Facial cosmetic surgery is a rapidly growing field, especially in the world of oral and maxillofacial surgery. With cosmetic surgery becoming more mainstream, patients are becoming more educated on options available, and the desire for minimally invasive or no-down-time procedures are on the rise. The use of thread-lift sutures as an alternative to traditional surgical rhytidectomy or neck lifting is becoming a more common practice among surgeons, and oral and maxillofacial surgeons are in a particularly unique place to offer these procedures. Few other sub-surgical specialties have as much familiarity with facial anatomy (Ferneini et al., 2017). Thread-lift sutures represent a relatively new technique that proved to be reliable. In particular, the Silhouette InstaLift® are polypropylene sutures with 9 cones spaced about 10mm apart. These cones contain poly-L-Lactic acid (PLLA), which is the principal component in the injectable Sculptra®. The cones take a long time to break down, and the PLLA stimulates a foreign body reaction resulting in a robust fibrous capsule formation. This allows the Silhouette thread-lift to demonstrate a more permanent result compared to alternative thread lifts as it acts as a filler with fibrin and collagen formation and with the mechanical tension on the thread. As stated in a recent publication by the authors, the efficacy of thread-lift sutures is controversial for several reasons with much of the data pertaining to other types of threads, such as Aptos® or Contour®. Currently, data of Silhouette InstaLift® are limited to review articles and case reports (Halepas, Chen, and Ferneini). Here, the authors demonstrated proof of concept with 21 patients. A retrospective review of patient records in a private practice was performed from January 1, 2019, to January 1, 2020, to study the efficacy of the Silhouette® thread-lift sutures. A total of 21 patients underwent the Silhouette InstaLift® procedure (20 females and 1 male). Patients’ age ranged from 38 to 69 years. Overall, 100% of the patients reported satisfactory results at 3-14 months postoperatively. Zero major complications were found in this patient population. To be considered a major complication, reports of at least 1 of the following inclusion criteria must have been made: infection, cellulitis, abscess, hypersensitivity reaction, nodules, granulomas, paranesthesia, facial palsy, overcorrection, and/or thread exposure/visibility. Minor complications, such as transient pain, swelling, bruising, and erythema, did occur as expected with any type of procedure. Surgeons should feel comfortable recommending these procedures to their aesthetic patients. Although their long-term efficacy is not as that of rhytidectomy, the InstaLift® procedure has a role in the cosmetic procedure arsenal, especially in younger patients. Knowledge of anatomical landmarks and facial anatomy is necessary in order for these procedures to be done safely. The next step would be to perform a larger trial with hopefully a 2-3-year follow-up period as the temporary effects are their greatest limitation. Other interesting follow-up studies would be comparing to rhytidectomy outcomes and patient satisfaction.