Several authors have described the use of “thread lifting” using permanent suture material and stable fixation for facial rejuvenation. Threads used for the Aptos technique, first published by Sulamanidze et al.,1–3 are made of 2-0 polypropylene monofilament with dents (Kolster Methods, Inc., Hayward, Calif.). These dents provide one-way travel of the thread through soft tissues aimed at preventing recurrent ptosis of the tissues.2 The thread is inserted under the skin, into the subcutaneous tissue using a long needle as a guide. The dents prevent the thread from moving in the opposite direction and provide a uniform gathering of the soft tissues, uplifting them and creating a new volumetric contour. A study of subdermal thread insertions using Aptos materials was carried out by Sulamanidze et al. from 1986 to 1989.2– 6 Threads 5 to 18 cm long were introduced in various sites of the face to create desired tissue traction. The author concluded that Aptos threads are useful as an alternative to surgery in the following circumstances: eyebrow lift and rejuvenation; forehead lift; cheek lift augmentation or rejuvenation; correction of nasolacrimal folds, nasolabial folds, or midface sagging; jowling and the loss of mandibular definition; early platysma correction; and neck rejuvenation.2 Lately, the technique regained some popularity in Israel because of an aggressive commercial marketing campaign. The thread suspension technique is appealing to patients frightened by surgery and/or anesthesia, and is attractive to patients who wish immediate results with a short recovery period. Unfortunately, the technique is also appealing to the ever-growing numbers of underqualified practitioners performing cosmetic procedures. According to Sulamanidze et al.,1–5 the suspension procedure is contraindicated in patients treated with anticoagulants. In addition, the technique is not recommended for patients with facial and scalp eczema or psoriasis and patients with a history of keloidal or hypertrophic scarring.