Aesthetic plastic surgery · 2026
A Prospective Cohort Study Demonstrating Measurable Facial Lifting with Fan-Shaped Poly-L-Lactic Acid Injections in Asian Patients.
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Liu Pei-Hsuan, Liao Jeffrey, Liu Pei-Han, Chang Chang-Cheng, Huang Yung-Hsueh, Hsu Ying-Chuan
Аннотация
INTRODUCTION: This study aimed to evaluate the efficacy of fan-shaped poly-L-lactic acid (PLLA) injections for facial lifting in Asian patients using quantitative measurements.
METHODS: Twelve Asian participants aged 18-50 years were enrolled in this prospective, open-label study. PLLA (Sculptra®, Galderma) was injected with blunt cannulas at two key anatomical sites: the temporal region (targeting the sub-superficial fascia) and the buccal region (above the SMAS layer near the anterior border of the masseter). Injections were administered in a retrograde, fan-shaped pattern. Facial assessments were performed at baseline and at weeks 4, 12, and 24 using 4-angle and 6-length measurements via the OBSERV® A+ skin analysis system. Participant satisfaction was also evaluated.
RESULT: At week 24, the tragus-oral commissure length shortened from 221.17 ± 16.90 mm to 209.14 ± 10.14 mm (p < 0.05), while the lower facial contour length was reduced from 264.83 ± 18.04 mm to 251.93 ± 12.21 mm (p < 0.05). Both measurements showed earlier significance at week 12(p < 0.01). In the upper face, the eyebrow peak angle rose from 21.79 ± 3.75° to 24.02 ± 4.92° at week 24 (p < 0.05), and the vertical palpebral fissure length increased from 9.92 ± 1.27 mm to 10.42 ± 1.05 mm at week 24(p < 0.05). The canthus-oral-nasal angle showed a transient increase at week 4 (37.8 ± 6.1° to 41.64 ± 4.26°, p < 0.05) but was not sustained thereafter. No serious adverse events were observed, and patient satisfaction remained consistently high throughout the study period.
CONCLUSION: Fan-shaped PLLA injections are a minimally invasive, well-tolerated, and effective approach to facial rejuvenation in Asian patients, yielding measurable improvements in periorbital features and sustained contour enhancement in the mid- and lower face.
LEVEL OF EVIDENCE II: 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 .
IMPORTANT POINTS: Fan-shaped PLLA injections provide a safe, minimally invasive option for mid- and lower-face rejuvenation, especially suitable for Asian patients. Facial contour improvements, including reduced tragus-oral and lower facial lengths, are maintained for up to 24 weeks. Although upper facial effects were less sustained, combining Fan-shaped PLLA injections with collagen-stimulating agents like hyaluronic acid may enhance and prolong results.
METHODS: Twelve Asian participants aged 18-50 years were enrolled in this prospective, open-label study. PLLA (Sculptra®, Galderma) was injected with blunt cannulas at two key anatomical sites: the temporal region (targeting the sub-superficial fascia) and the buccal region (above the SMAS layer near the anterior border of the masseter). Injections were administered in a retrograde, fan-shaped pattern. Facial assessments were performed at baseline and at weeks 4, 12, and 24 using 4-angle and 6-length measurements via the OBSERV® A+ skin analysis system. Participant satisfaction was also evaluated.
RESULT: At week 24, the tragus-oral commissure length shortened from 221.17 ± 16.90 mm to 209.14 ± 10.14 mm (p < 0.05), while the lower facial contour length was reduced from 264.83 ± 18.04 mm to 251.93 ± 12.21 mm (p < 0.05). Both measurements showed earlier significance at week 12(p < 0.01). In the upper face, the eyebrow peak angle rose from 21.79 ± 3.75° to 24.02 ± 4.92° at week 24 (p < 0.05), and the vertical palpebral fissure length increased from 9.92 ± 1.27 mm to 10.42 ± 1.05 mm at week 24(p < 0.05). The canthus-oral-nasal angle showed a transient increase at week 4 (37.8 ± 6.1° to 41.64 ± 4.26°, p < 0.05) but was not sustained thereafter. No serious adverse events were observed, and patient satisfaction remained consistently high throughout the study period.
CONCLUSION: Fan-shaped PLLA injections are a minimally invasive, well-tolerated, and effective approach to facial rejuvenation in Asian patients, yielding measurable improvements in periorbital features and sustained contour enhancement in the mid- and lower face.
LEVEL OF EVIDENCE II: 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 .
IMPORTANT POINTS: Fan-shaped PLLA injections provide a safe, minimally invasive option for mid- and lower-face rejuvenation, especially suitable for Asian patients. Facial contour improvements, including reduced tragus-oral and lower facial lengths, are maintained for up to 24 weeks. Although upper facial effects were less sustained, combining Fan-shaped PLLA injections with collagen-stimulating agents like hyaluronic acid may enhance and prolong results.