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Hybrid Lifting Homologous Therapy® (HLH THERAPY ®) A New Step in Natural Face Lift

Tsioumas G Sotirios

Diagnostic Clinic and Aesthetic Surgery Ophthalmology, Eye surgeon -Oculoplastic, President of Hellenic Society of Aesthetic Medicine and Non Invasive Surgery, Prof of University of Camerino for Aesthetic Medicine, Greece

DOI: 10.15761/CMI.1000144

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Traditionally, the only way to improve the signs of aging and in general the ptosis of the face contour due to aging was the surgical lifting. The famous facelift. Based on the basic principles of face anatomy and surgical lifting, the HLH THERAPY (Hybrid Lifting Homologous) appeared. An alternative natural lifting treatment, where in a natural and autologous way, without changing the shape of the face or the characteristics we manage to go back in time a give a younger look.

It is a bloodless treatment that gives the same results as surgical lifting, both in duration and appearance, but without the risk of distortion of characteristic or undesirable side effects.

HLH Therapy uses both, the Plasma exeresis technique using the PLEXR ® microsurgical device and the autologous threads treatment using the needle shaping technique and the machine Vibrance.

Briefly during the treatment, we have the simultaneous expansion of the thickness of the elastic fibers, reducing their length, changing their direction from vertical to horizontal (through Needle Shaping), while at the same time with the Plasma exeresis Techniques and the machine Plexr ®we have sublimation of excess of skin. Plexr® sublimates, does not pass the basement membrane but makes a sublimation of the corneocells, shrinking of the elastic fibers and at this point stabilizes the autologous thread. This parallel application of these two separate therapies (autologous threads with Needle Shaping Technioques and sublimation and shrinking of elastic fibers with the use of Plasma Exeresis in the same time) is the synthesis of the HLH methodology. We can say that it is the next step in soft surgery applications.

The results are impressive, with only few days of recovery and no anesthetic use. The treatment was first inspired by surgeon ophthalmologist Sotiris Tsioumas and was first developed by him after six years research and experience.


Natural facelift, Bloodless, SMAS, Plexr®, Needle Shaping, Autologous threads, Plasma exeresis, sublimation, Hybrid, Homologous


According to a recent study of the American Aesthetic Plastic Surgery Community, the total face lift occupies the 6th place in the ranking with the most popular aesthetic surgical procedures.

The scientific name of face lifting is facial rectification and is defined as a type of aesthetic surgery. The facial stimulation procedure applied for the reconstruction of facial points and to improve the appearance of giving account of youth in each patient.

Face lifting may include an operation to raise the upper third of the face, fore-head or brow-lift, or mid-face lift or the lower third of the face. It can also be combined with all of the above procedures, or combined with upper-lower blepharoplasty and / or liposuction of cheeks. The face lift is usually done under the skin in the epidermal musculoskeletal system (SMAS) by replacing the facial muscle and reducing the excess skin [1]. (Figures 1,9 and 10)

Figure 1. Structure of the skin.

All face support through face lifting focuses on the redesign of the Superficial Muscle Aponeurus System (SMAS). In the so-called SMAS lift, the plastic surgeon restores not only the skin but also the tissues to its normal position. Restoring the skin and facial tissues we have the inversion of the so-called triangle of youth [2]. (Figure 2)

Figure 2: Triangle of Youth.

Based on the basic principles of facial anatomy and the theory of surgical face lift, doctor Sotiris G. Tsioumas began the implementation and application of this bloodless HLH Therapy ® technique.

The term HLH Therapy ®is an abbreviation of the three words Hybrid Lifting Homologous - Hybrid Lifting Homologous. After five years of experience of the ophthalmologist in non-surgical blepharoplasty using the Plasma Exeresis method and the Plexr® device, as well as its five year experience on autologous threads using the Needle Shaping medical device and the homonymous method, it was inspired and then applied the new treatment of total bloodless and natural face lifting.

The term hybrid is used as the two above-mentioned techniques (PLASMA EXERESIS & NEEDLE SHAPING) are applied simultaneously during the application of the treatment. Two different techniques are used, combinatorial and concurrent, and applied in the same patient at the same time.

The term lifting is used, as the result after the application of the method, is total face and neck lift having reversed the direction of the triangle of youth from downward to upward.

The term Homologous is used because a basic part of the method is the use of the autologous thread method. Based on SMAS's basic theory of tissue repositioning, Dr. Tsioumas G. Sotiris, using the Needle Shaping technique, recreates existing aged tissue and reposition it by altering the density and direction of the facial elastic fibers without intervene surgically. Autologous technique means, when taken by an organism and given to itself. In this method, the existing aging elastic fibers are obtained and new ones are given, which are regenerated by Needle Shaping technique. The new therapy HLH Therapy®, based on its plasma (PLEXR ®) and autologous techniques (NEEDLE SHAPING) simultaneously, can be applied without fear and without complications to people with autoimmune diseases, people with a history of cancer even in people with diabetes [3].


