Reconsidering the Biomechanical Basis of the V-Lift Technique with Calcium Hydroxyapatite

This letter comments on the recent publication describing the "Vectorial-Lift" technique with calcium hydroxyapatite (CaHA) for non-surgical facial rejuvenation. We highlight that the proposed histologic, mechanical, and "contracture" mechanisms have not been demonstrated in facial ligaments, question the biomechanical plausibility of the "torch theory," and note safety concerns, particularly in periorbital regions. Further controlled studies are needed before clinical endorsement.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .