Innovative Advancements and Trends in Thread Lifting

While the beauty industry suffered a slight decline early on in the pandemic, aesthetic practices quickly rebounded, witnessing an immense increase in inquiries for cosmetic treatments, including thread lifting procedures.

Cindy J. Papp

December 16, 2021

8 Min Read
Innovative Advancements and Trends in Thread Lifting

While the beauty industry suffered a slight decline early on in the pandemic, aesthetic practices quickly rebounded, witnessing an immense increase in inquiries for cosmetic treatments, including thread lifting procedures.

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Thread lifts are popular with both practitioners and patients because, like injectables, they can be done in the office with local anesthetic.  An increase  in work-related teleconferences has driven consumers in search of anti-aging procedures to help them look their best and feel confident. Thread lifting treatments for the face are expected to experience the fastest growth rate during  the forecast period,  as they meet the demand for safe treatments with minimal recovery and maximum convenience.

To respond to the uptick in demand, product technology and innovation are driving the market forward with an expansion of the types of threads  offered  for  improved  versatility,  efficacy and safety. Today, practitioners can find a  variety  of  threads  to  help  lift  and  tighten  skin and stimulate collagen synthesis.

Polydioxanone  (PDO)  threads  come  in  a  variety of styles designed for customized results. Monofilament (mono) PDO threads are smooth threads used to tighten skin and fill in volume loss, while barbed threads can lift or re-drape skin and stimulate collagen production.  PDO  threads  remain  the  most  popular,  thanks  to  technology  like  in-cannula  threads  designed  for efficacy and patient comfort.

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Poly-L-lactic acid  threads  (PLA,  PLLA)  can increase  volume  in  sagging areas  to  restore  facial  shape  while  lifting  and  stimulating  collagen synthesis. These threads are resorbable and act on the deeper layers of skin.

Polycaprolactone (PCA) threads are composed of synthetic  caprolactone  and  are  the  latest  technology in threads. They are bio-absorbable, mono-suspension  threads  that  lift,  tighten  and provide the longest support structure for collagen production.

Continuous development in technology requires aesthetic physicians to keep up with trends and advances  to  determine  the  best  outcome  for  patients. Jan Balczun, MD, a board-certified facial plastic surgeon (Recklinghausen, Germany) with an interest in nonsurgical rejuvenation procedures,  said,  in  his  experience  PDO  threads  have come a long way.

 “When   thread   lifting   became   popular   in   Europe, the strength of PDO threads was not sufficient for  the  needs  of  the  patients,”  he  began. “For stronger lifting  effects  I  had  to  switch to PLLA threads, but the management of   these   threads   was   more   complicated.   You had  to  take  precautions  due  to  sterility  reasons and because threads were delivered without cannulas, the procedure was trickier, which meant more stress for the patient.”

With the  recent  advancements  in  PDO  threads,  Dr.  Balczun now uses only  PDO  threads in his practice. “The biodegradability is far better than with  other  threads,  and  over  time,  the  PDO  threads  grew  stronger  and  took  on  a  lot  of  indications  from  PLLA  threads.  In addition, the handling  of  PDO  threads is a lot easier, as most of the threads are  delivered  already  inside  a  cannula.  This means less stress  for  the  patient,  faster results and less complications.”

Thread Lifting for Facial Rejuvenation

Neurotoxins and  fillers  are  popular  cosmetic  treatments for facial rejuvenation that achieve fast  results  with  no  downtime.  Now, thanks  to  the  advancements  in  technology,  thread  lifting  can  be  added  to  a  physician’s  armamentarium  of  minimally  invasive  rejuvenation  therapies.

 Thread lifting is quickly becoming a preferred method  to  address  mild  to  moderate  skin laxity  of  the  face  and  neck.  According to Omotara Sulyman-Scott,  MD,  a  facial  plastic  surgeon  and  founder  of  That  Face in  Chicago, Ill., thread lifting may provide better results than other non-invasive rejuvenation treatments.

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 “Thread lifting is meant to reposition the soft tissue of the face,” she pointed out. “A more contoured jaw line and reduction of sagging skin is achieved by pulling up the cheeks, reducing jowls and tightening or pulling the neck in laterally. It can also open up the eyes by lifting the brow.”

Facial plastic surgeon, Vincent McGinniss, DO (Findlay, Ohio), shared one of his reliable protocols that serves as a foundation for a midfacelift. “Good entry points are chosen and include one a few millimeters anterior to the hair-bearing temple and another just anterior

to the tragus, he stated. “Other great options include the jaw angle, the mastoid region, and regions anterior to the sternocleidomastoid muscle, to name a few. These points make sense because some of these regions are used as anchoring points in traditional facelift surgery. The barbed threads come in a variety of sizes and the 19-gauge are my workhorse thread,” he added.

threads2_0.jpgDr. McGinniss clarified that certain indications require customized treatments and realistic expectations must be explained to the patient. “Additional lifts to the cheek, jowl, submental region, and neck will often require threads to be placed at the additional entry points mentioned above. The more lift needed, the more threads that will be required.”

