Mini-midface Lift Using Polydioxanone Cog Threads

Date 25 June 2025

INTRODUCTION As facial aging progresses, soft tissue ptosis occurs in every part of the face due to gravitational effects. Particularly in the case of the anterior cheek, which can signify youth, the downward migration of adipose tissue and volume can lead to a deeper-appearing nasolabial fold and an older-appearing face.1,2 A variety of conventional midface lifting techniques have been introduced to increase the volume of the reduced anterior cranial region and to correct soft tissue ptosis.3–5 The most representative conventional method involves a lower blepharoplasty incision with an extensive dissection of the subperiosteal layer, and the soft tissue is mechanically fixed in an upward direction through a device, such as an endotine,6 followed by remnant skin excision. However, these procedures require sedation or general anesthesia and a long recovery time for wound healing. Additionally, various complications can occur,7,8 burdening the decision-making process for the patients. In recent years, especially in East Asia, polydioxanone (PDO) threads of various lengths and shapes have been approved for use,9,10 and many lifting procedures can now be performed in a much less invasive manner.11–13 In an effort to improve patient satisfaction, we used cog threads made of PDO material to perform a mini-midface lift that has a shorter operative time and postoperative downtime and yields satisfactory results without incisions or postoperative scarring. Herein, we show the effect of this technique in terms of both patient satisfaction and an objective assessment of the physical change in the midface area.

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