What is a thread lift?

Thread lifts have gained a lot of publicity over the past year, whether marketed as “The one stitch Facelift” or “Puppet Facelifts”.

Given recent media coverage, one would think that threads are a new device, but they have been around over the last ten years but have only recently become popular in the UK.

The first thread lifts were pioneered in Europe using threads made from tendons,
nylon and gold in the 1970s; this was then followed by the use of prolene and the creation of the “anti-ptosis” or APTOS® (barbed) threads in the late 1990s.

So whats caused the sudden media interest in the last 12 months, which has led to the increased
industry promotion and marketing of thread products in the UK. A sudden increase in the promotion
and use of polydioxanone (PDO) threads in Korea has been a global influence in the cosmetic market. The threads themselves have certainly improved in the last 10 years, the techniques modified and optimised, but the controversy very much remains. Do thread lifts produce reproducible, lasting results? Is patient satisfaction above average? Do the potential risks outweigh the benefits? Plus, the most hotly debated concern of all: just who should, and more importantly, who should not be performing thread lifts?

Silhouette Soft arrived this year to our clinic. This has now completed our portfolio of threads and make River Aesthetics one of the UKs centres of excellence for thread lifting. Dr Woodward and I are national trainers for PDO threads and are seeing some fabulous results. For me being able to offer patients a safer alternative to a surgical face lift has opened lots of avenues for us.

Silhouette Soft is a revolutionary new treatment to treat signs of ageing that has a dual effect: –
The lift and in addition a regenerating collagen effect which can all be done without the use of incisions or sedation.

Silhouette Soft is considered to be a technological innovation offering men and women a simple way: to a redefined face, restored volume and reduced wrinkles by means of a 60-minute treatment providing a result that lasts up to 2. This ‘lunchtime face lift’ means you can be in and out within an hour whilst taking off several years of your facial age. This discreet procedure means you can even go straight back to work and you dont even have to tell your colleagues what youve had done. This is why Silhouette soft is probably used by many Hollywood stars who deny having surgery but look to have defied age and remain still naturally good looking without a done plastic appearance.

WHAT IS THREAD LIFTING?

Thread lifting is a procedure which involves lifting tissues that have started to sag due to age and the downward force of gravity. Threads are inserted using needles or cannulas and may need to be
anchored, pulled taut or simply placed in meshworks. Thread lifts are also referred to as suspension face-lifts. As well as their use in face-lifting procedures, its worth noting that threads are now being used for their lifting and tightening effects in the breasts, buttocks, knees, hands and neck. We are having great results using PDO threads in the breast, In effect creating a non-surgical breast lift.

Also not all facial applications are for simple cosmetic purposes the procedure is also being utilised
for cheek repositioning and correction of asymmetries (e.g. lifting post-stroke), for mild upper eyelid ptosis, and for brow lifting.

As we have mentioned, threads or sutures are inserted using needles and cannulas, with some requiring anchoring, others being free-floating or self-supporting by hitching themselves into the
tissues once pulled taut, and others being laid in a matrix or scaffold structure to produce a lift through increased collagen formation following a foreign body reaction.

What are the advantages of a thread lift?

The great thing about a thread lift is that it offers quick recovery tog
ether with excellent results. This procedure requires a minimum amount of non-invasive surgery and leaves no scarring. Local anaesthetic is all that is required and there is no hospital stay required. Another good factor about the thread lift is that it is much more affordable than a regular face lift
and the results are long lasting. If you are looking for a quick and effective solution to a range of aging problems then a thread lift is the perfect solution.

So how does it work?

Silhouette Soft Threads are considered to be a discreet approach to achieving a fresher, younger-
looking appearance.

The Silhouette Soft suture is made of a clear absorbable material of Poly Lacti
c Acid and absorbable cones, which dissolve and promote your skins own collagen production.
These anchoring sutures are inserted under the skin using a fine needle to elevate the sagging tissue and lift problem areas; the use of a fine needle means no incision is required.

Only a small local anaesthesia is needed at the entry and exit points of the sutures. The thread is
held in place with absorbable cones oriented in opposite directions (bidirectional).

