ABSTRACT
Background
Pregnancy induces a range of physical changes in the female body, some of which may persist long after delivery. This can result in body dissatisfaction and reduced quality of life. Skin laxity, diastasis recti, and stretch marks pose a challenge to achieving the desired appearance.
Aim
This study aims to investigate the potential benefits of the consecutive use of Radiofrequency (RF) + Targeted Pressure Energy (TPE) and HIFEM + RF for the treatment of postpartum abdomen and improvement of appearance.
Methods
This prospective study enrolled 38 postpartum participants for the consecutive treatments of Targeted Pressure Energy plus radiofrequency and HIFEM plus radiofrequency on their abdomen. Follow‐up visits were scheduled at 3 months and 12 months. Global Aesthetic Improvement Scale (GAIS) evaluation, weight measurements, and circumference measurements were performed at 3 levels corresponding with 5 cm above the navel (circumference A), at navel level (circumference B), and 5 cm below the navel (circumference C).
Results
The study results show a reduction in circumference. At 3 months post‐treatment, circumference A decreased by 1.57 cm, circumference B by 2.09 cm, and circumference C by 1.83 cm. At 12 months post‐treatment, circumference A decreased by 3.16 cm, circumference B by 4.69 cm, and circumference C by 4.06 cm. The GAIS evaluation at 3 months post‐treatment showed average improvements of 1.53 points for stretch marks, 1.58 points for skin laxity, 1.77 points for muscle toning, and 1.64 points for slimming effect. At 12 months post‐treatment, the GAIS evaluation showed improvements of 1.6 points for stretch marks, 1.8 points for skin laxity, 1.9 points for muscle toning, and 1.9 points for slimming effect.
Conclusion
The consecutive use of RF + TPE and HIFEM + RF has shown to be effective in the treatment of postpartum abdomen and has resulted in desirable effects. Overall appearance has improved significantly, which may also indicate an increased quality of life. The study results show that both devices complement each other, and their combined use leads to better outcomes than standalone therapy, particularly in terms of enhanced results in body contouring and skin tightening.
Keywords: postpartum abdomen, radiofrequency, skin laxity, stretch marks, targeted pressure energy
Abbreviations
- GAIS
Global Aesthetic Improvement Scale
- RF
Radiofrequency
- TPE
Targeted Pressure Energy
1. Introduction
During pregnancy, women undergo significant physical changes, including a 1.5‐fold increase in intra‐abdominal volume [1], which places considerable strain on their bodies. The skin stretches extensively and has been shown to lose elasticity, a condition observed to persist even 4 months after delivery, resulting in residual skin laxity. This stretching also increases the risk of developing stretch marks, a form of chronic dermal scarring. In Asian skin, excessive fibroblast during wound healing leads to thicker collagen deposition and an increased risk of visible scarring and post‐inflammatory hyperpigmentation [2]. Combined with diastasis recti and weight retention, these factors contribute to a loss of waist definition and present a cosmetic challenge.
These changes are common during and after pregnancy, and lack effective prevention [3], and are often resistant to lifestyle‐based interventions. Women often feel societal pressure to return to their pre‐pregnancy bodies and maintain a slim figure with unmarked skin [4]. Moreover, women from Asian cultures may face additional obstacles related to traditions that can affect postpartum weight management, such as restrictions on physical activity after childbirth [5, 6].
RF has been widely used in cosmetic dermatology as a non‐invasive method for skin rejuvenation [7]. The radiofrequency energy absorption and transformation to heat cause a release of various growth factors, such as fibroblast growth factor 2 [8], transforming growth factor beta 1, as well as dermal fibroblast stimulation, leading to the upturned collagen and elastin production. The old collagen and elastin fibers, moreover, undergo a reorganization, leading to an improved structure, similar to younger fibers. Heating of the fat tissue in the temperature range of 43°C–45°C, on the other hand, enforces adipocytes to undergo apoptosis, resulting in their elimination, without the risk of inflammation or necrosis [9].
The radiofrequency effect is enhanced when coupled with other modalities. RF, when paired with TPE, has been shown to effectively treat skin laxity and cellulite by increasing dermal thickness and remodeling adipose interlobular septae, with enhanced collagen and elastin content [10]. The benefits of TPE rely on the proliferative activity of fibroblasts and the creation of suitable conditions for collagen re‐synthesis. The combination of RF and TPE induces significant changes in the connective and subcutaneous tissues and is suggested to be more effective than using either RF or TPE alone or consecutively [11, 12].
