Abstract: A tissue approximation device and method, particularly in the mid-face region, are provided. The device is an implantable, biodegradable construct that has attachment points emanating from a supportive backing. The device also has an extension member or leash which extends from the backing which is configured to receive a tissue or bone attachment device at one of a plurality of selectable locations along the elongated member, for example via engagement holes extending in a line away from the backing. Once tissue is engaged with the attachment points, the extension member is pulled until the tissue is approximated in the desired position. Then the appropriate extension member hole(s) are selected to attach the extension member to supportive tissue or bone (for example temporal fascia) for permanent tissue approximation.