Due to the unique design of the specially designed soft barbs or cogs of the threads, the surrounding tissues act to hold the threads in place without the need for visible scars. For the mid-face procedure, the surgeon makes a tiny incision close to the ear and the threads are advanced along the previously marked contours toward the chin and jaw line, thus creating a firm hold on the underlying tissues without causing additional trauma. The barbs or cogs do the work of holding, by being fixated to tissue as they are softly contoured into place.