Flaccidity or laxity of the face is considered one of the characteristics that most contributes to the appearance of facial aging. Over time, research has shown that laxity involves all facial tissues: skin, subcutaneous cellular tissue, retention ligaments, superficial aponeurotic muscle system and even bone support. Surgery has been considered the Gold standard treatment for flaccidity but due to the greater tendency of patients to perform minimally invasive procedures with the consequent reduction of surgical risks, the use of facial lifting with threads had increased in response to this trend. The absorbable threads of Polidioxanone are presented as a good option for the lifting of the flaccid facial tissues through the improvement of the skin, through the induction of collagen synthesis and by the traction exerted by the suture, at the level of the tissue subcutaneous cellular. Methodology: series of cases, description of a technique with Polydioxanone threads as a treatment of the flaccidity of the middle and lower third of the face and description of the results, through the staging of flaccidity with the validated scale of facial laxity classification (FLR) at the start of treatment and three months after it. Results: The use of the validated scale of Facial Flaccidity Classification (FLR) as a comparison tool allowed to have objective results. A statistically significant change was observed in the improvement of the flaccidity of the middle and lower third of the face with the treatment with Polydioxanone threads. This coincides with a high percentage of satisfaction (78.5%) between good (35.7%), very good (35.7%) and excellent (7.1%). It was observed that more than 50% of the patients the degree of pain experienced with the procedure was mild to moderate. Only one patient (7.1%) reported pain as moderate to severe, making this a very tolerable procedure. The report of complications in this series is similar to that of other studies, being mainly minor complications, among others: dysesthesias, edema, erythema. Conclusion: treatment with Polydioxanone threads is a significant option for the management of sagging of the middle and lower third of the face. The description of new techniques for the application of threads and their results opens the doors to new therapeutic options in the field of Aesthetic Medicine for the treatment of facial sagging. Studies with higher levels of evidence will be required for their recommendation.
