Virginia Marcia Amaral1  iD• Helena Hotz Arroyo Ramos2 • Fernanda Aquino Cavallieri3 • Mariana Muniz4 • Guilherme Muzy5 • Ada Trindade de Almeida6

1 IVA Medical Institute, Av. dos Bandeirantes 1518, Belo Horizonte CEP: 30.315-032, Brazil

2 Vito´ria, Brazil

3  Rio de Janeiro, Brazil

4 Sa˜o Paulo, Brazil

5 Sa˜o Paulo, Brazil

6 Hospital do Servidor Pu´blico Municipal de Sa˜o Paulo, Sa˜o Paulo, Brazil

Received: 13 January 2024 / Accepted: 9 April 2024 / Published online: 7 May 2024

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© The Authors 2024, corrected publication 2024

Abstract  Background The facial aging process entails alterations in the volume, shape, and texture of all skin layers over time. Calcium hydroxyapatite (CaHA) is a well-established safe skin filler with unique properties to resolve some skin alterations by stimulating neocollagenesis. The vectoral-lift (V-lift) technique targets the global repositioning of facial structures by addressing distinct anatomical injection planes. It includes deep facial augmentation with Radiesse PlusTM to retain ligament restructuring and superficial subcutaneous enhancement with diluted Radiesse DuoTM. Herein, we present cases that illustrate the use of this approach.

Methods This pilot study enrolled 36 participants (33 women and three men; ages 37–68 years) in a Brazilian clinical setting, and all patients underwent a single treatment. Photographs were taken at rest, in frontal and oblique views, before injection, and 90 days after treatment.

Results Treatment resulted in elevation of the upper and middle face, notable improvements in the infraorbital hollow, and adjustment of the mean facial volume.

Conclusions The V-lift technique is a three-dimensional pan-facial treatment that relies on ligament support and face vectoring to obtain a lifting effect and facial contour restoration. It encompasses deep facial augmentation involving the use of Radiesse PlusTM for restructuring and retaining ligaments and Radiesse DuoTM for superficial subcutaneous enhancement. This approach targets a global repositioning of the facial structures by addressing distinct anatomical injection planes. It achieves a repositioning of the overall facial anatomy without requiring a substantial volumetric expansion.

Level of Evidence IV 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.

Keywords Skin aging   Collagen  Plastic surgery  Dermatology  Aesthetics  Calcium hydroxyapatite  Biostimulation