Barbed sutures: a review of the literature.

BACKGROUND: Despite substantial mention in the popular press, there is little in the plastic surgery or dermatology literature regarding the safety, efficacy, longevity, or complications of barbed suture suspension procedures. The authors review the literature to estimate several clinical parameters pertaining to barbed thread suspensions. METHODS: The authors performed a MEDLINE search using the keywords "barbed and suture," "thread and suspension," "Aptos," "Featherlift," and "Contour Thread." RESULTS: The authors identified six studies that met their criteria of addressing midface elevation with barbed thread suspension. These detected some adverse events, but most of these were minor, self-limited, and of short duration. Less clear are the data on the extent of the peak correction and the longevity of effect. Objective outcome measures and long-term follow-up data were not provided in a systematic manner in the few available studies. CONCLUSIONS: Suspension of the aging face with barbed sutures offers the promise of a minimally invasive technique with diminished adverse events. The technique is in its infancy, but it has potential to be a useful and effective clinical tool as further innovations are made in the clinic and laboratory.

De novo adipose formation in a vascularized engineered construct.

While the field of tissue engineering is a burgeoning one, progress with fat engineering has lagged, due in large part to problems associated with nurturing and sustaining this unique tissue in vivo. In a pilot study using an experimental rat model, we induced liponeogenesis with a combination of Matrigel and basic fibroblast growth factor in an fibrovascular scaffold, isolating the construct to a pedicled blood supply (the superficial inferior epigastric vessels) via a silicone housing, creating an engineered three-dimensional adipose tissue construct. Adipose tissue and vascular ingrowth were assessed histologically and followed by serial study at 4-week intervals for 16 weeks. We demonstrated persistence of shaped adipose tissue constructs over time, and postulate that incorporating a vascular supply may enhance the durability of experimentally induced fat constructs and potentially provide a means for microsurgical transfer of the construct.