Application of double plication suspension utilizing barbed sutures on SMAS in middle and lower face lift

Abstract

Objective This paper describes a technique of facelift that utilizes bidirectional barbed sutures for superficial musculoaponeurotic system (SMAS) double plication. It corrects the facial aging of middle and lower part. Methods An extensive skin flap was undermined subcutaneously, and the sagging tissue of SMAS was lifted latero-superiorly by a secured barbed suture in two oval-shaped areas, with double plication, and without the need for knots, in order to correct the nasolabial groove and descended jowls, repositioning the midfacial volumes. Results A very high patient satisfaction was obtained in 76 patients. One patient had a small hematoma, and one patient had a temporary contour irregularity in the cheek. All resolved without any treatment. Conclusions The double plication facelift utilizing barbed sutures, mainly affects the middle and lower third of the face. Its advantages are: quick procedure, pleasant results, low complication rate, and short recovery period. It also eliminates the possibility of knot visibility, palpability, or extrusion. Key words: Face lifting; Superficial musculoaponeurotic system; Aging face