Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2022; 10(27): 9783-9789
Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9783
Efficacy evaluation of True Lift®, a nonsurgical facial ligament retightening injection technique: Two case reports
Peter Huang, Chih-Wei Li, Yong-Quan Yan
Peter Huang, Department of Medicine, China Medical University, Taichung City 406040, Taiwan
Chih-Wei Li, Department of Delicate Clinic, New Taipei 110, Taiwan
Yong-Quan Yan, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei 242, Taiwan
Author contributions: Li CW and Yan YQ were involved in the acquisition, analysis, interpretation of the data, critical revision of the manuscript, and final approval of the version to be published, all authors contributed to the conception, study design, and the acquisition, analysis, and interpretation of the data; Huang P was involved in the design, acquisition of the data, and drafting and revision of the final manuscript, all authors gave final approval of the manuscript.
Informed consent statement: The ethical principles outlined in the Declaration of Helsinki and Good Clinical Practice were followed. Informed consent and permission to use their photographs for publication were obtained from each patient.
Conflict-of-interest statement: All authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Peter Huang, MD, Department of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Road, Beitun Dist, Taichung City 406040, Taiwan R.O.C., Taiwan.
Received: March 4, 2022
Peer-review started: March 4, 2022
First decision: May 30, 2022
Revised: June 16, 2022
Accepted: August 14, 2022
Article in press: August 14, 2022
Published online: September 26, 2022

With aging, four major facial retaining ligaments become elongated, leading to facial sagging and wrinkling. Even though synthetic fillers are popular, however, it cannot address the problems of soft tissue descent alone, and injection of these fillers requires knowledge of the injection technique including the selection of injection sites, the amount of filler, and the dosage used per injection site.


This report aimed to assess the safety and efficacy of a nonsurgical retightening technique to lift and tighten the true ligaments of the face, to improve age-related skin sagging and wrinkling. We objectively quantified the aesthetic lifting effect of a nonsurgical facial retightening procedure that strategically injected high G’ fillers into the base of the true retaining ligaments of the face in two female patients. Facial images were recorded with a three-dimensional facial imaging system for comparison of the clinical outcome. The primary efficacy outcome was the change in facial anthropometric measurements obtained prior to and after injection. The patients were followed for 6 mo after the procedure. Skin retightening was observed, with an evident lift in the orbital, zygomatic, and mandibular regions, and the lifting effect was still observable at the 6-mo follow-up. Few mild adverse events, such as mild-to-moderate pain, tenderness, and itching, occurred during the 1st week after the procedure. No adverse events were reported 1 mo post-procedure.


The results of this study demonstrated that our nonsurgical retightening procedure with strategically placed high G’ fillers achieved quantifiable aesthetic improvements in the orbital, zygomatic, and mandibular regions of two patients. Future research with a larger sample could provide a more in-depth evaluation and validation of the aesthetic improvements observed in this study.

Keywords: 3D photogrammetry, Facial retightening, Facial retaining ligament, Cosmetic techniques, True Lift®; Restylane®; Lyft Lidocaine, Anesthetics, Case report

Core Tip: We objectively quantified the aesthetic lifting effect using facial anthropometric measurements. Our results showed direct retightening of the true retaining ligaments by strategically planned high G’ fillers to the base of the ligaments achieved immediate lifting effect.