What is a Ribbon Lift?

the celebrity blogs are talking about madonna getting a ribbon lift. They say a ribbon lift is “[A tube-like device] is tunnelled under the skin and has lots of tiny hooks that attach to the muscle and tissue,” plastic surgeon Alex Karidis explains. “We then pull it upwards to lift the whole area.”  I also have sagging facial skin and wonder if I should seek this out or are there better methods.

Doctor Answers 12

Absorbable neck lift device - not to be confused with thread lifts

The 'ribbon lift' is a procedure performed with Coapt Systems 'Endotine Ribbon' device. The key to the procedure is not the device, but the surgeon and procedure that is actually performed. This is not the same device or the same procedure as the older thread lift. The ribbon device is like a collar with spikes on one side. The device is made of an absorbable material so that the body dissolves the device over time, unlike older thread devices which were permanent. The theory behind the device is to insert the spikes of the device into the platysma muscle and pull the muscle back. This is the same thing which is done with neck lifts performed in conjunction with lower facelifts. The procedure will do nothing for the jowls, cheeks, or other parts of the face. It is promoted for use in people with platysmal bands (turkey neck) and excess skin.
It can be inserted simply by making a small tunnel the width of the device. This can lead to suboptimal results. If broad elevation is undertaken as with more convential neck lift procedures, good results can be obtained.
For more information about the device itself, check out the manufacturers web site at:

Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 reviews

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Ribbon and thread lifts

You can see the satisfaction rates from threadlifts on the RealSelf website... only 13% of patients were happy with their decision to have a thread lift. 87% of patients were unhappy.

A ribbon lift employs a similar philosophy of no undermining pulling on tissue. Experienced facelift experts know that thread lifts simply pull through, as the results slip away. The only thing remaining are the threads, which are troublesome to remove, especially if there are many of them. Typically, revision facelifts involve removal of old threadlift material and knots.

Endotine has various lifts but these are usually performed with undermining surgery as an additional lifting tool. They do involve large supposedly self-dissolveable multi-hook structures that are left in the face. There have been problems with the early versions with pain and palpability, so Endotine is redesigning them.

Your best bet is to save up for a proper facelift with a facelift expert, take the 10-14 days off, and have a much better, more natural, and longer lasting result.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 103 reviews

Pass on the "ribbon lift"

It was enticing a few years ago to try to produce some of the effects of a facelift without surgery. Thread lifts and ribbon lifts are all part of this concept. The problem with them is that they really didn't work much at all and even when there was a change it didn't last long. The procedure cost much more than it was worth because the company that made the threads priced them to the doctors at a very high level. Now, nobody is doing these anymore.

A properly done facelift (not a mini or a Life Style lift) performed by an expert will give you the full result you want without looking operated on. There is only a 2 week recovery until you are extremely presentable and the pain is very minimal for most patients. The result will last and you will be very happy you went this way.

Ribbon Lifts might not be for everyone

The ribbon lift use a multipoint fixation device to elevate and secure the deeper tissues of the face. It workes great in theory, however, the device has remained palpable for some for longer than three months. It seems to work best with a full facelift when it is placed deep to the muscle layer and fat as opposed to on top of the muscle and fat. We are seeing some great results with the ribbon lift of the brow and cheeks.

Charles Perry, MD
Sacramento Plastic Surgeon
4.5 out of 5 stars 17 reviews

The Ribbon Lift Explained

We all recognize that facial aging is associated with the thinning and sagging of soft tissues of the face. Depending on the degree of sagging, various Facelift techniques are employed to reposition the tissues in their higher youthful positions.

The vast majority of Facelift methods undermine the skin widely but differ in the extent of undermining of the next layer, the SMAS, which is then suspended higher, taking the tension off the skin closure.

In recent years, we have witnessed a failed attempt to lift the face WITHOUT skin undermining. This method used barbed sutures which caught the deeper subcutaneous tissues and allowed the surgeon to INITIALLY lift them. Invariably, without scar fixation, the elevated tissues sagged with time and the operations were complicated by cable suture palpability, visibility and infection.

The Ribbon Lift uses a similar lifting concept. A flexible, dissolving ribbon with barbs / tines in it is pushed into the deep facial tissues AFTER the skin has been largely lifted off. the ribbon is thereby engaged and is then pulled up until the desired lift was accomplished at which time it is stitched to the temple muscles. This allows the fixation to be kept until the ribbon dissolves months later. The problem is that the ribbon may be palpable AND that in the absence of scar the higher fixation may not be maintained as it is with a regular Facelift.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 69 reviews

Ribbon lifts are ineffective as a solitary procedure

The ribbon is basically a specialized suture. The company initially marketed it as a stand alone noninvasive procedure but this quickly proved to be a poor procedure with a low success rate. The ribbons can be successfully use at the time of a real Facelift just to supercharge the tightening result. I typically use the ribbons in this way when people have thicker necks and more difficult anatomy because they allow for a powerful tightening effect.

Jason B. Diamond, MD
Beverly Hills Facial Plastic Surgeon
4.0 out of 5 stars 5 reviews

Ribbon lift

The ribbon lift is basically a midface cheek lift performed with Coapt's endotine device. It is a limited incision procedure...the long term results are not known.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Ribbon lift

The Ribbon lift is based on an implant that looks like a quarter inch "ribbon" of absorbable material with little teeth that grab at one end and. It looks like its made of plastic and similar in appearance to a cable tie. It is typically placed under the skin to snag the deeper tissues. It is then anchored at a higher location to lift and hold them in place. The extra skin is then removed. Over time the device is completely absorbed (usually 6-12 months. The advantages to these procedures are clear: less surgery. However, the results are generally less than expected and most patients find them unsatisfactory. This is why you will see great initial enthusiasm but rarely see these devices persist over time as their populariy wanes.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 54 reviews

Ribbon lift versus comprehensive face and neck lift

 Placing a device underneath the skin with an attempt to try to tighten the skin is only a temporary measure  that has not stood up to the test of time. The thread lifts have also been taken off the market for a variety of complications. We have removed many of them  in our facelift practice.
 Comprehensive facial rejuvenation involves tightening the facial muscles and lifting the jowls, tightening the neck muscles in 3 locations, a platysma plasty, removal of fat above and below the  platysma muscle in the neck, and conservatively tightening excess skin in the face and neck.
 For many examples, please see the link below to our comprehensive facial rejuvenation photo  gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Ribbon Lift results

A ribbon lift is ay type of lift that uses the ribbon to fix the facial tissues into position. Ribbons can be used for facelift, mid-facelift, brow lifts, and neck lifts.

Ribbons do not give you results. The surgeon does. The best way to think about this is that the ribbon is essentially a type of suture material. Excellent results are ultimately achieved by the surgeon and how he uses his instruments and materials in order to obtain the desired results.

My best recommendation to you is to focus on finding a surgeon that will give you the results you desire, rather then the materials used to achieve this.

Jacob D. Steiger, MD
Boca Raton Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.