Conceptual Approaches to Facial Lifting Using Hyaluronic Acid Fillers: An Anatomical and Biomechanical Perspective

Area of Science:

• Aesthetic Medicine
• Biomechanical Engineering
• Anatomy

Background:

• Hyaluronic acid (HA) fillers are integral to non-surgical facial rejuvenation.
• Current HA filler strategies for facial lifting include myomodulation, dual-plane, and retaining ligament approaches.
• These frameworks often focus on discrete anatomical layers or structures, overlooking the interconnectedness of the facial fibrous network.

Purpose of the Study:

• To review contemporary HA filler-based facial lifting approaches.
• To propose an integrative framework viewing the facial fibrous network as a unified biomechanical unit.
• To provide a structural and functional basis for reinterpreting facial lifting with HA fillers.

Main Methods:

• Review of current anatomical and biomechanical perspectives on HA filler facial lifting.
• Analysis of existing frameworks: myomodulation, depth-oriented dual-plane, and retaining ligament-targeted approaches.
• Development of a proposed integrative framework based on the continuous facial fibrous supporting network.

Main Results:

• Existing frameworks address specific anatomical targets but differ in mechanistic interpretations.
• A key finding is the potential to interpret the continuous facial fibrous network as a unified biomechanical unit.
• This unified network perspective offers a novel structural basis for facial lifting with HA fillers.

Conclusions:

• Reinterpreting the facial fibrous network as a unified therapeutic unit provides a new model for HA filler applications.
• This integrative framework aims to enhance future clinical applications and research design in facial rejuvenation.
• The proposed fibrous network-oriented framework requires prospective validation.