The simultaneous application of HIFEM technology became an innovative method among non‐invasive body contouring options. While RF targets skin laxity and fat tissue, HIFEM technology is effective for muscle strengthening [13]. The electromagnetic field of HIFEM induces supramaximal contractions in the treated muscle, akin to intense physical activity, leading to muscle hypertrophy and hyperplasia through the activation of satellite cells and heat‐shock proteins [14, 15]. The combination with RF enhances the HIFEM effect by increasing blood flow, which improves nutrient delivery and waste product drainage [16]. This, in turn, boosts the results of abdominal body shaping, as the simultaneous application of RF and HIFEM leads to a significant increase in rectus abdominis muscle thickness and a reduction in subcutaneous fat. Together, these technologies amplify both muscle growth and fat reduction, optimizing the overall body contouring effect [13].
This study aims to investigate the potential benefits of the consecutive use of RF + TPE and HIFEM + RF for improving the appearance of the postpartum abdomen.
2. Methods
This prospective, open‐label, single‐center interventional study enrolled thirty‐eight postpartum women (n = 38, mean age 35.2 ± 3.1 years, BMI of 21.6 ± 2.8 kg/m [2]), who underwent abdominal treatment consisting of consecutive sessions of RF + TPE and HIFEM + RF.
Among the inclusion criteria were a postpartum period of at least three months for patients with vaginal delivery, and at least 6 months postpartum period for patients delivering through C‐section, but no longer than 36 months post‐delivery, and willingness to have photographs of their abdomen taken. The exclusion criteria were the presence of the intrauterine device, pregnancy, nursing, or any other medical conditions that contraindicate the application of electromagnetic field, radiofrequency, and targeted pressure energy, such as cardiovascular disease, malignant tumor, or electronic implants.
Subjects were given instructions about the study procedures, voluntarily participated in the study, and signed a written informed consent. The study adhered to the Declaration of Helsinki principles.
Study participants received six treatments, spaced 10 days apart. For the first four procedures, they underwent 30 min of HIFEM + Synchronized Radiofrequency (Emsculpt Neo, BTL Industries Inc.), followed by 15 min of Targeted Pressure Energy + Radiofrequency (Emtone, BTL Industries Inc.). A 15‐minute break was provided between treatments to allow the area to cool down. The subjects received only a 30‐minute HIFEM + Synchronized Radiofrequency therapy for the last two scheduled procedures. The intensities of each modality were adjusted to maximally tolerated levels according to the subjects' feedback. Follow‐up visits were scheduled 3 months and 12 months after the last treatment.
Circumference measurements and standardized photographs were taken at baseline, 3 months, and 12 months post‐treatment. Circumference was measured at three levels: at the umbilical level (B), 5 cm above (A), and 5 cm below the umbilical level (C). The umbilical circumference was measured from the umbilicus to the floor and marked on the body to ensure measurement accuracy.
Subject photographs were taken from two angles, from the front and from the side. Three independent clinicians (an aesthetic doctor, a body specialist, and a specialist in postpartum care) evaluated the obtained photographs according to the GAIS, where 1 means worse than the initial condition, and 2 means drastic improvement, easily noticeable.
The patients' height was measured only at the baseline visit, while weight was measured at the baseline and both follow‐up visits to track changes and calculate BMI.
Descriptive analytics (mean value, standard deviation) were performed. The Shapiro–Wilk normality test was used to verify whether the variables were normally distributed. The statistical significance was assessed using the Wilcoxon matched‐pairs test, with α = 0.05 considered the significance level.
3. Results
Thirty‐eight subjects (n = 38, females, 35.2 ± 3.1 years, BMI 21.5 ± 2.8) were enrolled in this study. All subjects attended their 3‐month follow‐up visits, and sixteen (n = 16, females, 35.4 ± 3.2 years, BMI 21.7 ± 2.4) willingly participated in the 12‐month follow‐up visit.
