The PATH Protocol for Integrated Facial Rejuvenation: A Preliminary Three-Patient Case Report Series and Narrative Review of the Literature

Background and Clinical Significance: Facial aging is a multifactorial process involving
the skin, subcutaneous tissues, facial fat compartments, muscles, ligaments, and skeletal
structures. Integrated minimally invasive protocols are increasingly used to improve facial
harmony and skin quality while preserving natural expression. The PATH (Profundity,
Action, Timing, and Home care) protocol combines chemical peeling, hyaluronic acid–
succinate filler, intradermal biorevitalization, and post-procedural homecare in a sequential
and individualized approach to facial rejuvenation; Case Presentation: Three female
patients aged 52–58 years with clinical signs of facial aging were treated according to
the PATH protocol. Assessments were performed at baseline and after 60 days using
standardized photography, OBSERV 520®, Antera 3D PRO®, and QuantifiCare LifeViz®
Infinity Pro. No serious adverse events or systemic complications were reported during the
60-day follow-up period. Mild edema, erythema, and ecchymosis resolved spontaneously
within 48–72 h. At 60 days, all patients showed natural improvement in facial appearance,
with better midface and lower-face balance, increased skin brightness, improved texture,
and no overcorrection or alteration of facial expression. Instrumental evaluations supported
the clinical findings, showing improvements in skin regularity, chromatic uniformity,
microrelief, and soft-tissue distribution; Conclusions: This preliminary case series suggests
that the PATH protocol may represent a coherent multimodal strategy for integrated
facial rejuvenation. The main clinical lesson is that a sequential, depth-oriented, and
individualized approach may achieve natural aesthetic improvement. No serious adverse
events were reported in the three patients during the 60-day follow-up period; however,
the limited sample size and short follow-up do not allow definitive conclusions regarding
safety. Further controlled studies with larger samples and longer follow-up are needed to
confirm these exploratory findings.