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The Procedure

The Procedure

Step By Step Procedure

The following pages will guide you through all the key steps when performing the Silhouette InstaLift procedure.

For complete instructions, please see Silhouette InstaLift™ Instructions For Use.

Silhouette InstaLift: Technique Steps

  • Proper Patient Selection
  • Marking the Vectors
  • Local Anesthesia
  • Suture Insertion
  • Setting the Sutures
  • Post Procedure Care

Proper Patient Selection

Ideal Patient

  • Strong underlying bony projections
  • Good skin quality (neither too thick or thin)
  • Tissues can be mobilized during examination
  • Moderate sagging in the mid-face
  • Visible marionette lines and/or NLR

Non-Ideal Patient

  • Excessive skin due to advanced aging and thin skin
  • Excessive skin in the mandibular region associated with thick skin
  • Hypertrophic type aging
  • Very thin skin with little or no underlying fat

Step By Step Procedure

Marking The Vectors

  • Determine the desired movement of tissue
    • Visualize by palpating the tissue with your fingers
  • Vectors should be in a straight line
    • Straight lines provide the most efficient pull of tissue
  • Mark the entry and exit points for each suture

Local Anesthesia

  • Infiltrate with lidocaine 1% with epinephrine at entry and exit points only
  • Prior to insertion, tighten the knots of the suture with a steady tug
  • Use 18 G needle to create an entry point
  • Ensure complete penetration of the dermis

Prepare The Silhouette InstaLift Sutures

Remove Silhouette InstaLift device from the tray, and with slight traction pull on each end of the suspension suture, to tighten the knots and check the device conditions

Suture Insertion

  • Insert 1st suture needle to a depth of 5 mm (black line marker on the needle) perpendicular to skin
    • Turn it at 90 degrees
    • Advance toward the exit point while staying in the subcutaneous plane
  • Needle should advance within the subcutaneous tract and should be painless
  • Insert 2nd needle in exact same entry point and at the same 5 mm depth
    • Turn 90 degrees
    • Advance toward second exit point while staying in the subcutaneous plane

Setting The Sutures: Anchoring The Medial Cones

  • Apply tension on the medial part of the suture
  • Massage tissue up and over the lower cones to reposition the skin and engage cones in the dermis
  • Slightly overcorrect

Setting The Sutures: Anchoring The Lateral Cones

  • Once the medial cones are anchored, pull on the superior (lateral) portion of the suture to achieve the desired tissue repositioning
  • Press directly down on the superior cones to engage them in the dermis
  • Allow the sutures to “rest” a few minutes and then adjust further if needed
  • Once satisfied with tissue movement, lift and trim the sutures
  • Pull suture and cut at surface thus allowing the end of the suture to sink below the skin surface

Post Procedure Instructions

  • Apply cold packs after procedure
  • Refrain from wearing make-up for 24 hours
  • Sleep face-up with head elevated for 3-5 nights
  • Do not aggressively rub face for 5 days
  • No saunas for 3 weeks
  • Avoid excessive neck and facial movement for 1 week
  • Avoid high impact sports for 1 week
  • Avoid direct exposure to sunlight/UV light for 1 week
  • Avoid dental surgery
  • Avoid facial or face down massages

Patient may experience minimal acute inflammatory tissue reaction. Symptoms may also include pain, swelling and bruising.


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