By Lisa Vuich, MD, Owner of Renew Medispa
You might have not heard about it yet, but thread lifting is one of the latest non-surgical facial rejuvenation procedures gaining increased attention in the medical spa community. This technique has been around for decades, but in the last five years has become more popular in the United States- especially since 2015 when actress Gwyneth Paltrow placed thread lifting in the media spotlight by covering the procedure for her online magazine, Goop. The technique of repositioning sagging facial tissue with threads was first introduced by Russian surgeon Marlen Sulamanidze in the late 1990s. Some of the earlier thread types which were permanent/non-dissolving were withdrawn from the market early on due to complications such as breakage and migration. Subsequently, “absorbable” sutures were developed and are FDA cleared for use in the United States.
The right expectations
A thread lift is not the equivalent of a surgical facelift. It is instead an option for those who are not interested in surgery or those wish to avoid the risks and downtime associated with a surgical procedure. Thread lifting can also be used to delay a surgical facelift, or even 5 to 7 years after a surgical facelift for those who are starting to notice the return of sagging skin.
The downtime associated with a thread lift varies according to how much has been done (the number and type and placement of the threads) but in general consists mainly of mild to moderate swelling, temporary surface irregularities such as minor ripples or dimples, the potential for bruising, and tenderness to touch in the areas treated.
Who can perform a thread lift?
In most states, thread lifting is performed only by physicians, surgeons, and sometimes nurse practitioners who have been trained in this technique. Although thread lifting is considered minimally invasive, an advanced level of knowledge of facial anatomy is essential to success with this technique. It is technically more difficult than dermal filler injection and should not be performed by those who have not had extensive training in facial anatomy and in the technique itself.
Types of LiftingThreads
Threads available in the United States are “absorbable”, which means that over time they dissolve. However, while present in the tissue they stimulate collagen formation, and that collagen will long outlast the thread material. The main absorbable thread used is made of Polydioxanone (PDO), which traditionally is a material used in the operating room as surgical suture. Another popular thread type is the Silhouette InstaLift suture which is partially made of PLLA (Poly L Lactic Acid), a collagen stimulating material.
Threads used for lifting have surface irregularities, in the form of “barbs” for PDO threads or “cones” for the Silhouette sutures. This design allows the threads to hold tissues in place once they are inserted into the fatty layer under your skin. Variations in barb design, thread length, and design of placement will all affect results and longevity so it is important to go to a highly experienced provider when considering this type of facial rejuvenation procedure.
Non-barbed/ non lifting threads are also available which are also termed “monofilament” or “smoothing” threads. These are much finer threads placed under the skin to stimulate collagen production in an area where fine lines have formed.
Barbed PDO threads and Silhouette Instalift sutures are often used to elevate facial tissue, particularly when adding more volume (such as dermal filler) is not desired. They can also be used for a non-surgical brow lift.
The cost of a thread lifting procedure will depend heavily on the number and type of threads used and the level of difficulty of the procedure. The general range is $975 to $4000 in our region. Some opt to start with a limited procedure, such as brow or cheek lifting. Others will go for full face and neck lifting as their initial procedure. A consultation with the physician is the best way to determine this as it will depend heavily on your facial anatomy/degree of laxity, the suture types planned, and your goals for the outcome. These variables will also affect when a “booster” session will be recommended. These threads do dissolve over time, and since we cannot halt the aging process, at some point you will be looking to add more threads.
Selecting a Provider
As is always the case in medical aesthetics, it is important to ask some questions when selecting who will be performing your procedure. How many years have they been performing threads, and how many cases do they do per week? You should be able to view before and after images of cases that provider has personally performed. Always have before images taken, and after images at 3 months is a good time to assess your result as there will be additional collagen at that time which often results in further improvement beyond the initial/immediate lift.
The Renew MediSpa Training Institute in Derry, NH offers thread lift procedure training to physicians interested in adding this technique to their aesthetic practice. I offer individual and small group training or preceptorships in MINT PDO threads, Eurothreads eye threads (for tear trough deformity) and Silhouette Instalift sutures. For more information on Thread Lifts or Thread Lift training, call us at 603-894-0070 or email [email protected]