SMAS Plication with Absorbable Barbed Sutures

BACKGROUND: SMAS plication is the simplest approach to treat the deep soft tissue structures during face-lifting procedures. Many different techniques were described for SMAS plication using either absorbable or non absorbable sutures, with either simple sutures or with running continuous sutures. Suture technology, although often overlooked, is a major interest to anyone who performs operations. Barbed sutures allow tissue approximation without the need for surgical knots, and they spread the tension more evenly across the suture line. METHODS: This paper describes SMAS plication with 2-0 V-Loc absorbable barbed sutures manufactured by Covidien. Procedures were done under local anesthesia and I.V. sedation. RESULTS: This technique was used in 191 patients between January of 2011 and March of 2014, producing shorter plication time, without knots that can be felt through the skin and without related complications. DISCUSSION: Plication of the SMAS is one of the methods to treat the deep soft tissue structures during face-lift. Barbed sutures consist of standard suture materials with tiny barbs cut into the length of the filament. This configuration allows tissues to be approximated without surgical knots. The barbs secure the suture in the tissues and spread the tension evenly over the entire suture. The tissue is anchored in place as soon as the suture pass through them, with no drawback. The use of these sutures for SMAS plication are convenient to use, it allows exact positioning of the sutures, with shorter plication time and without any knots that can be felt under the skin after the operation. CONCLUSION: SMAS plication with Absorbable barbed knotless sutures is easily performed under local anesthesia, with no extra complications and very good results.