Suture suspension of the malar fat pad

Background: Elevation of the malar fat pad by use of suture suspension to rejuvenate the central third of the face has been previously described. Objective: The authors evaluated the ability of suture suspension to successfully elevate the malar fat pad. Methods: Four fresh frozen cadaver dissections were studied. With the standard preauricular, subcutaneous approach, the malar fat pad was identified, and a suspension suture was placed at the inferior and lateral aspect of the fat pad. The vector of pull was directed vertically, and the tension that was applied to the suture was measured. The dermis was then elevated from the malar fat pad to examine suture placement and ensure that the dermis was not caught in the suture. Results: An average tension of 11 lb was applied before rupture of the suture. In none of the cases did the suture pull through the malar fat pad. Conclusions: Suture suspension is an effective technique for elevation of the malar fat pad. The results are easy to reproduce and are very effective in addressing the changes that accompany aging and the descent of the malar fat pad. (Aesthetic Surg J 2002;22:446-450.)