Fixed-Tension Sutures for Face and Neck Lifting

ElKafrawi, Hossam Y.

doi:10.21608/ejprs.2022.220414

Fixed-Tension Sutures for Face and Neck Lifting

Document Type : Original Article

Author

Hossam Y. ElKafrawi

The Department of Plastic Surgery, Faculty of Medicine, Alexandria University

10.21608/ejprs.2022.220414

Abstract

Background: Surgical facelifts has always been the
pinnacle of facial rejuvenation, however in face of an evergrowing
trend towards less invasive techniques, the ability
of plastic surgeons to sell this idea to their customers is
ever decreasing. Most of our patients are unwilling and
afraid of a long downtime, postoperative scars and possible
complications.
Thread lifting has been introduced to turn a facelift into
a less invasive, scarless, low complications technique. However
the absorbable PDO sutures, which are well advertised and
widely used by cosmetologists, have failed to gain the acceptance
of plastic surgeons based on their lack of durability, lack
of true fixation, and the fact that they work on the skin, not
the SMAS. Few thread techniques are available that combine
the use of permanent threads, stable fixation point, and work
on the SMAS layer. However, such techniques require the
use of expensive suture materials or specially designed instruments
and need special training courses, which limit their use
in our society being a very cost sensitive market.
Patients and Methods: In this paper, the author presents
his modification of the fixed, permanent suture technique,
using only widely available straight needles, and commercially
available coated polyester sutures (Ethibond), and was performed
in 50 patients over the last two years. The patient had
only mild or moderate sagging that could benefit from SMAS
suspension without the need for skin excision, patient with
marked skin laxity were advised for a surgical face lift.
Conclusion: The technique is intended for a plastic surgeon
with moderate to good experience of face lift as it needs the
ability to assess the different planes of the face and be able
to grab the SMAS in the sutures. The technique offers good
results in patient with mild to moderate sagging and should
be thought of as a substitute for surgical face lift.

Keywords

Main Subjects

Aesthetics

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