{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:05:07Z","timestamp":1790265907799,"version":"4.1.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":249,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020638","name":"Allergan Aesthetics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020638","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019211","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019211","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Deja Scott-Shemon"},{"DOI":"10.13039\/100023970","name":"LLC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100023970","id-type":"DOI","asserted-by":"publisher"}]},{"name":"OPEN Health company"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multimodal facial aesthetic treatment has potential benefits that extend beyond facial enhancements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to assess satisfaction with improvement in facial appearance and quantify the psychological, social, and emotional impact of comprehensive, multimodal, full-face aesthetic injectable treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, open-label, multisite study, participants (n = 64) sequentially received a combination of a hybrid injectable containing hyaluronic acid (HA) plus calcium hydroxyapatite, HA injectables, and onabotulinumtoxinA over 5\u2005months. The primary efficacy endpoint was change in FACE-Q Satisfaction with Facial Appearance Overall scale score. Secondary endpoints included the following assessments: FACE-Q Aging Appraisal, Psychological Function, Social Function, and Satisfaction with Skin; Global Aesthetic Improvement Scale (GAIS); Periorbital Aesthetic Appearance Questionnaire (PAAQ); and participant self-perception of facial age. Outcomes were measured as change in score from baseline to final visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants demonstrated significant improvement on the FACE-Q Satisfaction with Facial Appearance Overall scale (mean score increase = 46.6; P &amp;lt; .0001). In secondary efficacy analyses, significant improvement was observed on FACE-Q Psychological Function, Social Function, Aging Appraisal, and Satisfaction with Skin scales (P &amp;lt; .0001) and PAAQ (P &amp;lt; .0001). All investigators and participants noted improvement in facial appearance on the GAIS. A majority (85.5%) of participants reported improvement in age-related facial appearance. Most participants documented mild or moderate injection-site reactions (ISRs), and mean ISR durations ranged from 1.0 to 14.5\u2005days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The Brazil HARMONY study provides further support that a combination of HA injectables, biostimulators, and neuromodulators leads to significant improvements in participant satisfaction and psychological and social well-being on validated patient-reported outcome scales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 4 (Therapeutic)<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asjof\/ojag159","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:34:43Z","timestamp":1787657683000},"source":"Crossref","is-referenced-by-count":0,"title":["Brazil HARMONY: Improved Satisfaction With Facial Appearance and Psychosocial and Social Well-Being Following Combined Facial Aesthetic Treatment"],"prefix":"10.1093","volume":"8","author":[{"given":"Ada","family":"Trindade de Almeida","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilia","family":"Ramos dos Santos Guadanhim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edil\u00e9ia","family":"Bagatin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Barzi Loureiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Wanick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Felix","family":"Bravo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"de Melo Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia","family":"Oba Galv\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9gia","family":"Patriota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme","family":"Kerson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Cazerta de Paula Eduardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"2026092411203384700_ojag159-B1","author":"American Society for Dermatologic Surgery"},{"key":"2026092411203384700_ojag159-B2","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1177\/147470491301100107","article-title":"Self-perceived attractiveness, romantic desirability and self-esteem: a mating sociometer perspective","volume":"11","author":"Bale","year":"2013","journal-title":"Evol Psychol"},{"key":"2026092411203384700_ojag159-B3","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1037\/0033-2909.111.2.304","article-title":"Good-looking people are not what we think","volume":"111","author":"Feingold","year":"1992","journal-title":"Psychol Bull"},{"key":"2026092411203384700_ojag159-B4","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.jdin.2023.07.021","article-title":"Safety and tolerability of onabotulinumtoxinA in the treatment of upper facial lines from global registration studies in 5298 participants: a meta-analysis","volume":"14","author":"Brin","year":"2024","journal-title":"JAAD Int"},{"key":"2026092411203384700_ojag159-B5","volume-title":"Botox Cosmetic [Package Insert]","year":"2024"},{"key":"2026092411203384700_ojag159-B6","doi-asserted-by":"publisher","first-page":"2186","DOI":"10.1111\/jocd.15706","article-title":"Facial rejuvenation with the new hybrid filler HArmonyCaTM: clinical and aesthetic outcomes assessed by 2D and 3D photographs, ultrasound, and