Smart PDOs™ and the Cartesian Technique™: A milestone in facial rejuvenation with bioactive scaffolds

Abstract

Objectives: Evaluate the controlled release of silicon from smart polydioxanone suture (Smart PDOs™) and the clinical effect of the Cartesian Technique™ in face lifting. Material and Methods: This study was preclinical and clinical trials randomized, uncontrolled, and phase I carried out. Preclinical trials included instrumental analysis of silicon-enriched sutures by light microscopy, electron microscopy, and Ultraviolet-visible (UV-vis) spectroscopy. The clinical trial included 35 patients with primary and secondary rhytides, grade I lipomatosis, and grade I deflation. Polydioxanone (PDO) sutures are inserted following the Cartesian Technique™, a vectorial lift from the intersection of the Cartesian planes of the face. Once the cannulas were inserted with the PDO thread, 0.1 mL of organic silicon was dosed. Turgidity was examined by the pinch test of skin turgor. To measure the position of flaccid or deflated tissues, the scale used was the deflation scale. Results: The controlled release of organic silicon from the PDO sutures was verified. Its clinical application revealed that after 8 days the improvement in turgidity, wrinkle reversal, and flaccidity tightening was maintained in 100% of the sample. At 15 days, reversal of rhytides was observed, softening of deep furrows in 80%, and the initial turgor and skin tightening maintained without deflation in 90% of cases. Histopathological findings reveal that silicon synergistically potentiates the tissue effect of the PDO suture, generating greater biostimulation of fibroblasts with better quality collagen fibers, greater restructuring and redensification of the skin, and avoiding the late inflammatory response. Conclusion: The Cartesian Technique™ with Smart PDOs™ is an effective protocol for skin replenishment that enhances cell biostimulation through the release of bioactive drugs.