Barbed Polypropylene Sutures for Midface Elevation

Abstract

In the past decade, the popularity of minimally invasive procedures for midface rejuvenation has greatly increased. We describe a new technique using percutaneous barbed polypropylene sutures to specifically address midface aging. It can be performed in a closed or open approach, depending on the degree of tissue repositioning required. To determine the efficacy of the barbed polypropylene suture in the elevation of the aging midface and the rate of associated early complications. Examination of the results obtained in 44 patients in whom we used the barbed polypropylene suture in a private practice plastic surgery facility. Of these patients, 34 underwent an open-approach and 10 a closed-approach procedure. Attention was focused on improvement of the aging midface, including the infraorbital hollow, lower lid position, nasolabial and melolabial creases, and nasojugal groove. Attention was also focused on improvement of the jowls. All patients demonstrated improvement in the midfacial area and jowls, with minimal complications. The suture evaluated in this article provides another technique that can be used by facial plastic surgeons in selected patients to address, in particular, ptosis of the midface.