Self-retaining barbed sutures, innovations for nonsurgical facial and neck rejuvenation, are currently available as short APTOS threads or long WOFFLES threads. The author uses APTOS threads for malar rounding, facial tightening and firming, and uses WOFFLES threads as a sling, suspending ptotic facial tissues to the firm, dense tissues of the temporal scalp. (Aesthetic Surg J 2004;24:582-587.) Nonsurgical facial rejuvenation is the Holy Grail of aesthetic surgery and has stimulated a decades-long, if not centuries-long, search for innovative techniques. Persistence of results and safety have been 2 major obstacles in achieving this goal. Facial rejuvenation has traditionally included a face lift, neck lift, and upper and lower blepharoplasties. These procedures involve significant recovery time, potential complications, and results that may not restore patients to the way they looked when they were younger. Treatments for eradicating wrinkles, such as Botox (Allergan, Irvine, CA), narrowing lower facial width (Botox facial sculpting), and improving facial sheen (Mesobotox); synthetic fillers for volumetric restoration or enhancement of facial contours; and a wide variety of no downtime facial treatments1 have brought us closer to achieving the instant gratification that patients want. However, what has eluded us is a safe and effective “lunch hour” procedure for elevating and redraping the soft tissues in an upward direction, with minimal or no patient downtime. The smooth suture elevations of Fernandes (oral personal communication, 2002), Graziosi,2 and Erol3 provided simple solutions to brow or midface elevation with little morbidity, but the results were unpredictable. Sutures tended to cut out too easily, and puckering and pleating of the surrounding skin were disturbing, resolving with a concomitant loss of lifting effect. Suture suspension techniques of Keller, 4 Sasaki and Cohen,5 and De Cordier and Vasconez6 have shown encouraging results but require some form of tissue dissection and belong in the surgical category because they have appreciable downtime. In recent years, barbed sutures have been proposed as the method to achieve a nonsurgical face lift. This technique has captured the interest of patients and surgeons worldwide. However, experience has taught us that new techniques may emerge, become popular, and then quickly fade into oblivion when they do not live up to their promise or are replaced by newer and better technology. Here I will describe the current status of barbed sutures, with consideration as to whether they will stand the test of time and achieve what they promise. Since 2002 I have had experience with more than 200 APTOS and WOFFLES lift procedures using the WOFFLES threads (Kolster Methods Inc., Corona, CA).