Twenty-four months long-term follow-up report on the effect of poly lactic-co-glycolic acid suspension suture in Asian with mild-moderate face laxity

Abstract

Background: There was evidence of improvement in mid-face laxity using three pairs of suspension sutures in mid-face lifting in our early and mid-term follow-up.Objective: This 24-month prospective follow-up study aimed to determine the efficacy of mid-face lifting and lower jawline contouring using poly lactic-co-glycolic acid (PLGA) sutures in Asian patients.Methods: Ten healthy volunteers received three pairs of 8-cones bidirectional cones sutures at the mid-face. One of the ten volunteers lost to follow-up, and all remaining patients followed up for 24 months. Our primary outcome measure is the change in the facial laxity rating scale (FLRS), an "improvement" defined as at least "one-grade change" in FLRS. Other assessment parameters include the severity of the nasolabial fold (NLF), assessed on the wrinkle severity rating scale (WSRS). The secondary outcome measures were the self-satisfaction rating scale (SSRS) and global aesthetic improvement scale (GAIS), rated by participants at each follow-up interval.Results: A linear improvement in the mid-face was observed almost immediately after treatment, with progressive improvement up to at least 12 months following the intervention and no deterioration by 24 months. This improvement was significant (p<0.05), and the differences between before and after treatment at each follow-up interval were large (Cohen's d>0.8). Contour improvement for the lower face followed a similar trend, except for a delay in the observable differences at three months (Cohen's d=0.29, 0.8 at six weeks and three months, respectively). The differences in the level of patient satisfaction were significant (p<0.05) from 6 weeks to 24 months, peaking between 12 and 18 months, based on both the GAIS and SSRS ratings. No observed complications. Conclusion:Mid-facing lifting in Asian patients with mild-to-moderate laxity is safe and effective with PLGA bidirectional cone sutures, with concurrent improvement in the lower face contour and elevated patient satisfaction over the 24-month follow-up period.