Can Monocryl 3-0 Suture Be Used for Lifting the SMAS Layer?

i got a smas facelift done a year and 8mths ago .There was no difference at all so the plastic surgeon done correction work after 1 year he made incisions only half way up around both ears back and front he then put a thread which was a monocryl 3-0 suture into the smas layer to lift it .needless to say this also failed i only had mild to moderate jowls to begin .ive still got them i was told his facelift would last 7 years

Doctor Answers 11

Monocryl and Lifting the SMAS

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A 3-0 Monocryl suture is certainly adequate in strength to suspend the SMAS.  I personally use 4-0 Nylon to re-suspend the SMAS.  It is unlikely that the SMAS could be adequately exposed and freed up through the limited incisions around the ears.  This is most likely the reason for the lack of improvement of your jowls.  We have published a study looking at the longevity of a SMAS facelift.  Using our technique the length of time between a primary facelift and a secondary facelift was 11.9 years.  


Orange County Plastic Surgeon

Minimally invasive threadlifting

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Unfortunately, limited procedures to improve jowls and other areas of the lower face have limited results. It sounds as if you might need a more substantial lifting procedure. Incidentally, the type of sutures used seldom has a significant effect. The procedure is more technique driven and many different sutures can achieve similar results. Good luck.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Monocryl for lifting the SMAS

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Monocryl can be used to lift the SMAS but the key to long term success is releasing the SMAS so that when it is tightened, it will not pull apart and fall back down. What was done the second go round was a glorified thread lift and was likely not going to help. Short of a redo facelift, I am not sure what else I could suggest.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Failed Revision Facelift

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A SMAS lift typically entails dissection and elevation of the SMAS layer (SMAS imbrication).  You look young and most likely you had a mini-lift, Swift Lift, Thread Lift or some other minimally invasive procedure that "plicates" the SMAS.  These approaches are often not aggressive enough to adequately correct the problem.  These terms and the techniques described are very confusing to well trained facial plastic surgeons, let alone a patient without medical training.  Certainly your second procedure was a thread lift.  A monocryl suture dissolves over time, so I don't really understand the rationale for using this in the manner you described.  At this point your only choice is to seek another opinion.  I would recommend someone who specializes in just the face.  

John Bitner, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 90 reviews

Thread Facelift

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I've seen patients who have had thread facelifts done and been disappointed with the shortlived results.  To achieve the best results, the facelift needs to be properly performed by addressing the SMAS layer by trimming, lifting, and suturing it to a desired position that will lift your face and give you natural appearing results.  Only by doing this will you get a result that will last.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Face Lift

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An actual SMAS facelift requires the proper technique, which as stated before involves undermining, trimming and then lifting and suturing to the desired position. The skin is then smoothed down over the lifted area and the excess skin is removed to give you a natural youthful appearance without a pulled look where just skin is removed. I prefer to do some SMAS work in almost every lift I do. It makes the lift more effective and allows you to treat the mid face as well as the neck giving a more desired outcome. Many different sutures may be used by different surgeons and monocryl is one of those. However the procedure you are discussing above does not fall under any parameters of the description of a SMAS Face lift. A complete review of the operative report would probably be more helpful in understanding the exact procedure done. Best regards

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 215 reviews

Can 3-0 monocryl suture be usde to lift the SMAS during a Face Lift?

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The SMAS should be undermined, trimmed, lifted and sutured back together, IMHO, in any type of Face Lift for it to be effective.  If, on the other hand, a suture (regardless of type), thread or some other fixation method is used to lift and/or fold the SMAS on itself... this is likely to fail, allowing the SMAS to return to the sagged position. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Face lift

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Moncryl sutures are very good sutures for any surgery. the results of a face lift is not determined by the suture material. success of a face lift is understanding your expectations an execution of the surgery, sutures have minimal effect.

Get your preoperative pictures and post operative pictures, the post revision pictures and the operative notes. Cosult a BOARD CERTIFIED PLASTIC SURGEON (AMERICAN BOARD OF PLASTIC SURGERY)

Write your questions, your expectations of the final result you want , and have all questions answered.

The pictures posted are too small to judge

Samir Shureih, MD
Baltimore Plastic Surgeon

Can Monocryl 3-0 Suture Be Used for Lifting the SMAS Layer?

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                I typically use a PDS so that it can last longer to allow adequate scar formation, but this may work as well.  A permanent suture can be used as well, but if it is palpable or develops an abscess or infection this will have to be removed.



Kenneth Hughes, MD Los Angeles, CA

Monocryl sutures for SMAS

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I think Monocryl may be Ok although I usually use a longer lasting absorbable suture like a PDS.  Some use permanent sutures.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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