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Facial Plast Surg 2020; 36(03): 268-275
DOI: 10.1055/s-0040-1712469
Original Research
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Influence of the Insertion Angle on Middle and Lower Face Tissue-Mechanics When Treating the Nasolabial Folds with Facial Suspension Threads—An Experimental Split-Face Cadaveric Study

Martin Braun   *
1   Vancouver Laser and Skin Care Centre, Vancouver, Canada
,
Konstantin Frank   *
2   Department for Hand, Plastic and Aesthetic Surgery, Ludwig – Maximilians University Munich, Munich, Germany
,
David L. Freytag
2   Department for Hand, Plastic and Aesthetic Surgery, Ludwig – Maximilians University Munich, Munich, Germany
,
Robert H. Gotkin
3   Private Practice, New York, New York
,
Nirusha Lachman
4   Division of Plastic Surgery, Department of Anatomy and Department of Surgery, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota
,
Gloria Hsu
5   GLO MDS, Toronto, Canada
,
Diana L. Gavril
6   Private Practice, Cluj-Napoca, Romania
,
Maria V. Silva
7   Private Practice, Buenos Aires, Argentina
,
Christie Bialowas
8   Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, New York
,
Sebastian Cotofana
9   Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
› Author Affiliations
Further Information

Publication History

Publication Date:
08 June 2020 (online)

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Abstract

A novel treatment approach to address the nasolabial fold is the insertion facial suspension threads. However, there is a paucity of data available to guide insertion techniques and material selection. Three female and two male cephalic specimens of Caucasian ethnicity (73.6 ± 6.5 years; 21.41 ± 2.2 kg/m2) were included into this experimental split-face study. One facial side was treated with polycaprolactone (PCL) thread: 180 mm, bidirectional, 18G 100 mm cannula, 20 degrees trajectory, preauricular approach whereas the contralateral side was treated with polydioxanone (PDO) thread: 100 mm, bidirectional, 19G, 60 mm cannula, 50 degrees trajectory, infraorbital approach. Three-dimensional imaging outcome measures included vertical and horizontal skin displacement and volume changes at the nasolabial sulcus, at the labiomandibular sulcus, and along the jawline. Comparing PCL 180 mm 20 degrees to PDO 100 mm 50 degrees: vertical lifting effect 1.42 ± 2.63 mm versus 1.24 ± 1.88 mm (p = 0.906); horizontal lifting effect 3.42 ± 1.44 mm versus –2.02 ± 1.84 mm (p = 0.001); nasolabial volume change –0.80 ± 0.65 mL versus –0.52 ± 0.17 mL (p = 0.367); labiomandibular volume change –0.45 ± 0.42 mL versus –0.16 ± 0.16 mL (p = 0.191); jawline volume change 0.02 ± 0.43 mL versus –0.01 ± 0.21 mL (p = 0.892). The study provides objective evidence for the short-term effectiveness of facial suspension threads in treating the nasolabial folds. The results point toward a better aesthetic outcome when utilizing long facial suspension threads that can effect full-face changes as compared with short facial suspension threads.

Keywords

facial suspension threads - face - anatomy - soft tissue repositioning

* Both authors contributed equally to this work.