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Suspension sutures in facial reconstruction
1Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois, USA. jrobin5@lumc.edu
Summary
Suspension sutures are valuable tools in facial cosmetic surgery and reconstruction. They help achieve linear closures, prevent distortions, and improve aesthetic outcomes by mimicking natural facial contours.
Area of Science:
- Plastic Surgery
- Facial Reconstruction
- Cosmetic Surgery
Background:
- Suspension, pexing, or tacking sutures have applications in both cosmetic and reconstructive facial surgery.
- These techniques are increasingly utilized in complex facial reconstructions.
Purpose of the Study:
- To elucidate the applications and benefits of suspension sutures in facial cosmetic surgery and reconstruction.
- To detail the mechanism by which suspension sutures achieve desired aesthetic and functional outcomes.
Main Methods:
- The technique involves attaching suspension sutures to stable facial structures like the orbital rim or zygomatic arch.
- Tissue advancement is achieved by incorporating the superficial musculoaponeurotic system into the suture.
- Anchoring involves a U-shaped pass into the fascia extending to the periosteum.
Main Results:
- Suspension sutures facilitate linear wound closure and prevent distortion of free margins (e.g., ectropion, eclabium).
- They effectively prevent tenting across concavities and stabilize closure lines at cosmetic unit junctions.
- While they can reduce scar spreading in wounds under tension, they do not eliminate it entirely.
Conclusions:
- Suspension sutures are instrumental in achieving linear closures, preventing free margin distortion, and fixing closure lines at cosmetic unit junctions.
- By redirecting tension, these sutures mold facial contours to replicate natural folds and curves.
- Their judicious use simplifies aesthetic reconstructive procedures and enables segmental facial reconstruction aligned with cosmetic unit principles.