The subjects (n = 38) had on average 2.1 ± 0.9 successful pregnancies in the past, with six subjects having twins in their last pregnancy prior to the start of the study. The mean postpartum period was 12.2 ± 9.4 months. Twenty‐four subjects had a natural delivery, while fourteen subjects underwent a C‐section.
Changes in all three measured circumferences were statistically significant with p < 0.0001. At the 3‐month post‐treatment visit, the maximum reductions observed were 6 cm, 10 cm, and 7 cm for circumferences A, B, and C, respectively. Women with three or more pregnancies exhibited greater reductions in circumferences B and C, while the reduction in circumference A was similar between women with three or more pregnancies and those with two or fewer.
At the 12‐month post‐treatment visit, none of the subjects experienced an increase in circumference, and all 16 subjects showed a reduction. One subject showed maximum reductions across all three measurements: 10 cm for circumference A, 13 cm for circumference B, and 11 cm for circumference C. Women with two or fewer pregnancies experienced an above‐average reduction in circumference, resulting in a greater decrease than that observed in women with three or more pregnancies. Women who had C‐sections showed greater reductions in circumferences A and B compared to those with natural births. See the summary of key results in Tables 1 and 2, and visual documentation of treatment effects in selected participants at key timepoints is available in Figures 1, 2, and 3. There were no adverse events or side effects reported throughout the study.
TABLE 1.
Summary of GAIS scores at 3 M and 12 M follow‐up.
| Measure | 3 months (n = 38) | 12 months (n = 16) |
|---|---|---|
| GAIS‐Stretch Marks | 1.5 ± 0.6 | 1.6 ± 0.4 |
| GAIS‐Skin Laxity | 1.6 ± 0.6 | 1.8 ± 0.2 |
| GAIS‐Slimming Effect | 1.6 ± 0.4 | 1.9 ± 0.1 |
| GAIS‐Muscle Toning | 1.8 ± 0.3 | 1.9 ± 0.1 |
TABLE 2.
Reduction in circumference measurements at 3 M and 12 M follow‐up.
| Measure | 3 months (n = 38) | 12 months (n = 16) |
|---|---|---|
| Circumference A | 1.57 ± 1.44 cm | 3.16 ± 2.81 cm |
| Circumference B | 2.09 ± 2.21 cm | 4.69 ± 4.06 cm |
| Circumference C | 1.83 ± 1.99 cm | 4.06 ± 3.02 cm |
FIGURE 1.
Baseline (left), 3 months post‐treatment (middle), 12 months post‐treatment (right). Visible slimming and muscle toning effect on a 39‐year‐old subject, 8 months postpartum. At 12 months post‐treatment, the patient's circumference decreased by 10.0 cm (A: 5 cm above umbilicus), 13.0 cm (B: at umbilicus), and 11.0 cm (C: 5 cm below umbilicus).
FIGURE 2.
Baseline (left), 3‐month post‐treatment (middle), 12 months post‐treatment (right). A noticeable reduction of stretch mark appearance, as well as a slimming effect and muscle toning, on a 32‐year‐old 3 months postpartum patient. At 12 months post‐treatment, the patient's circumference decreased by 1.5 cm (A: 5 cm above umbilicus), 2.0 cm (B: at umbilicus), and 1.0 cm (C: 5 cm below umbilicus).
FIGURE 3.
Baseline (left), 3‐month post‐treatment (middle), 12 months post‐treatment (right). Improvement in the appearance of stretch marks and muscle toning on a 30‐year‐old 3 months postpartum patient. The patient's circumference at 12 months post‐treatment decreased by 2.0 cm (A: 5 cm above umbilicus), 4.0 cm (B: at umbilicus), and 4.0 cm (C: 5 cm below umbilicus).
4. Discussion
This clinical study aimed to explore the potential benefits of consecutive treatments using HIFEM+RF and RF + TPE technologies for postpartum abdominal improvement. The results demonstrated measurable improvements in abdominal circumference and overall appearance. At 3 months post‐treatment, the average reductions were 1.57 cm, 2.09 cm, and 1.83 cm in the abdominal circumference, measured 5 cm above the umbilical level, at the umbilical level, and 5 cm below the umbilical level, respectively. Aesthetic outcomes evaluated using the GAIS scale showed improvements in stretch marks (1.5 points), skin laxity (1.6 points), muscle toning (1.8 points), and a slimmer abdomen (1.6 points). At 12 months, GAIS scores remained high, with 1.6 points for stretch marks, 1.8 points for skin laxity, and 1.9 points for muscle toning and slimming effect. These findings support the effectiveness of combining both technologies within a single session to address multiple postpartum concerns.