Once the suture has been applied, we apply slight compression to the tissue to reshape it by hand
and to obtain the desired lifting effect. The non-inserted ends of the thread are cut off and you’re
done.

Who is a thread lift suitable for?

A thread lift is more suited to men and women between the ages of 35 and 70. The procedure is
most effective on skin that has minimal sagging and laxity and offers the best results for cheeks, jowls, brows and the neck area. If you are looking for results that are more effective and long lasting than Botox and other fillers, then a thread lift is the ideal choice. If you are put off by traditional surgery or don’t want general anaesthetic then a thread lift is great as it is minimally invasive and can be carried out under local anaesthetic.

As with many procedures performed in aesthetic medicine, everyone can do them, but not everyone should be doing them. From the patient’s perspective the correct choice of practitioner, who is using the correct choice of thread type for the effect that is required and who is analysing both
anatomy and patient expectations is the only way that will produce an outcome that is satisfactory to both patient and practitioner. Dr Victoria Manning emphasises that patient selection is key in the decision to go ahead with a thread lift procedure. Unhappy patient very much equals unhappy practitioner.

Some patients are just not suitable for a thread-lift, they have either to little skin-laxity or too much, which would not make the procedure beneficial or effective for them. Patients must understand that a thread lift is not a surgical facelift and hence, it will not produce the same results or last the same amount of time.

he ideal candidate for a thread lift is aged from the late 30s to the late 50s-60s, and who are prepared to follow the post-operative regimen of taping. (This support the facial tissues whilst the
threads are embedding and anchoring into the tissues) also not to carry out high impact sport or have dental appointments post procedure.

RESULTS AND LONGEVITY

Threads have been subject to much controversy, particularly with regard to their efficacy. One of the biggest criticisms you will hear when you ask medics about thread lifts is that the results and the
longevity of any correction are satisfactory to poor.
When compared to the longevity of results from temporary cosmetic injectables such as dermal fillers and botulinum toxins, the thread lift results do last longer. However In our practice we are seeing on average PDO thread lifts lasting about 12-14m and Silhouette Soft slightly longer. At the 12
month review a couple of extra threads have proven to prolong the overall effect for a lot longer rather than going back to time zero. From having performed hundreds of these procedures to date, the best outcomes come from the best patient selection. Be critical in your examination, if you don’t think you can achieve wow results don’t do it. Consider an alternative treatment or refer them on.

COMPLICATIONS

There are multiple potential complications arising from thread lift procedures. When counselling
patients for adverse events, it is easiest to divide them into early and late. Transient issues with swelling and bruising are, of course, expected. Initially post insertion patients describe a very
transient intermittent sharp stabbing sensation at the end of the threads; this tends to settle quickly as the thread softens with hydration. Thread breakage, is rare with careful application but it can happen, mainly due to opening the mouth to widely such as in yawning, thread migration, or threads poking back out from their insertion holes, as well as skin dimpling or puckering at anchor/entry points are not uncommon.

Scarring and epidermal inclusion cysts have been reported, as has thread visibi
lity especially around the brows and forehead. In some cases, threads can be removed, but additional trauma is likely to result with barbed types. Asymmetries can often be more easily corrected. The main complication although transient and easily sortable is that of skin puckering and or tethering. This is normally self-limiting but if persistent it can be easily sorted with a simple procedure of hydro dissection. This is mainly seen when patients have minimal subcutaneous tissue over the lateral aspects of the face and the threads are placed quite superficially.

WHO SHOULD BE PERFORMING THREAD LIFTS?

This is a question which splits opinion within the industry. This is should be decided in part to the
skill needed to carry out the procedure, but also, and more importantly to the ability and having the
clinical expertise to be able to deal with any complications which may arise.
Any practitioner performing thread lifts should be confident and be trained in minor surgery t
o be able to remove threads if required, remove granulomas and be able to hydro-dissect the tethered ti
ssue. In my opinion if you are not competent to perform these, you really shouldn’t be doing thread-lifts. The understanding and complete respect of the anatomy and different planes of the facial tissues is something which those who are surgeons and cosmetic physicians possess more so than other medical and non-medical disciplines.

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