Prolene Suture Suspension Within a Multimodal Facial Rejuvenation Protocol: A 30-Year Experience

With rising life expectancy and increasing emphasis on quality of life, demand for facial rejuvenation procedures has markedly grown. This study describes a 30-year single-surgeon experience with a minimally invasive suture suspension technique and reports descriptive findings on patient satisfaction in a retrospective case series.

A retrospective chart review was conducted on 4400 patients (3800 female and 600 male) aged 18 to 65, who underwent brow, temporal, or cheek suspension. All procedures were performed without surgical dissection, using small stab incisions for permanent suture placement. In selected cases, the technique was combined with micro-fat grafting or laser resurfacing. Patient satisfaction was assessed during routine follow-up visits using a non-validated 5-point Likert scale as a descriptive measure.

A total of 2500 brow and 1900 cheek/temporal suspensions were performed. Among patients with documented ratings, 93.2% reported satisfaction scores of 4 or 5 on this descriptive scale. Common early postoperative findings included transient swelling, dimpling, and bruising. Revision under local anesthesia was necessary in 2.3% of cases. The longevity of results was estimated from photographic documentation and patient feedback in a subset of patients. In this multimodal treatment cohort, aesthetic improvements appeared to be maintained over time in selected patients. However, the duration of effect could not be systematically quantified because follow-up was retrospective and not standardized.

Within the limitations of this retrospective descriptive case series, this suture suspension technique appears to be a safe, well-tolerated, and minimally invasive option for selected patients with early facial aging, and it can be combined with adjunctive cosmetic procedures as part of a multimodal protocol.

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