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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.

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54. Percutaneous correction of diastasis of the abdominal rectus muscles by means of the Elasticum thread and two-tipped needle

The Elasticum EP4 elastic thread mounted on the two-tipped Jano needle can be used to correct moderate diastases of the rectus muscles, without leaving scars. This Elastic Plastic Surgery procedure enables the muscles to be drawn back together in a stable manner, without tissue dissection and without leaving scars. Patient selection is important.
Palpation and echography are used to identify the diastasis of the abdominal rectus muscles accurately. It is useful to draw the pathway of the thread.
Local anesthesia is achieved by means of a modified Klein solution.

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53. Elastic canthopexy in elastic MACS and neck lifting

The preoperative design shows: the incision that crosses the sideburn and stops at the tragus, the pathway of the elastic canthopexy thread, the parallel neck threads, and the vectors of the isosceles triangles that suspend the cheeks and the malar region. The operator uses a finger to check whether the dissection has extended beyond the zygomatic arch. There is no dissection in the cheeks and neck and therefore no trophic damage to the facial tissues. The elastic threads (Elasticum Korpo srl, Italy) replace the SMAS, with the advantage of being able to exert traction close to the aesthetic defect and to be minimally invasive. The Elasticum suture makes facelift interventions outpatient.

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52. Elastic Canthopexy

This patient wants to elongate her eyes and correct the exposure of the sclera. With aging, the eyes lose their almond shape and become round. Moreover, if adipose pouches are removed from the lower eyelids by means of skin incisions, this frequently results in loss of the elongated shape of the eyes. To correct this undesirable appearance, we have designed elastic canthopexy, a less invasive technique than traditional canthopexy procedures, and one which is able to rejuvenate the eyes and, as in this case, modify their slope.
In this procedure, traction is exerted not only on the external canthus, as in normal canthopexy procedures, but also on the tissues lateral to the canthus that come within the Isosceles traction triangle. When the eyes are lengthened and raised, the skin of the lateral portion of the upper eyelids often presents some drooping. For this reason, a few months later, when stabilisation is complete, we perform upper blepharoplasty, a technique published in the section “Timedsurgery”.

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51. Elastic MACS lift and elastic Canthopexy

Correction of drooping cheeks and round eyes. An elastic MACS lift and elastic canthopexy are carried out. The point of anchorage of the elastic thread is marked very close to the external canthus or immediately below it. The apex of the malar suspension triangle and the two apexes of the triangles that will lift the cheeks are marked out. The bisectors of the Isosceles triangles are also drawn.
The elastic threads (Elasticum EP3,5 – EP4, Korpo) are implanted. The first Isosceles suspension triangle is the one used for canthopexy. After elastic MACS lifting, no bandaging is required; only an ointment is applied to the incisions. As the threads do not cut into the tissues, and are transformed into ligaments, the result is permanent.
If necessary, elastic MACS lifting can also be performed in the third decade of life, as it is minimally invasive and prevents gravitational ptosis.