Barbed sutures for aesthetic facial plastic surgery: indications and techniques.

This article describes the indications and techniques related to the use of barbed sutures in facial aesthetic plastic surgery. The principle applications for barbed sutures in facial aesthetic plastic surgery are those involving lifts of the brow, midface, and the lower face and neck. Usually all three areas require surgical maneuvers to create a harmonious rejuvenation. Regardless of where in the face bidirectional barbed sutures are planned, five essential steps are needed: (1) making the incision or incisions, (2) dissecting soft tissue, (3) proximal anchoring, (4) deploying threads, and (5) molding soft tissue.