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Surgical Technique |

A Novel Bioabsorbable Device for Facial Suspension and Rejuvenation

P. Daniel Knott, MD; James Newman, MD; Gregory S. Keller, MD; David B. Apfelberg, MD
Arch Facial Plast Surg. 2009;11(2):129-135. doi:10.1001/archfacial.2008.519.
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To evaluate the safety and efficacy of a novel bioabsorbable suspension device made of a polymer of polylactic acid and polyglycolic acid (Endotine Ribbon), we performed a retrospective multi-institutional case study of 21 patients who underwent minimally invasive or open rhytidectomy with the use of the device in an ambulatory surgery center setting. Twelve patients had an excellent result, 7 a good result, and 2 a fair result. Early complications were corrected with technical modifications. Patient satisfaction was high. The Ribbon is a safe and effective adjunct for performing both minimally invasive and open rhytidectomy and cervical lifting.

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Figures

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Figure 1.

The polymer ribbon (Endotine Ribbon; Coapt Systems, Palo Alto, California), showing 17 rows of double tines with a long leash made from polyglycolic and polylactic acid.

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Figure 2.

The polymer ribbon in the protective housing. The “keel” allows it to be easily deployed or reinserted into the housing.

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Figure 3.

Fixation of the device to the fascia after removal of excess length of the leash.

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Figure 4.

Placement of the ribbon against the midplatysma through a minimal-access incision behind the auricle.

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Figure 5.

Posterosuperior traction on the ribbon to tighten the platysma, define the jawline, and rejuvenate the neck. Notice the anchoring stitch on the anterior aspect of the device (arrow).

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Figure 6.

Jowl elevation performed via a temporal hairline incision.

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Figure 7.

Patient 1. Right (A) and left (B) preoperative photographs and right (C) and left (D) 8-month postoperative photographs of a patient who underwent a cervical polymer ribbon lift without adjunctive procedures.

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Figure 8.

Patient 10. Right (A) and left (B) preoperative photographs and right (C) and left (D) 6-month postoperative photographs of a patient who underwent a cervical polymer ribbon lift in conjunction with open face- and neck-lift.

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