Mid-face reshaping using threads with bidirectional convergent barbs: A retrospective study

J Cosmet Dermatol. 2021 Jun;20(6):1591-1597. doi: 10.1111/jocd.14038. Epub 2021 Apr 5.


Background: Minimally invasive procedures, such as thread suspension techniques, are a growing trend for facial rejuvenation. However, not enough data are available on the efficacy, outcomes, and morbidity of suture suspension techniques in mid-face reshaping.

Aims: Our goal was to assess treatment outcomes and patient satisfaction following mid-face reshaping using threads with bidirectional convergent barbs (DefinisseTM free floating threads).

Patients/methods: We performed a retrospective analysis of 60 patients who underwent treatment for mid-face reshaping using DefinisseTM free floating threads. Response to treatment was assessed at 6 months using the mid-face-specific Mid-Face Volume Deficit scale (Allergan® ), Global Aesthetic Improvement and FACE-QTM scales.

Results: Sixty patients underwent mid-face treatment with the suspension thread technique (mean age 51.3, 90% female). No concomitant procedures were done. A reduction by one point or more in the Mid-Face Volume Deficit Scale (MDFVS) score treatment was seen in all patients after 6 months. Mean overall MFVDS and FACE-QTM scores were significantly improved. On the GAIS, most patients were rated as improved or better both by the evaluating investigators and during self-assessment. No major complications were observed, and none of the patients requested the removal of the threads (mean follow-up 9.8 months, range 6-14 months).

Conclusion: Our results suggest that mid-face reshaping with DefinisseTM free floating threads is a safe and reliable procedure characterized by low complication rates and good esthetic results. This minimally invasive procedure is a good alternative for normal or combination skin patients who refuse or want to delay the need for traditional rhytidectomy.

Keywords: bidirectional threads; mid-face lift; minimally invasive.

MeSH terms

  • Face
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Rejuvenation
  • Retrospective Studies
  • Rhytidoplasty*
  • Skin Aging*
  • Suture Techniques