Inevitable Biological Aging
The shifts in facial features associated with aging are complex, influenced by various factors such as volume loss, ligament attenuation, fat atrophy, diminished skin elasticity, and the effects of gravity (Wulc et al, 2012). With the exception of bone loss, threads prove to be a valuable tool in addressing and mitigating these aging forces.
Different threads are strategically employed for lifting various facial structures, including the eyebrows and eyelids, tear trough, nose tip, nose bridge, nasolabial fold, marionette lines, chin, neck, cheeks, and jowls. Each thread application is tailored to counteract specific aspects of aging, contributing to a more comprehensive and personalised approach to facial rejuvenation.
Figure 1: Illustration of the aged face versus the youthful face with markers of changes that occur with aging.
General concept
Thread procedures, particularly those utilizing barbed or cogged sutures, offer a unique ability to not only reposition the skin but also to stimulate significant collagenesis. A study by Yoon in 2019 revealed histological findings after 12 months, showcasing neocollagenesis, fat reduction, tissue contraction, a fibrous merging effect, and an improved vascular environment surrounding the thread. This innovative approach contributes to the effectiveness of thread procedures in achieving natural and lasting results.
This procedure has the remarkable ability to significantly reposition the skin in relation to the overlying muscle layer and transform the skin's composition, potentially inducing more collagen than other modalities. The outcome is firmer, tauter skin, a brighter skin tone, reduced pore size, diminished abnormal pigmentation, and fewer acne concerns. This stands as a distinct advantage over surgical facelifts, as thread procedures biologically alter the skin, unlike surgical methods that primarily rely on the removal of excess skin and repositioning of the remaining skin for a smoother appearance.
Type of Threads
In our discussion, we'll cover a variety of threads available in the market. Mono and spiral threads are suitable for those with thinner skin and less prominent jowling. They have minimal effect on collagenesis and volumization unlike mesh/ braided or barbed threads. For better repositioning and approximation, barbed threads are more widely used to maximized the effect of thread lift.
In addition to various thread types, we employ threads with different molecular compositions, including Polydioxanone (PDO), Polycaprolactone (PCL), and Poly-l-Lactic Acid (PLLA), either individually or in combination. The differences between the two most commonly found compositions are outlined below.
Composition | Polydioxanone (PDO) | Polycaprolactone (PCL) |
Duration till total absorption | 6 - 8 months | 12 - 18 months |
Stiffness | Moderate | Low |
Flexibility | Moderate | High |
Advantages | Comfortable, brightening effect | Longer lasting effect |
Disadvantages | Shorter duration | Due to higher flexibility, may have slight chance of breakage |
Process Overview
To start of, your skin is gently numbed for comfort, clean and prepared. A fine needle will be used to create an entry point. The thread is then inserted with a cannula, reaching the superficial musculoaponeurotic system (SMAS) at the correct plane. The thread will be positioned and spread evenly to achieve the desired lifting effect. Any excess thread is trimmed to enhance the overall result. You will be thrilled to see the immediate lift as the procedure concludes and the overall changes the following months.
For a more comprehensive understanding of the process, here’s a video for your reference.
Traditional Face Lift v.s. Thread Lift
Traditional Face Lift | Thread Lift | |
Administration | Removing lax skin and tighten underlying muscle | Embedding threads to dermis layer of skin |
Outcome | Generally results in a less natural-looking outcome | Tends to produce a more natural-looking result. |
Anesthesia | Typically performed under General Anesthesia, with a higher associated risk | Commonly performed under Local Anesthesia, with a lower associated risk. |
Effect Duration | Last longer, up to 10 years | Last for 1+ year |
Costing | Higher cost | Lower cost |
Scarring | Carries a higher risk of scarring | Involves a lesser risk of scarring |
Recovery | Longer down time, up to 2 weeks | Immediate or up to 2 days |
How long till I see the result?
You can expect to experience immediate lifting results, which is quite exciting! However, for noticeable changes in the skin, such as texture and tone improvements, it typically takes about 1 to 2 months.
How many threads do I need?
To achieve the best results, we typically recommend addressing 2-3 vectors, adjusting the number based on the severity of your concerns. For each vector, we generally advise using at least 2 threads to ensure adequate support. This approach allows us to tailor the treatment to your specific needs and provide the necessary structural support for optimal outcomes.
Should I consider threads? Or fillers? Oh wait! What about Fotona 4D lift and HIFU???
Considering treatments like fillers, Fotona 4D, and HIFU for a lifting effect is a thoughtful decision. Each of these modalities offers unique benefits, and choosing the one that suits you best depends on your specific goals. Some individuals seek a quick lift, while others prioritize a holistic approach, addressing not only laxity but also skin tone and texture. Non-invasive options like Fotona 4D lift and HIFU are known for their ability to enhance skin integrity, albeit requiring multiple sessions for optimal results. These treatments are particularly comforting for those averse to needles. While HIFU stimulates collagen and elastin reformation from multiple fixed depths from the contact surface, the Fotona 4D lift targets multiple layers from intraoral to external skin to achieve an all rounded lift and tightening of the skin. Injectable fillers used as a liquid facelift provide strength and support to the facial ligaments, restoring the initial tensile strength of your face. On the other hand, thread lifts are effective in repositioning the skin and stimulating deeper structures, making them ideal for addressing evident jowling. All these treatments are highly versatile, concrete knowledge, skills and experience from the operator are the crucial factor of success to obtain desired results.
There is no one best treatment. It's crucial to educate yourself on the available treatments and apply stepwise approach to anti-aging. Seeking guidance from an aesthetic professional is crucial. Here in dream clinic, we provide thorough explanation of the advantages and disadvantages of each option, helping you make an informed decision tailored to your specific goals. See us to get lifted physically and spiritually!
Reference
Kim, N. M. (2023). Threads counter the anatomy of aging. Non-Surgical Thread Procedures, 9–14. https://doi.org/10.1007/978-3-031-36468-6_5
Kim, N. M. (2023a). Non-surgical thread procedures: The Future of Aesthetic Medicine. Springer.
Yoon JH. Tissue changes over time after polydioxanone thread insertion: an animal study with pigs. J Cosmet Dermatol. 2019;18(3):885–91.
Zhukova, O., Dydykin, S., Kubíková, E., Markova, N., Vasil’ev, Y., & Kapitonova, M. (2022). A new complex minimally invasive thread lift method for one-time three-step fixation of the face and neck soft tissues. Archives of Plastic Surgery, 49(03), 296–303. https://doi.org/10.1055/s-0042-1748641
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