The sample of patients that was used to apply the new HLH THERAPY BY TSIOUMAS SOTIRIOS ® method was 10 women, aged 50-80 years old, non-smokers and without having any surgical lifts operations in the past. The treatment process begins with the doctors taking photos. The doctor photographs the patient's face from a 45 and 90 degree angle, enface and profile. After that the doctor moves on with the complete antisepsis in the area of the face and neck and then applying anesthetic cream to the same areas. The patient waits for an hour in order to act the anesthetic cream. Within one hour, the application of the anesthetic cream is repeated. After one hour the patient is ready to start the treatment [4].

The doctor then follows the two main lines that are used as his guides, which are called hinderer lines. (Figure 3)

Figure 3: Hinderer Lines.

As soon as the hinderer lines are designed, the first phase of the treatment begins. The doctor is using the large diamond acupuncture needle and inserts the first needle into the skin. (Figure 4) The patient holds an electrode of the NEEDLE SHAPING device and the doctor holds the second electrode with his naked hand. At this point the doctor pulls the acupuncture needle upwards and turns the needle with outwards direction. At this point, external superficial zones and wrinkles are created from the excess of skin. At the same time that the doctor revolves and moves the acupuncture needle upwards, through the doctor- patient electrodes, the energy is delivered from the doctor's hand to the needle and from the needle into the elastic fibers. (Figure 5) These electrodes create micronoses that penetrate the elastic fibers. What happens internally is that the elastic fibers vibrate and engage (like sticking) on the acupuncture needle. (Figure 6) By pulling upwards and outwards, the elastic fibers follow the same upward course. At the same time, due to the sticking on the acupuncture needle the elastic fibers become more dense, more Picture compact, thick and upwards directed [5,6]. (Figure 7)

Figure 4 : Inserting accupuncture needle.

Figure 5: Vibration and Catching of the elastic fibers.

Figure 6: Sticking the elastic fibers.

Figure 7: Thickness of elastic fiber.

Figure 8: Sublimation of the epidermal and locking the elastic fibers to the right point and fixation of autologous threads.

At this point the elastic fibers have been re-positioned and their quality improved. The doctor with his second hand, simultaneously using the microsurgical device Plexr®, sublimates at the same time the excess tissue that is created. With sublimation, what is achieved, is the disappearance of the wrinkles, wrinkles at estrofletion zones, as well as the fixing of the elastic fibers (autologous threads) at the point where the doctor has delimited them. We have flattened the external superficial zones and locked the elastic fibers to the right point. (Figure 8) Once the sublimation has been completed, the doctor removes the acupuncture needle, which due to the locking of the fibers at the key point of the retraction, the needle is removed with some difficulty. Because of sublimation, at the areas where HLH therapy® is applied, some crusts are created that fall down on average 5 days after treatment. After the crusts fell down, the skin has a slight irritation which, over the next 20-30 days, has disappeared, using an anaplastic cream. Just after treatment, a special protective makeup with a high sun protection factor is applied to the patient and he can immediately leave the clinic [7,8].

At this point, we should mention that after the treatment no antibiotics will be needed, no bandages or total anesthesia. All of these elements make the treatment absolutely safe and of course it reduces its cost compared to a traditional surgery [8-10].

Following is a photographic material indicating the step by step methodology
Photo presentation of HLH THERAPY ® STEPS:


The results from the new treatment are immediate and extremely impressive. The patient leaves the clinic, already seeing the difference in his face with a strong sense of pulling and tightening.

Due to the fact that this new treatment is based on already successful techniques such as Plasma Exeresis (Plexr ®) and Needle Shaping, the effects that are observed are more than ten.

First, due to the use of Plasma Exeresis (Plexr®) method, we have the creation of collagen type III in sublimation areas after one month after the therapy. Past histological examinations for the use of Plexr® have proven it. Secondly, through the Plasma Exeresis technique and the Plexr® machine, we have complete sublimation of the keratinocytes. Through the Needle Shaping technique we achieve the creation of autologous threads as well as the change of the direction and quality of the elastic fibers. The elastic fibers become shorter and thicker. Again, histological analyzes for Needle Shaping have showed that new elastic fibers are created after 28 days. Summarizing the most important effect is that through the simultaneous use of the needle shaping and Plexr techniques we have the simultaneous sublimation of excess tissue in combination with the fixation of the elastic fibers and their shrinking. In simple words with HLH Therapy®, we shrink the elastic fibers, we make them thicker, organize them, change their direction from vertical to horizontal, and at the same time through Plexr® we make the fixation of the autologous threads. All this give the effect of reshaping the whole face.

