Minimally Invasive Suture-crossing Technique for Facial Contour Restoration Using Poly-l-lactic Acid/Polycaprolactone Aptos Threads

Background: Facial aging leads to progressive soft tissue descent, skin laxity, and loss of mandibular definition. Thread lifting has emerged as a minimally invasive approach to reposition and anchor tissues while stimulating collagen synthesis. This study presents a modified technique using Aptos Excellence Visage sutures with a strategic suture-crossing method to enhance cervicofacial contour. Methods: This retrospective study analyzed data from 22 participants who underwent the modified thread-lifting technique for cervicofacial rejuvenation. The procedure involved the insertion of 10 multidirectional barbed threads (5 per side) in a structured sequence, using a crossing pattern along the mandibular contour. Aesthetic outcomes were assessed using the visual analog scale for contour improvement and skin quality, combined with standardized 2-dimensional photography and 3-dimensional imaging for objective evaluation. Adverse events were systematically recorded. Results: High satisfaction was observed, with 90.9% of participants reporting significant improvements. Objective assessments confirmed enhanced mandibular contour and skin tightening. The procedure demonstrated a strong safety profile, with only transient edema and bruising, all resolving within 7 days. No cases of thread migration, persistent pain, or asymmetry were reported, supporting the predictability and stability of the technique. Conclusions: The modified thread-lifting technique offers a safe and effective solution for cervicofacial rejuvenation, combining immediate mechanical support with biostimulation. This approach provides a minimally invasive alternative for patients seeking natural, long-lasting aesthetic results. Further studies are warranted to confirm long-term efficacy.