National report — Contour Threads (Surgical Specialties) offer surgeons an innovative tool for providing nonsurgical browlifts, and newer sutures due to come out soon could offer more effective results, but questions about longevity, a bit of a learning curve and a fair amount of general skepticism are still hurdles the technique needs to overcome, experts tell Cosmetic Surgery Times.
A patient is shown (from left) before undergoing browlift with Contour Threads (A), immediately post-procedure (B), two months post-procedure (C) and six months post-procedure (D).
The device, made from clear polypropylene, represents the only nonabsorbable barbed suture product that the Food and Drug Administration has approved for the elevation and fixation of midface, brow and neck areas.
Brow area challenging
"The brow can be a particularly tricky location for the sutures, however, and a key to success with barbed threads in this area is mastering the technique and properly inserting and securing the sutures," says Gregory Ruff, M.D., who introduced Contour Threads and is the medical adviser for the product manufacturer.
A patient is shown (from left) before undergoing browlift with Contour Threads (A), immediately post-procedure (B), six months post-procedure (C) and 12 months post-procedure (D).
"There is a big effort by the company now to train doctors to make sure the sutures are deep in the fat, because if you put them too close to the surface, they can show through," observes Dr. Ruff, who is also in private practice in Chapel Hill, N.C.
"In the forehead, it's tricky because there isn't a lot of fat and the bone is right there, but doctors can be taught to put the sutures in as deep as possible without going too deep," he says.
Dr. Ruff says plastic surgeons may be put off by the large needles.
"Plastic surgeons, who have mastered their eye-hand coordination skills, may think they can just quickly put in these threads, but they're using a tool they've probably never used in their life — a needle that is 7 inches long," he says. "There's really an art to putting the threads in, especially if you're trying to curve them around someone's forehead, and this is not a time to try to go fast."
When performed correctly, the Contour Threads browlift can offer improved results over such nonsurgical alternatives as Botox and lasers, Dr. Ruff asserts.
"Botox injections may offer only a lift of maybe a millimeter or two, whereas a Contour browlift can go up 5 or 6 mm, and it certainly lasts longer than Botox or lasers," he says.
Dr. Ruff says he's seen results that have, in fact, lasted several years, but others say they have yet to see such results.
Some physicians add that lackluster results in the midface and neck areas have dimmed their view of the thread lift concept in general.