Background: In recent decades, several minimally invasive methods provided by EBDs and injectables have emerged as an attractive alternative to surgical facelifts. An innovative approach to SMAS lifting has been demonstrated by a pneumatic needle-free device. Aims: This study aimed to enhance the facelift protocol by increasing pressure in the temporal area and using crosslinked and non-crosslinked HA. Methods: Nine subjects with moderate to severe skin aging and laxity were randomized into three groups: 1) 1CG—current EnerJet protocol with non-crosslinked HA; 2) 2NCLH—elevated pressure with non-crosslinked HA; and 3) 3CLH—elevated pressure with crosslinked HA. The treatment’s safety was evaluated by reports of adverse reactions and pain levels through the NPRS Scale. The clinical effect was evaluated one-month post-treatment by two investigators using the GAIS Scale via four aesthetic categories: 1) reduction of fine lines and wrinkles, 2) skin’s firmness, 3) eyelid lift; and iv) overall skin change. Patients were asked to answer a satisfaction questionnaire on treatment effects and experience. Results: All treatments were well-tolerated, with an average pain score of 2.8 ± 1.9 (out of 10). No known or new adverse reactions were documented. 2NCLH and 3CLH groups demonstrated better results than 1CG in most aesthetic features. The patient’s satisfaction rate of 2NCLH and 3CLH was also higher than that of 1CG for most aesthetic features. Conclusion: This small group study has shown enhanced efficacy of the kinetic facelift protocol when higher pressure was applied in the temporal area, without compromising the treatment’s safety profile.
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