ArticleAesthetic plastic surgery2026
A Prospective Cohort Study Demonstrating Measurable Facial Lifting with Fan-Shaped Poly-L-Lactic Acid Injections in Asian Patients.
Article in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThis study aimed to evaluate the efficacy of fan-shaped poly-L-lactic acid (PLLA) injections for facial lifting in Asian patients using quantitative measurements.
methodsTwelve 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.
resultAt 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.
conclusionFan-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.
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