Ann Plast Reconstr Surg | Volume 4, Issue 2 | Research Article | Open Access

Use of Facial Sutures with Cones (Silhouette Lift*) in the Treatment of Facial Ptosis: Technique, Indications and Outcome in the Palliative Treatment of Facial Paralysis and for Rejuvenation Surgery

Sylvie Poignonec*

Department of Face and Neck Surgery, University Hospitals Pitié Salpêtrière - Charles Foix, France

*Correspondance to: Sylvie Poignonec 

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Since January 2008, the author has been interested in the use of suspension wires for treating facial ptosis. Initially this concerned the palliative treatment of certain facial paralyses where no other technique was possible or appropriate, and simultaneously, for the treatment of ptosis of the midface during ageing in healthy subjects. In all cases, the patients wanted non- or minimally invasive techniques, performed under local anesthetic and as outpatient treatments. In a significant number of cases, additional procedures (fat grafting, canthopexy) were combined with the suspension using silhouette* sutures. The particular characteristic of these sutures is that they contain polylactic acid cones absorbable over the course of a few months and nodes between each cone in a non-absorbable polypropylene wire; this is not merely a passive suspension of tissue in the malar and cheek region,
but the inducing of a healing response with fibrosis and neocollagenesis, prolonging the action of the wire beyond the absorption of the cones. The sutures can be readjusted or retightened 1 to 2 years later by accessing them in the temporal region of their insertion. It is possible to combine other surgical procedures with this technique, especially lipofilling, canthopexy, plasty of the nasolabial fold, etc.


Treatment of facial ptosis; Serrated sutures; Face-lift; Facial paralysis; Mid-face rejuvenation; Palliative surgery of facial paralysis; Tightening wires; Canthopexy


Poignonec S. Use of Facial Sutures with Cones (Silhouette Lift*) in the Treatment of Facial Ptosis: Technique, Indications and Outcome in the Palliative Treatment of Facial Paralysis and for Rejuvenation Surgery. Ann Plast Reconstr Surg. 2020;4(2):1057..

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