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Thread Lifts: Has Their Time Come?


Dr. Paul Nola - May 31, 2019 - 0 comments

The cosmetic industry is responding to client demands for minimally invasive treatments to fight the inevitable signs of aging by introducing new procedures and improving existing ones. Thread Lifts are one example, emerging ten years ago as a possible alternative to facelift surgery. They gained prominence after being mentioned on Gwyneth Paltrow’s popular lifestyle website Goop.

But thread lifts weren’t without their own problems. Ten years ago some of the side effects were a chronic infection, abscesses, skin puckering, and damage to blood vessels and nerves. But have things changed since then?

What are Thread Lifts?

Under a local anesthetic, a barbed stitch or suture (AKA a thread) is threaded under the skin from in front of the ear towards the mouth. The skin is then bunched up so the barbs catch on the tissue under the skin. The thread is snipped at skin level and then the skin is released. Because the barbs are now holding the cheeks in place sagging cheeks, jowls and necks are now lifted.

10 years ago the hope was that thread lifts would give the benefits of a facelift without the downtime or expense. Unfortunately, it did not work out that way because these permanent threads caused too many complications. The barbs caused unsightly skin puckering with movement. Sometimes they eroded the skin causing ulcers. Or eroded nerves and blood vessels. They got infected and caused abscesses. Permanent threads soon fell out of favour for all but a few doctors.
Latest Generation Thread Lifts

Recently a new generation of threads has been developed to try to avoid these problems. Dissolving sutures made of poly-L-lactic acid (PLA) or polydioxanone (PDO) have been safely used for many years. Now barbs have been added to these sutures in order to turn them into threads. These threads are used in the same way as first generation threads.

Dissolving threads are softer so do not provide as much lift as permanent threads. But they don’t cause as many complications either. And because they trigger the body to produce collagen (you may know someone who developed a firm lump of collagen around a dissolving suture) the body can use this new collagen to lift the cheeks, jowls, and neck. PDO and PLLA threads dissolve away after about 6 months but the hope is that this new collagen will make the lift last longer.

Pros and Cons:

If you are looking for a facelift result from threads you will probably be disappointed. On the plus side, a thread lift is a minimally invasive procedure. The recovery time is brief; people can get back on their feet immediately. Since it does not require extensive surgery, the cost of the treatment is lower. And modern PDO and PLLA threads are much less likely to cause the side effects of the first generation permanent threads.  The main disadvantage is that PDO and PLLA threads may not provide enough lift for long enough to make them a viable alternative to fillers or surgery. Some patients are very happy with their results but some are disappointed, undergoing filler or surgical treatment because the thread lift was not effective enough for them.

Still, techniques are always improving but time will tell if the PDO or PLLA thread lift will be worth the time and expense. In the meantime, it is early days. Take care.

Dr. Paul Nola.

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