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60. Elastic canthopexy with three threads

The chosen line is first drawn up to the hairline then in the direction of the eye. The line extends to below the level of the lower eyelashes, approximately 8mm/10mm from the apex of the outer canthus. The bases of the isosceles traction triangles are drawn. The base is not less than 2.5 cm long in women and about 3 cm in men. If the patient wants the eyes to be raised, the base is moved upwards. The same is done if one eye is more horizontal than the other; on the side that needs to be lifted more, the base of the isosceles triangle is drawn 5 mm/10 mm higher. The aim is to make the patient's look as symmetrical as possible.
A skin access is created with a slightly inclined 16G needle at the lower end of the base of the isosceles triangle. This hole will not be sutured, no scar will remain.
The thread Elasticum EP 3.5 (Korpo.com ) that forms the isosceles triangle is implanted; traction will be exerted on the left eye and on the lateral tissues inside this triangle.
The access holes are medicated with an antibiotic ointment twice a day. The eyes are now symmetrically elongated and equally narrow with minimal trauma and without dissection.

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59. Elastic lifting of the lower lip

This patient asked us to correct the detachment and drooping of her lower lip, the outcome of maxillofacial surgery performed years earlier to reduce the length of her face. During the maxillofacial operation, her chin was reduced and reinforced with a metallic plate, which caused the tissues of the chin to lose their adherence. This loss of adherence caused the lip to sag and droop. This can easily be corrected by implanting an elastic thread (Elasticum EP4), to suspend the lower lip to the two fasciae of Loré. Elastic lifting of the lower lip can also be carried out to reduce the visibility of the lower teeth. As is known, the elastic thread is impalpable and, once colonised by connective cells, is transformed into a natural "ligament". 

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58. Lifting marionette wrinkles with 2 or 4 elastic threads and removal of the preauricular skin

In more ptotic faces, the elastic lifting of the marionette’s wrinkles is done through an 8 mm incision behind both lobes. In this case, two isosceles triangles are implanted. The marionette elastic wrinkle lifting is usually performed after the elastic MACS lift or the elastic cheek lift. The preauricular skin in excess is removed. During the procedure, elastic lifting of the neck with one elastic thread or elastic lifting of the neck with three elastic threads and four safety pins can be carried out through the same incisions behind the earlobes. This last procedure is particularly indicated in patients with very aged neck skin. As is known, the skin of the cheek and neck are not dissected; the tissues are simply repositioned. This new lifting, 3 sutures 4 pins, reduces the vertical wrinkles and the low horizontal wrinkles of the neck without causing unnecessary trophic damage to the tissues.

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57. Lifting marionette wrinkles with 2 or 4 elastic threads and removal of the preauricular skin

Marionette wrinkles can be corrected by exerting oblique traction by means of the elastic thread mounted on the atraumatic two-tipped needle. An elastic thread is now implanted to exert traction perpendicularly to the marionette wrinkles. A 1 cm incision is made behind the lobe of the ear and the skin above the fascia of Loré is dissected. A retractor is inserted. The two-tipped needle, which has been inserted into the cavity, partially emerges from the preauricular skin. It is then rotated and inclined so as to anchor the elastic thread to the fascia of Loré. The Jano needle now follows the preoperative design. The retractor is inserted into the dissected cavity and the two-tipped needle travels in the direction of the small entry incision.

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56. Elastic rhinoplasty with removal of a cartilaginous hump and correction of the anterior septum

A long nose can be shortened by implanting an elastic thread through a 2 mm incision or through the hole made by a 16 or 18 G needle. Elastic lifting of the nose, or elastic rhinoplasty, has an effect that is not only esthetic, but also functional; by correcting the nasolabial angle, this procedure also improves the patient's breathing.

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55. Local anesthesia in elastic gluteoplasty

This patient's bottom looks hollowed and drooping. An elastic gluteoplasty procedure will lift and firm up the soft tissues of the buttocks. This is done by means of the EP4 Elasticum thread and the two-tipped Jano cannula (Korpo).

The preoperative design of the pathways of the elastic threads to be implanted is the same as the one we used in the first elastic gluteoplasty with two circular sutures, which was published on CRPUB in 2013.