–58. [Google Scholar] [PubMed]
  32. Gallo, L.; Kim, P.; Churchill, I.F.; Gallo, M.; Yuan, M.; Voineskos, S.H.; Thoma, A.; Pusic, A.L.; Klassen, A.F.; Cano, S.J. Measuring the impact of surgical and non-surgical facial cosmetic interventions using FACE-Q aesthetic module scales: A systematic review and meta-analysis. Plast. Surg. 2024, 33, 403–418. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  33. Ottenhof, M.J.; Veldhuizen, I.J.; Hensbergen, L.J.V.; Blankensteijn, L.L.; Bramer, W.; Lei, B.V.; Hoogbergen, M.M.; Hulst, R.R.W.J.; Sidey-Gibbons, C.J. The use of the FACE-Q aesthetic: A narrative review. Aesthetic Plast. Surg. 2022, 46, 2769–2780. [Google Scholar] [CrossRef] [Scilit]
  34. Davis, H.D.; Mazzaferro, D.; Habarth-Morales, T.E.; Messa, C.A., 4th; Talwar, A.A.; Desai, A.A.; McAuliffe, P.B.; Broach, R.B.; Serletti, J.M.; Percec, I. A large prospective volumetric and patient-reported outcome analysis of hyaluronic acid facial fillers. Plast. Reconstr. Surg. 2025, 156, 550–559. [Google Scholar] [CrossRef] [Scilit] [PubMed]
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