The suggested mechanism of improved appearance is increased collagen and elastic fiber content in the dermis. RF energy stimulates neocollagenesis and neoelastogenesis by heating the dermis and subcutaneous tissue, which helps improve skin laxity and reduce stretch marks [17]. It also promotes blood flow and induces adipocyte apoptosis, contributing to localized fat reduction. TPE improves skin elasticity as it induces lipolysis and neovascularization and increases collagen fiber density [11]. HIFEM induces an electric current in the underlying tissues, causing involuntary supramaximal muscle contractions. Stimulation of the muscles promotes muscle tissue hypertrophy, also known as muscle building [18, 19]. The combined use of these modalities enables comprehensive targeting of skin, fat, and muscle layers, which results in more effective contouring of the abdominal area [12, 20, 21, 22, 23, 24].
Compared to other non‐invasive treatments like standalone radiofrequency, cryolipolysis, and ultrasound, which often cause temporary swelling and delayed results, the absence of side effects with HIFEM+RF and RF + TPE is a notable advantage [18].
Beyond physical outcomes, these treatments may also support psychological well‐being. The postpartum period often involves significant physical and emotional challenges, with body dissatisfaction contributing to stress and, in some cases, postpartum depression [25]. Aesthetic improvements may help alleviate appearance‐related stress and contribute to improved quality of life during this period. The convenience and safety of these noninvasive procedures make them particularly appealing for new mothers managing demanding routines [26].
The main strength of this study is the long follow‐up, which was conducted for up to 12 months. Another study strength is the number of enrolled patients, with 38 attending the 3‐month follow‐up visit. Despite a reduced number at the 12‐month follow‐up (n = 16), the sample size remained adequate for meaningful analysis. Methodological limitations include the absence of a placebo group and a group receiving treatment with only one of the two technologies. Future research would benefit from increasing the number of subjects evaluated at the 12‐month post‐treatment visit and extending the follow‐up observation. In addition, it would be beneficial to perform an MRI and ultrasound evaluation of the results. Nevertheless, more attention could be focused on pairing the two technologies, which could lead to the development of new devices utilizing the benefits of HIFEM+RF and RF + TPE.
5. Conclusions
Our study shows that consecutive noninvasive treatments by HIFEM + Synchronized RF and RF + TPE significantly improve the abdominal appearance of postpartum women. The treatments reduce stretch marks, tighten skin, and enhance muscle tone. No adverse effects were reported, further supporting the treatment's safety and efficacy for post‐pregnancy abdominal concerns.
Author Contributions
All authors contributed equally.
Ethics Statement
The authors confirm that the ethical policies of the journal, as noted on the journal's author guidelines page, have been adhered to. All subjects voluntarily participated and signed a written informed consent. Additionally, informed consent was obtained from all participants for the use of their photographs.
Conflicts of Interest
The authors declare no conflicts of interest.
Acknowledgments
Hannah Lo Fui Jun, MD, and Tingsong Lim, MD, cooperated on the study methodology and design and contributed equally to manuscript drafting and finalization. Grace Tay Wen Yue, MD, Chua Chong Hwee, and Tee Xiang Jie, MD, performed the analysis of the photographs. Gwen Ong, Yao Ching Shi, Ding Siew Wen, and Lim Sook Wah performed the therapies and thus contributed to data acquisition.
Jun H. L. F., Lim T., Yue G. T. W., et al., “Clinical Evaluation of a Combination of Non‐Invasive Technologies to Improve the Effectiveness of Postpartum Abdominal Treatment,” Journal of Cosmetic Dermatology 24, no. 7 (2025): e70330, 10.1111/jocd.70330.
Funding: The authors received no specific funding for this work.
