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Absorbable Suspension Sutures: Recommendations for Use in a Multimodal Nonsurgical Approach to Facial Rejuvenation
Background:
Absorbable suspension sutures are an effective nonsurgical modality for correction of ptosis and tissue repositioning in the face and neck. The PLLA/PLGA suture is entirely absorbable and has a dual effect in that it both lifts tissues and induces collagenesis, thereby restoring contour. In clinical practice, nonsurgical modalities are rarely used in isolation, and combination treatments with fillers, neuromodulators, lipolysis, and energy-based devices are common.
Objectives:
The aim of this study was to share the authors’ extensive experience in safely combing absorbable suspension sutures with other modalities in order to achieve optimal aesthetic outcomes for patients. The current work provides guidance to physicians who wish to incorporate absorbable suspension sutures into their aesthetics practice.
Methods:
The authors discuss patient selection and expectation setting, rationale for selection and ordering of treatments, and optimal treatment spacing. Technologies discussed include fillers, neuromodulators, microfocused ultrasound with visualization (MFU-V), radiofrequency, lasers and intense pulsed-light (IPL), microneedling, and lipolysis.
Results:
The authors share their approaches for combining nonsurgical techniques and present case studies illustrative of outcomes achievable through combination treatment with absorbable suspension sutures. The technical considerations for safely combining treatments such that optimal additive or synergistic benefit is reached for a particular patient are discussed.
Conclusions:
By combining nonsurgical modalities that address each of the four Rs (Repositioning tissue, Relaxation of hyperkinetic musculature, Resurfacing, and Revolumization),1 nonsurgical patient outcomes can be further improved. Absorbable suspension sutures represent a unique technology in that they are able to provide significant support to ptotic tissue in the face and neck. J Drugs Dermatol. 2021;20(1):23-29. doi:10.36849/JDD.5684.
