Straight-Line Vector Planning for Optimal Results With Silhouette InstaLift in Minimally Invasive Tissue Repositioning for Facial Rejuvenation

July 2018 | Volume 17 | Issue 7 | Original Article | 786 | Copyright © July 2018

Z. Paul Lorenc MD FACS,a David Goldberg MD JD,b Mark Nestor MD PhDc

aLorenc Aesthetic Plastic Surgery Center, New York, NY; Department of Plastic Surgery, Lenox Hill Hospital, New York, NY bSkin Laser & Surgery Specialists of NY/NJ; Icahn School of Medicine at Mount Sinai; New York, NY Fordham Law School, New York, NY cCenter for Clinical and Cosmetic Research, Center for Clinical Enhancement, Aventura, FL; Department of Dermatology and Cutaneous Surgery and the Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL

been no serious adverse events and that noticeable bruising has occurred in less than 5% of patients. While irregularities and tissue dimpling, secondary to tissue advancement, are not uncommon, they resolve within one week.Representative results of patients treated with the technique outlined above are presented here.Patient 1: A 50-year-old female patient shown at baseline, 10 months, and 24 months post-treatment (Figure 5). The patient was treated with 8-cone Silhouette InstaLift™ sutures: two in the mid-face and one in the jowl (SVLP pictured, Panel A). Note the effect on the nasolabial fold and jowl, as well as the revolumization present, due to the biostimulatory effects of the suture. Courtesy Z. Paul Lorenc, MD, FACS.Patient 2: A 60-year-old female patient with jowling around the mandibular boarder and obtuse neck angle (Figure 6). The patient was treated with three 8-cone Silhouette InstaLift™ sutures, 1 in the jowl area and 2 in the neck at the first cervical crease (SLVP pictured, Panel A). Immediately post-procedure (Panel B), a pronounced advancement was apparent with a concomitant elimination of the jowl, along with a delineation of the cervicomental angle. Courtesy Z. Paul Lorenc, MD, FACS.Patient 3: A 55-year-old female patient shown at baseline, 6 months, and 24 months post-treatment (Figure 7). The patient was treated with six 8-cone Silhouette InstaLift™ sutures: three in the mid-face R/L (SVLP pictured, Panel A). Note the enduring reconntouring in the midface at 24 months. Courtesy Z. Paul Lorenc, MD, FACS.


Utilization of absorbable suspension sutures provides unique benefits due to its biomechanical and physiochemical composition. In addition to the ability to reposition soft tissue along a two-dimensional axis, the InstaLift suture provides three-dimensional correction due to it’s biostimulatory nature. For example, as tissue is advanced along the supero-lateral vector, atrophied and ptotic fat compartments are compressed, alleviating some of the deflation characteristic of the volume loss that accompanies aging.17 Furthermore, the PLLA/PLGA composition of the suture/cones stimulates fibroblasts, which culminates in the synthesis of Type I collagen, thereby addressing volume loss through yet another avenue.9 Even as the sutures themselves dissolve, the fibrotic response continues to bolster the durability of the initial procedure.17 While the application of Silhouette InstaLift alone is rarely a complete answer to correcting facial aging, it is a powerful tool for use in concert with other approaches such as fillers, neurotoxins, or energy-based devices, or as a secondary approach for patients who have already undergone a surgical facelift.While the evaluation of Silhouette InstaLift technology and techniques is still at an early stage, the success of the authorsFIGURE6figure7