The Science of Absorbable Poly(L-Lactide-Co-ε-Caprolactone) Threads for Soft Tissue Repositioning of the Face: An Evidence-Based Evaluation of Their Physical Properties and Clinical Application

The use of bioabsorbable threads has become a common minimally invasive technique for the nonsurgical lifting of sagged facial tissues. It entails the passage of barbed threads that form a support structure under the skin of the face and neck to mechanically reposition sagging tissue. Poly(L-lactide-co-ε-caprolactone) has long been used as absorbable sutures and as such has a well-demonstrated efficacy and safety profile. This biomaterial also has a well-defined biocompatibility and degradation profile. All studies reviewed in this paper show that thread lifting with absorbable barbed threads is an effective and well-tolerated procedure for correction of ptosis in facial and neck soft tissue and is associated with minor and reversible adverse effects. Most patients and surgeons consider the procedure satisfactory, with good to excellent results. This publication reviews the literature and clinical data supporting the degradation, absorbability, biocompatibility, safety, and effectiveness of these threads when used for tissue repositioning and facial rejuvenation procedures.