A New Indication for Barbed Threads: Static Reanimation of the Paralyzed Face

Purpose: The objective of this study was to present the authors' experience in static facial reanimation using a straightforward incisionless procedure adapted from techniques commonly used for performing minimally invasive facelifts. Materials and Methods: Seventeen patients were treated by static suspension using barbed sutures and all resulting changes were reviewed. The technique used for suture placement is described in detail, as are the author's tips for achieving the best esthetic and functional results. All patients had preoperative indication for physiotherapy and rehabilitation procedures (local massage and mirror therapy). Facial nerve function was evaluated using the Arianna Disease Scale. Results: The cosmetic outcome improved in all cases, with marked amelioration of the preoperative facial asymmetry. Oral competence was enhanced by elevating the oral commissure and reinforcing the cheek, and amelioration of symptoms related to lagophthalmos was achieved through increased support and decreased pull on the inferior eyelid. The addition of physiotherapy with specific rehabilitation exercises before the surgical intervention increased the success rate. Conclusion: This technique proved to be a good alternative to other static reanimation procedures because of its straightforward technique, availability, good outcomes, low complication rate, and ability to perform minor adjustments and corrections at any time. (C) 2017 American Association of Oral and Maxillofacial Surgeons