Facial Tissue Biomodulation Using Non-Cross-Linked Hyaluronic Acid: Clinical and Instrumental Outcomes of the Triple R Technique

Skin aging is a multifactorial process characterized by the degradation of the extracellular matrix, reduced elasticity, and impaired skin barrier function. Biomodulation using non-crosslinked hyaluronic acid has established itself as a regenerative strategy aimed at restoring tissue homeostasis and improving overall skin quality. To evaluate the clinical and instrumental effects of the Triple R technique—a facial biomodulation protocol based on the sequential administration of non-crosslinked hyaluronic acid with different functional profiles— A prospective, observational, single-group clinical study was conducted in adult patients with signs of facial aging. Participants underwent a biomodulation procedure using INNO-CE® BI-DENS 2.5 and INNO-CE® MOIST 1.5, applied according to a standardized, anatomically guided protocol. a facial biomodulation treatment based on the sequential administration of non-crosslinked hyaluronic acid with different functional profiles. A prospective, observational, single-group clinical study was conducted in adult patients with signs of facial aging. Participants underwent a biomodulation procedure using INNO-CE® BIDENS 2.5 and INNO-CE® MOIST 1.5, administered according to a standardized, anatomically guided protocol. The results included measurement of the hypoechoic subepidermal band (SLEB) using high-frequency ultrasound. Statistical analysis was performed using paired t-tests, with a significance level set at p < 0.05. The treatment resulted in a statistically significant reduction in SLEB thickness (p < 0.0001), indicating an improvement in dermal structure. No serious adverse events were observed. The Triple R technique demonstrated significant improvements in key skin quality parameters, suggesting a biomodulatory effect that goes beyond simple hydration. These findings support the role of combined non-crosslinked hyaluronic acid protocols as a safe and effective strategy for facial tissue regeneration. Further controlled studies are needed to confirm these results.