{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:32:36Z","timestamp":1770741156050,"version":"3.49.0"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,7,16]],"date-time":"2019-07-16T00:00:00Z","timestamp":1563235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>It can be hypothesized that safety during soft tissue filler injection could be enhanced if the product could be positioned between the periosteum and the bone surface i.e. subperiosteal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study investigated the feasibilityof subperiosteal injections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p>We analysed 126 injection procedures performed in seven Caucasian body donors (4 males, 3 females) with a mean age of 75.29 \u00b1 4.95 years [range: 70 \u2013 87] and a mean body mass index of 23.53 \u00b1 3.96 kg\/m<jats:sup>2<\/jats:sup> [range: 16.46 \u2013 32.23]. The injection procedures were performed in the forehead, scalp, zygomatic arch and the mandible bilaterally. Injection procedures were conducted using 25G, 27G and 30G sharp\u2010tip needles (TSK Laboratory, Tochigi, Japan) and at various angles from the bone surface measured with a goniometer: 90 degrees (perpendicular), 45 degrees and 10 degrees (as tangential as possible to bone surface).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cadaveric dissections of the injection sites showed that no product was located deep to the periosteum in any of the investigated regions. This indicates that all performed injection procedures positioned the product superficial to the periosteum (100%) with a zero\u2010success rate of subperiosteal injections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the setting of this cadaveric investigation, despite varying needle size and injection angle, subperiosteal injection could not be achieved. This indicates that the product can spread uncontrolled into more superficial layers yielding an increased risk for adverse aesthetic and vascular events.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.13073","type":"journal-article","created":{"date-parts":[[2019,7,16]],"date-time":"2019-07-16T10:48:39Z","timestamp":1563274119000},"page":"590-595","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Subperiosteal injections during facial soft tissue filler injections\u2014Is it possible?"],"prefix":"10.1111","volume":"19","author":[{"given":"Tatjana","family":"Pavicic","sequence":"first","affiliation":[{"name":"Private Practice Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariya","family":"Yankova","sequence":"additional","affiliation":[{"name":"Private Practice Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thilo L.","family":"Schenck","sequence":"additional","affiliation":[{"name":"Department for Hand, Plastic and Aesthetic Surgery Ludwig\u2014Maximilian University Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6994-8877","authenticated-orcid":false,"given":"Konstantin","family":"Frank","sequence":"additional","affiliation":[{"name":"Department for Hand, Plastic and Aesthetic Surgery Ludwig\u2014Maximilian University Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David L.","family":"Freytag","sequence":"additional","affiliation":[{"name":"Department for Hand, Plastic and Aesthetic Surgery Ludwig\u2014Maximilian University Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Sykes","sequence":"additional","affiliation":[{"name":"Facial Plastic and Reconstructive Surgery UC Davis Medical Center Sacramento CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy B.","family":"Green","sequence":"additional","affiliation":[{"name":"Skin Associates of South Florida Coral Gables FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Hamade","sequence":"additional","affiliation":[{"name":"Department of Medical Education Albany Medical College Albany NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Casabona","sequence":"additional","affiliation":[{"name":"Ocean Clinic Marbella Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Cotofana","sequence":"additional","affiliation":[{"name":"Department of Medical Education Albany Medical College Albany NY USA"},{"name":"Department of Surgery, Division of Plastic Surgery Albany Medical Center Albany NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,16]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"American Society of Plastic Surgeons.2018 National plastic surgery statistics.2018.https:\/\/www.plasticsurgery.org\/documents\/News\/Statistics\/2018\/plastic-surgery-statistics-report-2018.pdf. 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