Expert Consensus on Soft-tissue Repositioning Using Absorbable Barbed Suspension Double-needle Threads in Asian and Caucasian Patients

Salvatore P Fundaro; Chee Leok Goh; Kwun Cheung Hau; Hyoungjin Moon; Purita P Lao; Giovanni Salti

doi:10.4103/JCAS.JCAS_138_19

Expert Consensus on Soft-tissue Repositioning Using Absorbable Barbed Suspension Double-needle Threads in Asian and Caucasian Patients

J Cutan Aesthet Surg. 2021 Jan-Mar;14(1):1-13. doi: 10.4103/JCAS.JCAS_138_19.

Authors

Salvatore P Fundaro¹, Chee Leok Goh², Kwun Cheung Hau³, Hyoungjin Moon⁴, Purita P Lao⁵, Giovanni Salti⁶

Affiliations

¹ Aeshtetic Medicine Department, MultiMed Poliambulatorio e Day Surgery, Bologna, Italy.
² Department of Dermatology, National Skin Centre, Singapore.
³ Dermatology Department, Perfect Skin Surgery Centre, Central, Hong Kong.
⁴ Aesthetic Surgery, Moons Aesthetic Surgery Clinic, Seoul, Korea.
⁵ Department of Dermatology, Makati Medical Center, Makati City, Philippines.
⁶ Department of Aesthetic Medicine and Aesthetic Plastic Surgery, Medlight Institute, Florence, Italy.

Abstract

Bioabsorbable barbed suspension double-needle threads have recently been thrust into the limelight as a minimally invasive alternative for skin repositioning. When compared to surgical face lifting, use of these threads requires reduced procedural and recovery time, no general anesthesia, confers immediate patient satisfaction, with no cutaneous incisions and no apparent scars, and is more tolerable. There is currently limited literature providing clinical guidance on the use of these suspension threads; hence, this consensus document was developed as the first publication to discuss the technical aspects of facial rejuvenation using the double-needle barbed bioabsorbable and hydrolyzable thread composed of copolymer poly (ε-caprolactone-co-L-lactic acid) or PC_xL_yA, that is, Definisse threads. The Board of Aesthetic Leaders and Investigators (BALI) is a panel of dermatologic surgery and plastic surgery experts who convened last July 2018 in Indonesia to discuss the aforementioned challenges. A thorough literature search was done where a review of specific technical recommendations based on prevailing practice and available guidelines pertaining to suspension threads were described and are summarized in this paper. A detailed list of pretreatment recommendations in the assessment of both Asian and Caucasian facial types, aging facial types, guidance on insertion techniques, and aftercare instructions for clinicians to review has been included here.

Keywords: Asian; Caucasian; The use of barbed thread suspension threads repositioning and tightening of facial tissue is now recognized as an important tool for aesthetic medicine. Threads can be used to achieve a nonsurgical soft-tissue repositioning to a certain extent. Procedural and technical aspects have been outlined to help learning practitioners understand the versatility of the thread for use in Asian and Caucasian facial types.; bioabsorbable barbed suspension double-needle thread; consensus guidelines; poly (ε-caprolactone-co-L-lactic acid).

Publication types

Review