Barbed sutures inserted by closed technique offer temporary improvement to patients seeking facial rejuvenation. The supposed advantages of barbed sutures over open facelift and browlifting techniques include less morbidity, downtime, and financial strain, and the fact that patients are more accepting of a less than optimal result than with an open technique. Unlike other temporary procedures, such as those using Botox and hylauronic fillers, which disappear over time, permanent barbed sutures remain as a foreign body that must be negotiated when subsequent open techniques are performed. It is the authors' experience that many patients present for open facelift procedures because of dissatisfaction or complications following use of closed barbed sutures. When approaching an open facelift after closed barbed suture placement, surgeons should be cognizant of unique technical problems and challenges that might compromise the final facelift result; these must be overcome. Although several supposed advantages for facial rejuvenation with the use of closed barbed sutures are known, the number of sound scientific long-term studies on this procedure is lacking. A review of the literature reveals reported complications of barbed sutures as listed in Table I. These complications are often ameliorated by barbed suture removal or local remedial surgery. Dissatisfaction with the temporary result of closed barbed suture placement, which may have been inappropriate and ineffectual for the degree of facial or brow laxity, leads a patient to seek predictable, effective, and more efficient cosmetic procedures to assist with facial aging in the future.