elastography","volume":"22","author":"Urdiales-G\u00e1lvez","year":"2023","journal-title":"J Cosmet Dermatol"},{"key":"2026092411203384700_ojag159-B7","doi-asserted-by":"publisher","DOI":"10.1097\/gox.0000000000006190","article-title":"A novel hybrid injectable for soft-tissue augmentation: analysis of data and practical experience","volume":"12","author":"Braz","year":"2024","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2026092411203384700_ojag159-B8","doi-asserted-by":"publisher","first-page":"2533","DOI":"10.2147\/ccid.s474587","article-title":"Evaluating the properties of a dual-effect facial injectable: from preclinical data to real-world evidence","volume":"17","author":"Ormiga","year":"2024","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"2026092411203384700_ojag159-B9","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1093\/asj\/sjx179","article-title":"Impact of comprehensive, minimally invasive, multimodal aesthetic treatment on satisfaction with facial appearance: the HARMONY study","volume":"38","author":"Weinkle","year":"2018","journal-title":"Aesthet Surg J"},{"key":"2026092411203384700_ojag159-B10","doi-asserted-by":"publisher","first-page":"NP115","DOI":"10.1093\/asj\/sjab114","article-title":"Multimodal facial aesthetic treatment on the appearance of aging, social confidence, and psychological wellbeing: HARMONY study","volume":"42","author":"Cohen","year":"2022","journal-title":"Aesthet Surg J"},{"key":"2026092411203384700_ojag159-B11","doi-asserted-by":"publisher","first-page":"S325","DOI":"10.1097\/dss.0000000000000548","article-title":"Patient satisfaction and efficacy of full-facial rejuvenation using a combination of botulinum toxin type A and hyaluronic acid filler","volume":"41","author":"Molina","year":"2015","journal-title":"Dermatol Surg"},{"key":"2026092411203384700_ojag159-B12","doi-asserted-by":"publisher","DOI":"10.1093\/asjof\/ojae130","article-title":"Canada HARMONY study: improvements in patient satisfaction with facial appearance and psychological impact of combined aesthetic treatment","volume":"7","author":"Rivers","year":"2025","journal-title":"Aesthet Surg J Open Forum"},{"key":"2026092411203384700_ojag159-B13","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/j.cps.2012.12.001","article-title":"Development and psychometric evaluation of the FACE-Q satisfaction with appearance scale: a new patient-reported outcome instrument for facial aesthetics patients","volume":"40","author":"Pusic","year":"2013","journal-title":"Clin Plast Surg"},{"key":"2026092411203384700_ojag159-B14","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1046\/j.1524-4725.2003.29112.x","article-title":"Social implications of hyperfunctional facial lines","volume":"29","author":"Finn","year":"2003","journal-title":"Dermatol Surg"},{"key":"2026092411203384700_ojag159-B15","doi-asserted-by":"publisher","first-page":"1380","DOI":"10.1093\/asj\/sjy239","article-title":"Aesthetic treatment positively impacts social perception: analysis of subjects from the HARMONY study","volume":"39","author":"Dayan","year":"2019","journal-title":"Aesthet Surg J"},{"key":"2026092411203384700_ojag159-B16","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1007\/s00266-020-01762-7","article-title":"MD codes: a methodological approach to facial aesthetic treatment with injectable hyaluronic acid fillers","volume":"45","author":"de Maio","year":"2021","journal-title":"Aesthetic Plast Surg"},{"key":"2026092411203384700_ojag159-B17","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1037\/pspp0000265","article-title":"The link between self-esteem and social relationships: a meta-analysis of longitudinal studies","volume":"119","author":"Harris","year":"2020","journal-title":"J Pers Soc Psychol"},{"key":"2026092411203384700_ojag159-B18","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1001\/jamadermatol.2018.2357","article-title":"Self-reported patient motivations for seeking cosmetic procedures","volume":"154","author":"Maisel","year":"2018","journal-title":"JAMA Dermatol"},{"key":"2026092411203384700_ojag159-B19","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.2466\/pms.1996.83.3f.1105","article-title":"Gender, self-esteem, and perception of own attractiveness","volume":"83","author":"Nell","year":"1996","journal-title":"Percept Mot Skills"},{"key":"2026092411203384700_ojag159-B20","doi-asserted-by":"publisher","DOI":"10.1080\/23311908.2014.996316","article-title":"Judging attractiveness: biases due to raters' own attractiveness and intelligence","volume":"2","author":"Sim","year":"2015","journal-title":"Cogent Psychol"},{"key":"2026092411203384700_ojag159-B21","author":"International Society of Aesthetic Plastic Surgery"}],"container-title":["Aesthetic Surgery Journal Open Forum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/asjopenforum\/advance-article-pdf\/doi\/10.1093\/asjof\/ojag159\/70974892\/ojag159.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asjopenforum\/article-pdf\/doi\/10.1093\/asjof\/ojag159\/70974892\/ojag159.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asjopenforum\/article-pdf\/doi\/10.1093\/asjof\/ojag159\/70974892\/ojag159.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:21:34Z","timestamp":1790263294000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asjopenforum\/article\/doi\/10.1093\/asjof\/ojag159\/8786440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":21,"URL":"https:\/\/doi.org\/10.1093\/asjof\/ojag159","relation":{},"ISSN":["2631-4797"],"issn-type":[{"value":"2631-4797","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026]]},"published":{"date-parts":[[2026]]},"article-number":"ojag159"}}