Thread choice is critical to achieve the desired, customized effect. “Threads can provide a natural facelift and barbed threads are best to grasp, lift and suspend sagging tissue,”

Dr. Balczun explained. “Basic and screwed threads are used for tissue rejuvenation, decreased laxity and to smooth small wrinkles.”

Dr. McGinniss explained how he incorporates these rejuvenation treatments in his practice. “I sometimes combine thread lifts with other therapies such as radiofrequency (RF) or ultrasound devices, platelet-rich plasma/fibrin, fillers and neurotoxins to customize treatments.” Choosing the right treatment depends on the patient and the desired outcome.

He reiterated that communication with the patient is key. “When choosing between fillers and threads, I like to tell my patients that fillers can fill, and threads can lift,” he noted. “The claim that fillers can lift is debatable. I feel that if we place enough filler in one location, the tissues could re-drape around it to some extent; however, if significant lift is needed, a large bolus of filler in a particular location may re-drape the tissues, but likely in a very unnatural way.

“Threads do a nice job of lifting the tissues that have descended from age and gravity,” Dr. McGinniss continued. “The descended volume of tissue is grabbed by the barbs of the thread and moved upward to create a more youthful appearance.”

While thread lifts can re-drape and tighten skin, Dr. Sulyman-Scott emphasized that thread lift candidates must be chosen carefully. “In some patients with thin skin, thread lifting to tighten may result in bunching up of the skin at the thread injection location, so if you are pulling the face up and laterally towards the ears, you can have excess skin bunched up in that area, which is not cosmetically appealing.

“Furthermore, when skin is very thin, the threads become visible or palpable where the patients can actually feel the threads underneath the surface of the skin,” she added.

Product Advances

 MedyGlobal  America  (Glenvar  Heights,  Fla.)  is  a boutique PDO thread company for healthcare professionals.  The  company  recently  patented  360°, three-dimensional helical barbed threads with   advanced   technology for attachment   points that deliver improved  support  of  sur-rounding tissue without manual twisting.

With  a  focus  on  reliable  results,  MedyGlobal  America  has  been  raising  the  standards  of  PDO  thread  performance  via  technology  advances  such  as  small  production,  contaminant-resistant fiber construction and high tensile  strength.  They  offer  monofilament  screw  threads  with  PDO  inlays  for  greater  support, mesh  threads  to  address  deep  wrinkles  and  nasolabial  folds,  as  well  as  RHINO  threads  specifically for the nasal area.

PDO Max® (Liverpool, N.Y.) is a trusted provider of PDO  threads  and  one  of  the  few  companies with a PDO thread-in-cannula device fully cleared by the FDA. The company provides over 20 varieties of threads, and recently launched a numbing cannula with lidocaine, designed to pre-tunnel and numb treatment areas.

According to  Dr.  McGinniss, the  future of  PDO Max holds more exciting advancements. “Consistent  with  PDO  Max’s  passion  for  sharing knowledge in this field, we are going to start a cadaver course next year focusing on teaching relevant anatomic nuances critical to mastery of precise, effective and safe PDO placement.”

JJ Medical (Rancho Cucamonga, Calif.) is the North American representative and distributor for BioSun  PDO  Threads.  BioSun supplies  the threads while JJ Medical offers ongoing sup-port and pop ups for newly trained injectors, as well as in-clinic trainers.

JJ  Medical  is fully  committed  to  safety  and  innovation.  The company’s  goal  is to  provide  products that are  safe  and  easy  to  use  with  a  commitment  to  additional  training  sessions  when  new  technologies  are  developed.  Informative, hands-on training  helps practitioners  gain,  and  continue  to develop,  the  appropriate skills  to  achieve immediate,  natural  looking results.

VIOLA Threads  (Brea,  Calif.)  provide medical  aesthetic  practitioners  with  various  types  of  fully biodegradable threads that come in dif-ferent shapes, sizes and even materials.

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Consisting    of    dyed    PDO, VIOLA  threads  are  indicated  for  use  in  soft  tissue approximation,    where    the    use  of  absorbable  sutures   is   appropriate.   The   complete   prod-uct  line  includes  both  cutting-type    (Cobra)    and    molded-type    (Molding)   threads   to   perform   all   types   of   thread    lifting    treatments  for  both  begin-ners    and    advanced    users.

Today’s aesthetic physician   and   cosmetic   practitioners have the  benefit  of  advanced  technology  at  their  fingertips.  As Dr.  McGinniss eloquently  stated, “Continued  growth  in  our  understanding  of  threads in vivo is what drives us to apply cut-ting  edge  technology  in  practice  in  order  to  offer world class treatment options for our pa-tients that are safe and effective.”

Reference:

1.    Market research. Giving Intelligence Teams an AI-powered advantage. (n.d.). Retrieved November 12, 2021, from https://www.reportlinker.com/p06028479/Aesthetic-Threads-Market-Growth-Trends-COVID-19-Impact-and-Forecast.html.

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