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
References
- 1. Petrenko A. P., Castelo‐Branco C., Marshalov D. V., et al., “Physiology of Intra‐Abdominal Volume During Pregnancy,” Journal of Obstetrics and Gynaecology 41, no. 7 (2021): 1016–1022, 10.1080/01443615.2020.1820470. [DOI] [PubMed] [Google Scholar]
- 2. Lv K., Xia Z., Scars O., and Behalf of the C Consensus Panel on the Prevention and Treatment of , “Chinese Expert Consensus on Clinical Prevention and Treatment of Scar+,” Burns & Trauma 6 (2018): 27, 10.1186/s41038-018-0129-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Gluppe S. L., Hilde G., Tennfjord M. K., Engh M. E., and Bø K., “Effect of a Postpartum Training Program on the Prevalence of Diastasis Recti Abdominis in Postpartum Primiparous Women: A Randomized Controlled Trial,” Physical Therapy 98, no. 4 (2018): 260–268, 10.1093/ptj/pzy008. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4. Coyne S. M., Liechty T., Collier K. M., Sharp A. D., Davis E. J., and Kroff S. L., “The Effect of Media on Body Image in Pregnant and Postpartum Women,” Health Communication 33, no. 7 (2018): 793–799, 10.1080/10410236.2017.1314853. [DOI] [PubMed] [Google Scholar]
- 5. Chen M., Makama M., Skouteris H., et al., “Ethnic Differences in Preferences for Lifestyle Intervention Among Women After Childbirth: A Multi‐Methods Study in Australia,” Nutrients 15, no. 2 (2023): 472, 10.3390/nu15020472. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6. Withers M., Kharazmi N., and Lim E., “Traditional Beliefs and Practices in Pregnancy, Childbirth and Postpartum: A Review of the Evidence From Asian Countries,” Midwifery 56 (2018): 158–170, 10.1016/j.midw.2017.10.019. [DOI] [PubMed] [Google Scholar]
- 7. Branham G. H., Khetarpal S., Ramanadham S. R., Wulc A. E., and Dover J. S., Advances in Cosmetic Surgery, 2024: Advances in Cosmetic Surgery, 2024, E‐Book (Elsevier Health Sciences, 2024). [Google Scholar]
- 8. Meyer P. F., de Oliveira P., Silva F. K. B. A., et al., “Radiofrequency Treatment Induces Fibroblast Growth Factor 2 Expression and Subsequently Promotes Neocollagenesis and Neoangiogenesis in the Skin Tissue,” Lasers in Medical Science 32, no. 8 (2017): 1727–1736, 10.1007/s10103-017-2238-2. [DOI] [PubMed] [Google Scholar]
- 9. Bonjorno A. R., Gomes T. B., Pereira M. C., et al., “Radiofrequency Therapy in Esthetic Dermatology: A Review of Clinical Evidences,” Journal of Cosmetic Dermatology 19, no. 2 (2020): 278–281, 10.1111/jocd.13206. [DOI] [PubMed] [Google Scholar]
- 10. Kinney B. M., Kanakov D., and Yonkova P., “Histological Examination of Skin Tissue in the Porcine Animal Model After Simultaneous and Consecutive Application of Monopolar Radiofrequency and Targeted Pressure Energy,” Journal of Cosmetic Dermatology 19, no. 1 (2020): 93–101, 10.1111/jocd.13235. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11. Fritz K., Salavastru C., and Gyurova M., “Clinical Evaluation of Simultaneously Applied Monopolar Radiofrequency and Targeted Pressure Energy as a New Method for Noninvasive Treatment of Cellulite in Postpubertal Women,” Journal of Cosmetic Dermatology 17, no. 3 (2018): 361–364, 10.1111/jocd.12525. [DOI] [PubMed] [Google Scholar]
- 12. Duncan D. I., “Combination Treatment for Buttock and Abdominal Remodeling and Skin Improvement Using HIFEM Procedure and Simultaneous Delivery of Radiofrequency and Targeted Pressure Energy,” Journal of Cosmetic Dermatology 20, no. 12 (2021): 3893–3898, 10.1111/jocd.14554. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13. Samuels J. B., Katz B., and Weiss R. A., “Radiofrequency Heating and High‐Intensity Focused Electromagnetic Treatment Delivered Simultaneously: The First Sham‐Controlled Randomized Trial,” Plastic and Reconstructive Surgery 149, no. 5 (2022): 893–900, 10.1097/PRS.0000000000009030. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14. Schoenfeld B. J., “The Mechanisms of Muscle Hypertrophy and Their Application to Resistance Training,” Journal of Strength and Conditioning Research 24, no. 10 (2010): 2857–2872, 10.1519/JSC.0b013e3181e840f3. [DOI] [PubMed] [Google Scholar]
