title: Novel face-lift suspension suture and inserting instrument: use of large anchors knotted into a suture with attached needle and inserting device allowing for single entry point placement of suspension suture. Preliminary report of 20 cases with 6-to 12-month follow-up.
abstract: BACKGROUND
  Various suspension suture techniques exist to elevate the mid-face, jowls, and neck.
  
  
  OBJECTIVE
  To assess safety and efficacy of a new suspension suture and inserting instrument with both standard and minimal incision (no-skin-excision) face-lifts.
  
  
  METHODS
  A new type of multianchor suspension suture assembled from commercially available 2-0 absorbable monofilament material, with 5 to 9 equally spaced knots through which are secured 7 to 9 mm bits of 0 thickness similar suture material, and an attached straightened needle, was used to elevate and suspend facial tissues to temporal or mastoid fascia. The suspension sutures are placed in the deep subcutaneous tissues, just above the superficial musculo aponeurotic system (SMAS), by use of a novel, blunt instrument, which does not require a second, distal exit point. The suspension suture distal end floats free. The proximal needle end is sutured to fascia. The suture was used on 20 patients. Fourteen of them underwent pure, "no-skin-excision," suspension lifts. Six had suspension suture elevation of the mid-face in conjunction with relatively conservative open lifts. Nine- to 12-month results were evaluated.
  
  
  RESULTS
  With open face-lifts, 9- to 12-month results are excellent with significant persistence of the correction initially achieved. Resulting scars remained fine line. There were no complications. With pure suspension lifts, initial results were impressive. By 6 months, correction started to fade. By 12 months 100% of initial correction for jowls, and 80 to 100% for mid-face, appeared lost. Recovery time was 2 to 4 days. There were no significant complications.
  
  
  CONCLUSIONS
  Large multianchor, absorbable monofilament sutures can safely and effectively enhance results of conservative lifts, with remarkable elevation of the mid-face not achievable with simple SMAS flaps. These suspension sutures can easily and safely achieve impressive, though relatively short-term results, with a minimal incision, "no-skin-excision" technique.
authors.affiliation: Cosmetic Surgery Unit, Division of Dermatology, University of California at Los Angeles, Riverside, California 92501, USA. sorin@surfbest.net
authors.forename: Sorin
authors.initials: S
authors.lastname: Eremia
authors.forename: Mark A
authors.initials: MA
authors.lastname: Willoughby
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D017060:Patient Satisfaction; D015361:Rhytidoplasty / Q000295:instrumentation* / Q000379:methods*; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D013997:Time Factors; D016896:Treatment Outcome