The 1.2.3.Dimensional Concept for the causebased treatment of the aging face has proven its value over the last 2 decades providing a clear vectorbased strategy to reverse many of these undesired 

changes related to the aging face. 

1D: Unidirectional vertical ptosis is being addressed by unidirectional vertical lifting, varying from en-bloc deep plane lifting of face and neck to triple-layer mid-facelift, tarsal tuck, ROOFlift and reversed brow lifting.

2D: Aging of the skin, being a 2Dimensional issue, initially was treated by superficial micro fat grafting + PRP. PRP resulted in a significant reduction of postoperative downtime (from 18.9 days to 13.2 days, p=0.019) and skin quality seemed to be improved by a modest reduction of fine wrinkles and improved skin texture and color (by a maximum of 10% or not significantly at all), a prospectively randomized clinical trial could not confirm any increase in skin elasticity (P>0.05).

3D: If loss of volume is involved, deep lipofilling (12-22cc per side of the face) yielded significantly better results than lifting alone (p<0.05). With this approach, overall results were highly satisfactory but never placed patients truly back in time. Today we present the 4th Dimension, an even impressive return back in time by adding Regeneration, being able to 'switch it on' using the 'Trauma Trigger'.  Mechanically dissociated adipose tissue by Fractionation (FAT-procedure) generates SVF intra-operatively within 15minutes. In combination with PRP, this allows for the manufacturing of Platelet Rich Stroma (PRS®). PRS is able to repair of severely damaged soft tissue and even arthritic joints, facial skin quality did not always improve as was wished for. A 'Trauma Trigger' appears to be required 

to unleash the full potential of PRS for Facial Aesthetic Surgery by adding a 40%-TCA-peeling. A 15-20 years' setback in time now seems possible.