A fastening system for use in apposing two sides of an incision or wound in a surface of skin tissue by holding the sides together under tension, comprising: a fastener comprising i. a bridge section including a first portion and a second portion, ii. a first leg section integral with the bridge section and extending from the first portion of the bridge section, the first leg section defining a first lumen extending therethrough such that the first leg section is cannulated, and iii. a second leg section integral with the bridge section and extending from the second portion of the bridge section, the second leg section defining a second lumen extending therethrough such that the second leg section is cannulated, a distal portion of each of the first and second leg sections (77a, 77b) being tapered, each of the first and second leg sections (77a, 77b) including at least one barb, the bridge section being sufficiently flexible to allow the first and second leg sections (77a, 77b) to spread apart angularly when implanted completely below the surface of the skin tissue, such that the sides of the incision or wound are held together under tension forces between the barbs, the bridge section and the first and second leg sections (77a, 77b) being formed from a single piece of material; and an insertion device arranged to deploy the fastener into the skin tissue from above and in a generally perpendicular orientation in relation to the surface of the skin tissue such that the deployed fastener is arranged to be disposed completely below the surface of the skin tissue to hold the sides of the incision or wound together by tension, the insertion device comprising a first needle configured to extend through the first lumen of the cannulated first leg section and a second needle configured to extend through the second lumen of the cannulated second leg section, the first and second needles (79a, 79b) being substantially parallel to each other, each of the first and second needles (79a, 79b) including a sharp end that is exposed with the fastener fully loaded onto the insertion device, the sharp ends for penetrating into the skin tissue, characterized in that each of the barbs includes a pointed element and is arranged to be oriented such that its pointed element is directed away from the surface of the skin tissue and such that the barb resists dislodgement of the fastener after the fastener is deployed into the skin tissue and below the surface of the skin tissue. a fastener comprising i. a bridge section including a first portion and a second portion, ii. a first leg section integral with the bridge section and extending from the first portion of the bridge section, the first leg section defining a first lumen extending therethrough such that the first leg section is cannulated, and iii. a second leg section integral with the bridge section and extending from the second portion of the bridge section, the second leg section defining a second lumen extending therethrough such that the second leg section is cannulated, a distal portion of each of the first and second leg sections (77a, 77b) being tapered, each of the first and second leg sections (77a, 77b) including at least one barb, the bridge section being sufficiently flexible to allow the first and second leg sections (77a, 77b) to spread apart angularly when implanted completely below the surface of the skin tissue, such that the sides of the incision or wound are held together under tension forces between the barbs, the bridge section and the first and second leg sections (77a, 77b) being formed from a single piece of material; and an insertion device arranged to deploy the fastener into the skin tissue from above and in a generally perpendicular orientation in relation to the surface of the skin tissue such that the deployed fastener is arranged to be disposed completely below the surface of the skin tissue to hold the sides of the incision or wound together by tension, the insertion device comprising a first needle configured to extend through the first lumen of the cannulated first leg section and a second needle configured to extend through the second lumen of the cannulated second leg section, the first and second needles (79a, 79b) being substantially parallel to each other, each of the first and second needles (79a, 79b) including a sharp end that is exposed with the fastener fully loaded onto the insertion device, the sharp ends for penetrating into the skin tissue,