Introduction: In the last thirty years, various techniques of face-lifting have been developed. Many of these operations require a long recovery. With the increased public awareness of cosmetic surgery, the demand for effective procedures with minimal downtime and quicker recovery is on the rise. We set out to examine a technique of facial rejuvenation with barbed sutures, originally described by Dr M.A. Sulamanidze, and its effectiveness. Materials and Methods: Twenty-seven patients were treated with the APTOS sutures for facial ptosis from May 2002 to October 2003. The patients were followed for 3 to 28 months. The areas treated were the brows, cheeks, jowls and neck. Digital images were taken at each preoperative and postoperative visit. Almost all of the cases (25 of 27) were performed under local anesthesia. The results were evaluated at each postoperative visit by the patients and the surgeons. Results: Two hundred and eighty-two sutures were placed in the 27 patients. The malar area was the most commonly treated (88.9% of patients) section of the face. The brows and jowls were the second most common area of treatment (40.7%). The neck was the least common area of treatment (29.6%). The patients' mean age was 50.9 years. The average follow-up time was 18.6 months. The results were evaluated by the patients and the surgeons based on a subjective rating of improvement when compared to the preoperation pictures in the specific area of treatment. Overallpatient improvement rating was highest in the malar region,at 55%, compared to a doctor improvement rating of 40%. Pearson correlation analysis showed that the patient's perceived degree of improvement was directly correlated (P < 0.01) with the patient's overall satisfaction. The most common reason for dissatisfaction was patient disappointSubmitted for publication May 26, 2005. From Inland Cosmetic Surgery (Dr Haiavy), Rancho Cucamonga, Calif. Retired from Inland Cosmetic Surgery (Dr Leventhal), Rancho Cucamonga, Calif. Corresponding author: Jacob Haiavy, MD, Inland Cosmetic Surgery, 9227 Haven Avenue, Suite 120, Rancho Cucamonga, CA 91730. ment with longevity of results. Complications encountered during the study were suture extrusion, bruising, pain, asymmetry, dimpling ofskin, and visible suture tracts. Conclusions: Placement of barbed sutures into the soft tissues ofthe face for facial lifting is a developing technique. The APTOS lift, as advocated by Dr Sulamanidze, is a limited procedure that is indicated primarily in patients with mild to moderate ptosis who are seeking a subtle improvement in their appearance that is temporary and requires minimal downtime. It is not a replacement for a facelift. When patients are properly informed and educated about the benefits and limitations of this procedure, the chances that they will be satisfied is much higher.