THREAD LIFTING

Since the late 1990s, when a Russian surgeon introduced the APTOS threads – a barbed suture to lift ptotic facial tissues which involved the placement of cogged threads. Initially, these were made of a non-absorbable material; however, they’re now made of a resorbable material. It’s now extremely popular in Asia to harness the body’s natural healing process with a type of acupuncture, to stimulate tissue production and diminish muscle contraction to firm up the skin.

You may have heard of different types or brands of threads. The most common ones are called PDO threads, and this refers to the material the thread is made from called polydionaxone – the same material used in a dissolvable stitch. There are many brands of this particular type available, such as Elionce, V Soft and Dermagenics.

We do not use PDO threads at our clinic instead the doctors use the APTOS and NORDYX brands which are made from a different material- a mix of polycaprolactone (PCL) and poly-L–lactic acid (PLLA) which have a greater sculpting capacity, plus higher collagen-boosting factor, than the lower-grade PDO versions.

These threads come in different shapes and sizes:

• Monofilament threads are short and straight and introduced into the skin with a needle. These are good for areas of fine lines, such as the upper lip, neck, chin, and sometimes around the eyes.
• Spring threads are tightly coiled around the needle and, when inserted into the skin, they provide volume – so are often used in the nose-to-mouth line area and the mouth-to-jawline area. They can also be used to give volume in the cheeks.
• Barbed threads tend to be longer and can be mounted on either a needle or a cannula. A cannula tends to be preferable here because the thread has to travel a larger distance and there is less risk of damage to underlaying structures.
• Cogged threads are similar to barbed threads, but have an arrow-shaped addition to the thread, which prevents removal of the thread once it has been inserted.

Another popular thread is Silhouette Soft, which is the brand name for a thread made of poly-L-lactic acid. These are cogged threads that are much longer than typical PDO threads. They will commonly have one or two entry points and two exit points per thread. We do not use Silhouette Soft threads at TLC.

There are many types of thread lifting. The methods used at TLC all employ dissolvable threads, which are mounted on a disposable needle or cannula to introduce the thread into the skin. Threads come in different shapes and sizes, ranging from monofilament threads, which are inserted in a type of lattice and cause tissue contraction, to spring threads which are coiled up to give volume in the skin, to barbed or cogged threads which provide lift. Our dissolvable threads are placed under the skin after an anaesthetic or numbing cream has been applied to make the treatment more comfortable.

Threads can be used in conditions such as Bell’s palsy, whereby the affected side can be elevated using a thread lift to match the unaffected side.

Yes absolutely, men can have thread lifting.

In theory yes, but it works particularly well on those with thicker skin or larger pores, because it contracts these well. We can also treat darker skins safely too.

With age, we all experience changes in the shape and volume of our skull, and the fat compartments of the face, which shrink and drop a bit. These volume changes enhance the (already present) issue of the dermis of the skin becoming thinner, thereby giving rise to more lines and wrinkles. There’s only so much we’re able to do with volume replacement, say with dermal fillers; sometimes we have to look at the suspension of the tissues in the face and neck. Threads are very effective at providing this suspension, and can cause bigger changes than would be seen with other non-surgical methods, such as radiofrequency or ultrasound. Threads are also used for tissue regeneration in the case of monofilament threads, giving an improved texture and firmness to the skin. The benefits of thread lifting include tightened skin, lifted jowls and cheeks, and reduced muscle pull.

You could view thread lifting as preventative if you only have mild sagging, because it will certainly prevent it from getting worse for a few years – and may hold off the need for surgical intervention until later. However, there is no published evidence to substantiate this, it is merely clinical observation.

The most popular areas are the mid face and jawline for sagging skin and the neck for loose skin. Threads can also be used to give a skin textural improvement in areas such as the upper lip, around the eye, chest, thighs and abdomen.

Some people use threads on the body for procedures such as a breast or buttock lift. It’s our preference not to use threads on the body, with the exception of monofilament threads for skin textural improvement. Other less common areas include the nose.

Thread lifting does have limitations, and is effective only on mild to moderate skin laxity. It’s not a replacement for a face or neck lift, and if there is excessive skin laxity then this treatment will not work, and surgery may be required. If there is volume loss in the face, the results of a thread lift will be suboptimal unless this volume is also replaced using dermal fillers. Likewise, if skin quality is poor, the threads will not provide a great outcome. Results on the neck tend to be less impressive than those on the face, and to lift the neck properly it’s often necessary to start with the face. TLC does not carry out threading for body lifting, preferring instead to refer for surgery in the vast majority of cases. However, treatments can sometimes be carried out for skin quality improvement. Threads for brow lifting likewise tend not to be hugely effective, and the preference is to refer for a brow lift.

It’s important that any thread lifting treatment is performed after a consultation to make sure it’s right for you. We’ll discuss with you what you’re looking to achieve from cosmetic treatment, and how the outcome should look. We’ll also discuss other treatments which could be an alternative to this one, that might be better for you, or which could complement a thread lift. We decide where the threads should be placed in order to give you the best lift. Sometimes, we mark up the skin and take a photograph to record exactly where the threads were placed for later reference. Local aesthetic injections are placed at the entry site for the threads or numbing cream is applied prior to the treatment. Your skin is cleaned, you’re given a headband and hat to wear to keep hair away from the site, a surgical drape is placed to keep the area sterile, and then the skin is cleaned again. Sometimes this cleaning solution can go up into the hair so please be aware of this, as you may need to wash your hair afterwards. The treatment is performed by making a small entry point, in the case of suspension threads, and then passing a thread mounted on a cannula through the entry point. The cannula is then removed leaving the thread in situ. This is performed five to ten times on each side of the face and/or neck, and the thread is then trimmed to tuck its end out of sight under the skin. Once this has been done, it’s not visible. You can sometimes see a small amount of rippling on the skin which if present typically resolves after no more than a week. There will also be some swelling. The hat, drape and head band are removed and you’re free to go home. Avoid exercise or bending down for five days post treatment, sleep with three pillows at night to elevate the head, and place a rolled up towel on either side of the head. It’s also important not to apply any makeup for 48 hours, not to have a facial, and avoid touching or massaging the area for at least two weeks.