- 15. Kinney B. M. and Lozanova P., “High Intensity Focused Electromagnetic Therapy Evaluated by Magnetic Resonance Imaging: Safety and Efficacy Study of a Dual Tissue Effect Based Non‐Invasive Abdominal Body Shaping,” Lasers in Surgery and Medicine 51, no. 1 (2019): 40–46, 10.1002/lsm.23024. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16. DiBernardo B., Chilukuri S., McCoy J. D., Katz B., and Goldberg D. J., “High‐Intensity Focused Electromagnetic Field With Synchronized Radiofrequency Achieves Superior Gluteal Muscle Contouring Than High‐Intensity Focused Electromagnetic Field Procedure Alone,” Aesthetic Surgery Journal Open Forum 5 (2023): ojac087, 10.1093/asjof/ojac087. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17. Ohara T., “Synergy of Monopolar Radiofrequency Heating and Targeted Pressure Energy as an Innovative Approach to Cellulite Reduction,” American Journal of Biomedical Science & Research 12, no. 1 (2021): 83. [Google Scholar]
- 18. Swanson E., “A Systematic Review of Electromagnetic Treatments for Body Contouring,” Annals of Plastic Surgery 90, no. 2 (2023): 180–188, 10.1097/SAP.0000000000003387. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19. Weiss R. A., Kinney B., and Jacob C., “Emsculpt _Neo Simultaneous emission of novel Synchronized Radiofrequency and HIFEM (magnetic fields) in a single applicator for fat elimination and muscle building,” (2020), https://351face.com/wp‐content/uploads/2020/11/.
- 20. Duncan D. I. and Busso M., “Effectiveness of Combined Use of Targeted Pressure Energy, Radiofrequency, and High‐Intensity Focused Electromagnetic Fields to Improve Skin Quality and Appearance of Fat and Muscle Tissue in Different Body Parts,” Journal of Cosmetic Dermatology 22, no. 1 (2022): 200–205, 10.1111/jocd.15280. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21. Duncan D. I., Enhanced Liposuction: New Perspectives and Techniques, London, UK: IntechOpen, 2022. ISBN: 978‐1‐83962‐823‐8. [Google Scholar]
- 22. Jacob C., Kent D., and Ibrahim O., “Efficacy and Safety of Simultaneous Application of HIFEM and Synchronized Radiofrequency for Abdominal Fat Reduction and Muscle Toning: A Multicenter Magnetic Resonance Imaging Evaluation Study,” Dermatologic Surgery 47, no. 7 (2021): 969–973, 10.1097/DSS.0000000000003086. [DOI] [PubMed] [Google Scholar]
- 23. Halaas Y., Duncan D., Bernardy J., Ondrackova P., and Dinev I., “Activation of Skeletal Muscle Satellite Cells by a Device Simultaneously Applying High‐Intensity Focused Electromagnetic Technology and Novel RF Technology: Fluorescent Microscopy Facilitated Detection of NCAM/CD56,” Aesthetic Surgery Journal 41, no. 7 (2021): NP939–NP947, 10.1093/asj/sjab002. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24. Weiss R. A., Bernardy J., and Tichy F., “Simultaneous Application of High‐Intensity Focused Electromagnetic and Synchronized Radiofrequency for Fat Disruption: Histological and Electron Microscopy Porcine Model Study,” Dermatologic Surgery 47, no. 8 (2021): 1059–1064, 10.1097/DSS.0000000000003091. [DOI] [PubMed] [Google Scholar]
- 25. Hung C. H. and Chung H. H., “The Effects of Postpartum Stress and Social Support on Postpartum Women's Health Status,” Journal of Advanced Nursing 36, no. 5 (2001): 676–684, 10.1046/j.1365-2648.2001.02032.x. [DOI] [PubMed] [Google Scholar]
- 26. Figueroa C., “Self‐Esteem and Cosmetic Surgery: Is There a Relationship Between the Two?,” Plastic Surgical Nursing 23, no. 1 (2003): 21–24, 10.1097/00006527-200323010-00005. [DOI] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.