A Case Report on Use of Cog Threads and Dermal Fillers for Facial-Lifting in Facioscapulohumeral Muscular Dystrophy.

Long-standing facial paralysis induces degenerative facial muscle changes on the involved side, thus making the individual seem older than their actual age. Furthermore, contralateral facial hypertrophy aggravates facial asymmetry (Sulamanidze MA, Fournier PF, Paikidze TG, Sulamanidze GM. Removal of facial soft tissue ptosis with special threads. Dermatol Surg 2002;28:367-71). The introduction of absorbable barbed thread has proved to be a good alternative for treating facial asymmetry. It also allows the association with other nonsurgical procedures, such as botulinum toxin use and/or dermal fillers in facial remodeling (Atiyeh BS, Dibo SA, Costagliola M, Hayek SN. Barbed sutures "lunch time" lifting: evidence-based efficacy. J Cosmet Dermatol 2010;9:132-41 and Kaminer MS, Bogart M, Choi C, Wee SA. Long-term efficacy of anchored barbed sutures in the face and neck. Dermatol Surg 2008;34:1041-7.). The aim of the treatment (threads) of the mid and lower third of the face was to promote the mechanical effect (lifting) and biological effect (neocollagenesis) with the improvement of the nasolabial folds, jaw, and jawbone contour.