One of the most popular modalities for patients who do not want invasive procedure is thread lift. Various cogged threads are anchored in the subcutaneous fat or SMAS for lifting sagging tissues and promoting collagenesis as a secondary effect. In the past, non-absorbable threads were used but have been replaced with absorbable threads due to various side effects (infection, protrusion, visible thread, and indentation, etc.).
PDO is one of the most widely used absorbable suture material. Generally PDO threads are completely absorbed and excreted in 6-8 months. PDO threads are available in untwisted mono thread and twisted or cogged thread. Short strands are inserted in the overall face to promote collagenesis or spring or screw type is used for stronger stimulation. Cogged thread is used to enhance the adhesion to tissues and the lifting effects.
As wrinkles, elasticity or sagging are the main target of treatment, the procedures can be planned considering the proper type of thread. In the past, a non-absorbable thread was inserted through a temporal incision and anchored onto the temporal fascia or periosteum to lift the sagging skin around the mouth or marionette lines. Recently, however, a long needle or cannula is inserted behind the hairline at the temporal region to create the desired degree of lift.
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Massaging should be avoided for about a month after thread lift. Excessive talking should also be avoided for the first 1-2 weeks. As a foreign material is inserted into the skin, caution should be taken to prevent infection, protrusion, irritation, pain, swelling, bruising, indentation, and breakage of the thread. If the outcome is not satisfactory, additional thread can be used after the bruising and edema subside.
The tumescent solution can be used to reduce bruising, however, some doctors say the pulling sensation is more accurate without swelling. I prefer local anesthesia but perform intravenous anesthesia in patients particularly sensitive to pain.
Recovery time differs across patients, however, slight pressure and pulling sensation can be felt in the first couple days up to a week. Similar to dermal filler and botulinum toxin, thread lift can also be repeated to maintain or enhance the desired outcome.
When the thread protrudes or becomes visible, it can be removed through a small opening made with a needle tip. It is important to prevent secondary scarring. Consulting a specialist prior to treatment is crucial for optimal outcome and safety.
Image 2. Before and after thread lift.
-To be continued-
