INTRODUCTION
Facial aging is the result of multiple interrelated processes. Reduced collagen and denaturation of the extracellular elastin fiber matrix leads to development of laxity and the atrophy characteristic of aging.2 In addition, volume loss in facial fat pads and bone resorption results in diminished facial volume, an issue compounded by attenuation of retaining ligaments and involution of bony attachments.3,4 Together, these processes lead to descent of facial features and inversion of the triangle of youth.5 Changes to skin texture and the development of static and dynamic lines are also apparent.The impact of the intrinsic factors detailed above is accompanied by the effects of extrinsic factors such photodamage due to UV exposure, damage due to smoking, or exposure to air pollution.4,6
In the arsenal of nonsurgical tools at the disposal of plastic surgeons and dermatologists is a wide array of devices designed to individually address elements of facial aging. Among these, absorbable suspension sutures are a unique technology for nonsurgical repositioning of facial tissue. Comprised of poly- L-lactic acid (PLLA) and poly-L-glycolide (PLGA) copolymers (82% PLLA monomers and 18% PGLA monomers), sutures are placed in the subcutaneous layer where they are able to support repositioned tissue and stimulate collagenesis. Along the length of the suture monofilament, bidirectional cones (4, 6, or 8 cones per side) serve to support repositioned tissue (Figure 1). On the inferior side of the suture, tissue is advanced and supported by the cones while cones on the superior side are used to anchor repositioned tissue in an elevated position.7
In the arsenal of nonsurgical tools at the disposal of plastic surgeons and dermatologists is a wide array of devices designed to individually address elements of facial aging. Among these, absorbable suspension sutures are a unique technology for nonsurgical repositioning of facial tissue. Comprised of poly- L-lactic acid (PLLA) and poly-L-glycolide (PLGA) copolymers (82% PLLA monomers and 18% PGLA monomers), sutures are placed in the subcutaneous layer where they are able to support repositioned tissue and stimulate collagenesis. Along the length of the suture monofilament, bidirectional cones (4, 6, or 8 cones per side) serve to support repositioned tissue (Figure 1). On the inferior side of the suture, tissue is advanced and supported by the cones while cones on the superior side are used to anchor repositioned tissue in an elevated position.7