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

Phoebe Kar Wai Lam; Chi Pun Fung; James Yui Lam; Wang Lung Luk; Alvin Ka Wai Lee; Cheuk Hung Lee; Paul Man Kei Tam; Edwin Kwan Chark Lau

doi:10.25056/JCM.2022.6.1.8

Original Article

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J Cosmet Med 2022; 6(1): 8-12

Published online June 30, 2022

https://doi.org/10.25056/JCM.2022.6.1.8

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

Phoebe Kar Wai Lam, MBCHB (OTAGO), MRCS (EDIN), MSCPD (CARDIFF)¹, Chi Pun Fung, MBBS, DFM, DPD², James Yui Lam, MBBS (HK), MRCSED, PGDIPCLINDERM (QMUL)³, Wang Lung Luk, MBBS, MSc, FCOHK, FCSHK⁴, Alvin Ka Wai Lee, MBChB (CUHK), DCH (Sydney), Dip Derm (Glasgow), Ms Clin Derm (Cardiff), Ms PD (Cardiff)⁵, Cheuk Hung Lee, MBBS (HK), FHKAM (MED), FHKCP, MSc PD (Cardiff), MRCP (UK), DPD (Wales), Dip Derm (Glasgow), PG Dip Clin Derm (London), MRCP (London), Grad Dip Derm (NUS), Dip Med (CUHK)⁵, Paul Man Kei Tam, MBBS(HKU), MRCP (UK), FHKAM, FHKCP, DDME (CUHK), DPD⁶, Edwin Kwan Chark Lau, MBBS (HK)⁷

¹Perfect Skin Solution, Hong Kong
²Dr. Fung Clinic, Hong Kong
³Dr. James Lam Clinic, Hong Kong
⁴Dr. Luk Wang Lung, Hong Kong
⁵Ever Keen Medical Centre, Hong Kong
⁶Sanitas Medical Clinic, Hong Kong
⁷FACE IT LTD, Hong Kong

Correspondence to :
Phoebe Kar Wai Lam
E-mail: myperfectskinsolution@gmail.com

Received: February 25, 2022; Accepted: April 9, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Abstract
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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.

Keywords: fascia, ligaments, nasolabial fold, rejuvenation, rhytidoplasty

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Fig. 1.The trend of average FLRS ratings and WSRS ratings for mid-face over 24 months (A) and treatment effect with Cohen’s d on FLRS and WSRS respectively (B). Cohen’s d: 0.2, small effects; 0.5, moderate; and 0.8, large effects. There was a steady linear rating (i.e., mid-face lifting) improvement over 24 months (0, best; 5, worst) (A) and the impact of treatment effect peaked around 6 months (WSRS) to 12 months (FLRS) and was large in the mid-face throughout the 24 months (>0.8) (B). FLRS, facial laxity rating scale; WSRS, wrinkle severity rating scale.

References

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Article

Original Article

J Cosmet Med 2022; 6(1): 8-12

Published online June 30, 2022 https://doi.org/10.25056/JCM.2022.6.1.8