Please try not to wear any makeup when you come in for the procedure, as even a small amount left on the skin can cause infection. We work really hard to keep everything clean, and this is made a lot easier if you come in with no makeup on, hair tied up and no earrings or facial piercings. If you’re prone to bruising, you may want to get some arnica or bromelain. If you have an important event coming up, you should schedule your treatment so you have an appropriate amount of time between the procedure and your event. Optimum results will take around four weeks to show, and there’s a chance that you may need to have an adjustment at this time.

If you’re prone to bruising, you may wish to use arnica or bromelain to minimise it. Actually, bruising is not that common with threads for lifting, and occurs mostly with threads for skin improvement. Swelling is common though.

For some people, a check-up after four weeks can be necessary, and we sometimes offer this option as part of the procedure, especially if we have not treated you before. As part of the ‘start low, go slow’ philosophy, it may be necessary to add more threads to obtain the optimal result. If, however, we agree that you don’t need to, then you don’t have to come back.

This treatment can be uncomfortable and it’s not for the squeamish. Numbing cream or a local anaesthetic injection is used at the site entry of the needle, and further local anaesthetic injections can be added throughout the insertion of the thread if required. Whilst the majority of the time all you’ll feel is a strange tugging sensation, there can be the odd area which can become slightly more painful. We do have various tricks to minimise any sensation at the time of treatment, such as the use of vibration, local and topical anaesthesia, and ice – but nothing can take away all sensation! After the treatment it can be sore, particularly on turning the head, or touching the area for a week or so afterwards.

Immediately after treatment you can apply a surgical makeup if desired; we have some in the clinic. To avoid infection, you should not wear your own makeup for 48 hours. You must be sure to keep the entry points, where the thread has been placed, extremely clean.

You’ll see an immediate lifting effect from the threads if you’re having treatment for tissue elevation. This will look its best after about one to two weeks. For monofilament threads for skin improvement, you’ll need to wait around four to six weeks to see benefits from the treatment.

It’s probably not a good idea to return to work immediately after a thread lift. Most patients would have this treatment on a Friday and return to work on the Monday. The reason for this is the local anaesthetic can make your skin feel quite weird, and you can be pretty swollen after the treatment.

This depends on the type of threads used, the desired result and the number of threads place at the initial treatment. Generally, when the results begin to diminish you may wish to place more threads, but you would most probably not need as many threads to get the same result.

This is not approved for use in pregnancy or whilst breastfeeding.

This is variable depending on the individual, the pre-existing quality of the skin, the amount of sagging, the number of threads placed, any other treatments that have or that are being carried out, and lifestyle factors. On average, the results last around 12 months, but can range anywhere from six-24 months. Wherever a thread is placed we get some collagen stimulation there, so even when the thread has dissolved, the tissue will still be elevated into its new position. Effects are cumulative, meaning the more threads we add, the more elevation is achieved.

Thread lifts are more common in those aged 30 and upwards, as these threads will treat a degree of tissue laxity. If there is no laxity, they will have no effect. Equally, a thread lift is not a substitute for a facelift – and are not recommended where there is excessive droop.

Absolutely yes, because threads do not change the structure of the face at all; they merely elevate the tissues. So we’re not adding volume to the face, simply suspending the tissues. The amount of improvement achieved with a thread lift is mild in comparison to a surgical solution, so results are never over-pronounced.

Yes, you’ll still be able to move as normal after a thread lift. You’ll most likely be a bit sore for a week or so post-procedure, but it shouldn’t impact at all on muscle movement after everything has settled down.

As long as your expectations are to keep the results on the natural side, then a person would have to have an eagle eye to spot any change to your appearance.

Whilst complications are rare, they can and do happen. This could be something like a bruise following treatment, which is not uncommon with thread treatments. Some swelling is also inevitable, and the amount of swelling is variable from person to person. Slight twinges are also normal, particularly on turning the head. More difficult complications would be issues such as asymmetry, as no two faces are the same on both sides (they should be sisters, not twins – but definitely not distant cousins!). There is a risk of infection, or damage to adjacent structures such as to local blood vessels and nerves. To minimise swelling, we prefer a ‘start low and go slow’ approach, to minimise the risk of anything like this occurring.

Not at all, we have many patients in their 30s who undergo thread lifting in order to get the tightness and elevation they desire. Everyone ages at different rates, and some people may be ready for a thread lift at a younger age because they have more tissue laxity. Particularly in patients who have gone as far as they can with other injectables but still want more lift, this works very well, and can help delay them needing something more drastic in future.

Thread lifting can be performed alongside PRP treatments, dermal fillers and wrinkle-relaxing treatments.

Threads are good for those who don’t mind the downtime, are happy to have an invasive treatment, and who want to see a larger lift than is possible than with ULTRAcel. They can be used in conjunction with dermal fillers, which will replace lost volume and also help give a lifting effect to the tissues. They’re particularly helpful where dermal fillers have already been used, but where still more lift is required.

Please note that you are paying for the treatment only and no guarantee is made of any outcome. Refunds cannot be given under any circumstances, as the product has been used and the service has been delivered.