Finally, with HLH Therapy®, due to the fact that we have a combination of techniques and tools, we can intervene and provide solutions to areas that could not be intervened with the scalpel, such as the areas in the crow’s feet and neck.

As far as the patient's psychosomatic balance is concerned, the patient is not subjected to any procedure of total narcosis that can cause complications, so he feels safe, feels fearless and can return directly to his daily routine.

But above all, the patient directly sees the result without having to wait and undergo long recovery times. We also have no complications during recovery as Keloid hypertrophic scars, facial deformities and numbness from nerve section. Finally none of the 10 cases experienced any complications either during or after treatment.


Now in all fields, so in medicine, the trend has changed and is directed towards the natural, the bloodless and the autologous. Based on the trend and the need for the more natural and bloodless results, the need for treatments that do not require long recovery times, treatments that do not cause fear and are not economically unbearable, HLH Therapy ®has been created. The next step in the treatment is the scientific documentation of the results of this combination through new histological examinations that will be carried out in the following period and will be exclusively about HLH therapy®.


  1. Sotiris TG, Georgiadou I, Ioannis N (2014) Noninvasive Upper Blepharoplasty In Relation To Surgical Blepharoplasty. Pinnacle Medicine & Medical Sciences 1: 436-440.
  2. Sotiris TG, Georgiadou I, Ioannis N (2014) Plexr: The Revolution In Blepharoplasty" Pinnacle Medicine & Medical Sciences 1: 423-427.
  3. Sotiris TG, Dimitris V, Nikolaos G (2015) Clinical And Histological Presentation After Plexr Application, Needle Shaping (Vibrance) And OFF" Pinnacle Medicine & Medical Sciences 2: 522-530
  4. Sotiris TG, Ioannis C, Papapostolou A (2015) The Efficiency of Vibrance (Needle Shaping) And O.F.F (NonSurgical Dermal Ablative Treatment) On Body Reshaping" Pinnacle Medicine & Medical Sciences 2: 506-509
  5. Geleki S, Tsioumas S, Vranou A (2015) Plexr In Acne Treatment" Pinnacle Medicine & Medical Sciences 2: 482- 486.
  6. Sotiris TG, Ioannis C, Irini Z (2015) The Induction Of Lipolysis Using The Machine Of O.F.F (Bags Under TheEyes) And The Application Of Needle Shaping Technique Using The Vibrance Machine (Tear Through)" Pinnacle Medicine & Medical Sciences 2: 445-448
  7. Sotiris TG, Ioannis C, Anastasia VL (2015) Comparison of The Efficacy Of Injectable Hyaloronic Acid Versus Needle Shaping (Vibrance) And O.F.F (Onde Flusso Frazionato) For The Aesthetic Treatment Of The Face" Pinnacle Medicine & Medical Sciences 2: 441-444.
  8. Georgia G, Maria S, Sotiris GT, Dimitropoulos V, Antonio S (2016) Presentation Of Old And New Histological Results After Plasma Exercises (Plexr) Application (Regeneration Of The Skin Tissue With Collagen III)" Pinnacle Medicine & Medical Sciences 3: 983-990.
  9. Sotiris TG. Georgiadis N, Georgiadou I (2015) The Gas Ionization by Plasma Technology for Noninvasive Techniques in Oculoplastic”. JOJ Ophthal 2: 555-584.
  10. Sotiris TG (2017) New Treatment with Plasma Exeresis for Non- Surgical Blepharoplasty . EC Ophthalmology 4: 156-159.

Editorial Information


Dr. Ume Wollina

Article Type

Research Article

Publication history

Received date: August 07, 2017
Accepted date: August 21, 2017
Published date: August 25, 2017


©2017 Sotirios TG. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Sotirios TG (2017) Hybrid lifting homologous therapy® (HLH THERAPY ®) a new step in natural face lift. Clin Med Invest 2: DOI: 10.15761/CMI.1000144

Corresponding author

Sotirios TG

Diagnostic Clinic and Aesthetic Surgery Ophthalmology, Eye surgeon -Oculoplastic, President of Hellenic Society of Aesthetic Medicine and Non Invasive Surgery, Prof of University of Camerino for Aesthetic Medicine, Greece.

Figure 1. Structure of the skin.

Figure 2: Triangle of Youth.

Figure 3: Hinderer Lines.

Figure 4 : Inserting accupuncture needle.

Figure 5: Vibration and Catching of the elastic fibers.

Figure 6: Sticking the elastic fibers.

Figure 7: Thickness of elastic fiber.

Figure 8: Sublimation of the epidermal and locking the elastic fibers to the right point and fixation of autologous threads.