Abstract

Objectives: To present the 4.Lift technique, a ligament-oriented hybrid approach with hyaluronic acid and calcium hydroxyapatite. By targeting four strategic ligament zones—zygomatic, masseteric, mandibular, and temporal—the technique aims to provide both immediate lifting and long-term collagen stimulation. Introduction: Facial aging involves ligament weakening, soft tissue descent, and loss of structural support, causing sagging and disharmony. Traditional filler strategies often prioritize volumization, sometimes creating unnatural results. Developed in 2022, the 4.Lift technique addresses structural aging by support of retaining ligaments while stimulating collagen. Materials / method: A prospective series is underway with patients treated using the 4.Lift protocol. Hybrid filler (HA + CaHA) is applied in four ligament zones. Assessments include standardized photography, GAIS, and patient-reported outcomes at baseline and follow-up. Results: Preliminary observations show improvements in jawline contour, midface support, prejowl sulcus reduction, and skin quality. The hybrid filler enables repositioning with bio-stimulation while minimizing volume. No major adverse events have been reported, with transient edema the most common. Patient satisfaction trends are favorable, though data remain under evaluation. Conclusion: The 4.Lift technique offers a reproducible protocol for global facial rejuvenation. By combining support of retaining ligaments with collagen stimulation, it may achieve natural, harmonious results while avoiding an “overfilled” appearance. Continued follow-up and final data analysis will further define safety, efficacy, and long-term outcomes.