Sponsored By Resculpt;
For hollowing and laxity in the delicate undereye area, absorbable polydioxanone (PDO) threads are providing a safe solution that avoids potential filler complications including bruising, bumps and migration. Over time, PDO naturally stimulates collagen production, thickening overlying skin so effectively that friends and even strangers tend to notice.
Some providers will not inject fillers in the tear troughs, noted Nancy Kim, MD, owner of Adagio Aesthetic Medicine and Thread Lift Center, and Resculpt Medical Threads, in West Los Angeles, Calif. This is because no matter how perfect one’s technique is, irregularities sometimes happen. “The skin is fragile there. Filler will sometimes bubble up to the surface and need to be dissolved.”
An absorbable 19G braided mesh PDO thread works so well under the eyes that when the distributor of this product closed, Dr. Kim took over distributing the product, now called Boost Threads by Resculpt. “It is a more natural way of treating that area because the threads stimulate so much collagen that it also thickens the skin enough that it looks like it has been filled,” she explained. In studies of infraorbital thread lifting, patients who underwent braided PDO thread lifting in the tear troughs achieved statistically significant improvements and high patient satisfaction.1,2
Braiding eight thinner threads in a ropelike fashion stimulates more collagen than similar lifts performed with eight individual threads, while using fewer insertion points, Dr. Kim shared. Providers can simply insert the braided threads, which come already loaded in a cannula, through two insertion points created with a needle, one on each side of the face.
Dr. Kim typically inserts two 38 mm threads per side. “It is best to insert a little beyond complete insertion because if there is any remaining thread extruding out of the hole, then the whole thread must be pulled out and replaced.” She also advised applying gentle pressure while retracting the cannula to ensure that the thread stays under the skin.
A particularly challenging case involved a woman with severe under-eye laxity who rejected surgery and fillers. “Because she had very thin skin, I opted not to go directly into the tear trough skin, but 3 mm to 4 mm below it so that the collagen stimulation that occurred there would spread into the area of delicate skin,” Dr. Kim explained.
When this specific patient was treated, she achieved enough skin thickening after one treatment that she chose to undergo two more procedures each spaced two months apart. During those sessions, Dr. Kim placed the threads more directly in the tear trough region without complications despite the thinness of her skin.
After this patient’s first treatment, a neighbor noticed so much improvement that she underwent the procedure herself. Additional new patients have requested the procedure after seeing results achieved by friends and total strangers, Dr. Kim reported.
Post treatment, patients should sleep on their back for a week to avoid displacing the threads. Because patients with fat herniation in the infraorbital region likely will experience significant swelling, she added, they should sleep with their head elevated for three days after treatment.
Most patients require one treatment, with results lasting one to two years. Additionally, the procedure combines well with traditional cheek and jowl treatments such as fillers or barbed-thread lifts.
1. Khan, G, Kim, BJ, Kim, DG, Park, E. Retrospective study of the absorbable braided polydioxanone threads’ usefulness in the aged lower eyelids’ rejuvenation. J Cosmet Dermatol. 2022; 21: 5952-5956. doi: 10.1111/jocd.15257
2. Lee W, Oh W, Kim HM, Chan BL, Yang EJ. Novel technique for infraorbital groove correction using multiple twisted polydioxanone thread. J Cosmet Dermatol. 2020;19:1928- 1935. doi:10.1111/jocd.13269