Expert Consensus on Absorbable Advanced Suspension Technology for Facial Tissue Repositioning and Volume Enhancement

July 2017 | Volume 16 | Issue 7 | Original Article | 661 | Copyright © July 2017

Mark S. Nestor MD PhD,a Glynis Ablon MD,b Anneke Andriessen PhD,c Julius Few MD,d Michael H. Gold MD,e David J. Goldberg MD PhD,f Z. Paul Lorenc MD,g Stephen Mandy MD PhD,h and Susan H. Weinkle MDi

aCenter for Clinical and Cosmetic Research, Center for Clinical Enhancement, Aventura, FL; University of Miami Miller School of Medicine, Miami, FL bUniversity of California, Los Angeles, CA; Ablon Skin Institute Research Center, Manhattan Beach, CA cUMC St Radboud, Nijmegen & Andriessen Consultants, Malden, The Netherlands dFew Institute for Aesthetic Plastic Surgery, Chicago, IL; University of Chicago Pritzker School of Medicine, Chicago, IL; Northwestern University, Evanston, IL eGold Skin Care Center, Nashville, TN; Tennessee Clinical Research Center, Nashville, TN; Vanderbilt University School of Nursing, Nashville, TN; Meharry Medical College, School of Medicine, Nashville, TN fSkin Laser & Surgery Specialists of NY/NJ; Icahn School of Medicine at Mount Sinai; New York, NY Fordham Law School, New York, NY gLorenc Aesthetic Plastic Surgery Center, New York, NY; Department of Plastic Surgery, Lenox Hill Hospital, New York, NY hSouth Beach Dermatology, Miami Beach, FL; Miller School of Medicine University of Miami, Miami Beach, FL iBay Area Medical Complex, West, Bradenton, FL


BACKGROUND: Signs of facial aging include wrinkles, loss of subcutaneous volume, decreased tone, texture, and sagging of the skin. The objective of this review is to determine whether facial suspension absorbable sutures are a safe and effective modality for facial rejuvenation.

METHOD: A group of US plastic surgeons and dermatologists who practice medical aesthetics convened to review evidence obtained from literature searches and to reach a consensus on clinical practice guidelines for the use of facial absorbable suspension sutures.

RESULTS: Currently, there are different types of lifting sutures available. Absorbable, facial suspension sutures allow for superior repositioning of tissue along a vector line together with the added benefit of volumization of the area. These benefits are for patients who have moderate facial aging and require treatment beyond the use of injectable products only.

CONCLUSIONS: Treatment with absorbable facial suspension sutures, when performed properly, is associated with minor and infrequent complications and offers a beneficial clinical alternative to traditional facial rejuvenation techniques.

J Drugs Dermatol. 2017;16(7):661-666.


The aging face involves changes in all facial structures, including skin and soft tissues, muscle, and bone.1-4 Typical signs of facial aging include wrinkles, loss of subcutaneous volume, decreased tone, texture, and sagging of the skin.1 Connective tissue of the skin becomes thinner and elastic fibers undergo a collapse. These changes also apply to the superficial muscular aponeurotic system and to the muscular tissue.4,5 In the aging face, volume changes are also associated with the loss of craniofacial skeletal support of the overlying soft tissue.1-4 In addition, redistribution and involution of superficial and deep fat leads to volume loss, contributing to the loss of malar projection and apparent deepening of the nasolabial folds.5,6 The surgical facelift procedure to correct advanced facial aging can be an elaborate procedure requiring anesthesia with a significant