摘要

Objectives: To rebuild deep facial support with high G-prime hyaluronic acid and then reposition tissues with PCL/PLLA threads in a controlled and predictable way, creating an “invisible lifting” effect that enhances facial architecture while preserving natural identity, with improved firmness, texture, and long-lasting refinement without volumizing the face. Introduction: Today, patients seek effective treatments that improve skin quality without drastic transformations. PCL/PLLA threads with multidirectional barbs provide precise mechanical lifting and collagen stimulation, improving overall skin quality when placed in the superficial subcutaneous plane. However, repositioning without foundation is temporary, and foundation without repositioning is incomplete—support must be rebuilt first. Materials / method: After assessment, photos, and asepsis, the protocol is performed in two phases. Phase 1: mark deep structural pillars and inject 5 mL of high G-prime HA in a deep plane to restore support (deep temple region, pyriform area, supra-auricular region) as the “invisible foundation.” Phase 2: mark thread vectors from two entry points (near tragus; posterior malar) toward jowl, marionette, nasolabial fold. Strict antisepsis, local anesthesia, superficial subcutaneous advancement. Results: Deep pillar reinforcement prepares a stable base so threads do not pull against weakened tissues, improving control and predictability of repositioning. Superficial subcutaneous placement allows barbs to anchor to the fibro-septal network, repositioning tissues while avoiding surface irregularities. Clinically, the combined approach supports natural elevation and progressive improvement in firmness and texture over time. Conclusion: By combining deep structural filler with PCL/PLLA threads, the Georgia Protocol addresses two levels of facial aging: loss of deep support and soft-tissue descent. This integration enables a harmonious, elegant rejuvenation focused on natural elevation and long-lasting refinement—an “invisible lifting” effect rather than facial volumization—continuing to improve over time.