As the age changes, the skin loses collagen and the distribution of facial fat changes, causing the egg-shaped face to gradually become a collapsed ice cream-like shape. In addition to surgical facelift and instrument skin tightening, another option is the thread lift, which is between surgery and instruments.
Principle of Thread Lift
The thread lift procedure is simpler than traditional facelift surgery, with smaller trauma, and can improve early sagging problems, such as mild facial sagging. These surgical threads will pull the skin tissue and reposition the skin layer tissue. The effect can be seen immediately, which lifts the treated area and eliminates sagging. In addition to being suitable for repositioning sagging tissue and lifting the skin, the thread material can also stimulate collagen production. Therefore, thread lift can also be used as a treatment for skin aging.
The face of Hong Kong people is relatively flat, without a pronounced contour like Westerners. By repositioning the fat of the cheeks, the apple muscles can be clearly defined, which can effectively reshape the typical Asian round frame into an oval frame with a V-shaped jaw, making it more attractive and achieving a slimming and shaping effect.
Types of Thread Material
In Hong Kong, the thread materials used in thread lift can be divided into two categories:
Non-absorbable – Because they are made of non-absorbable materials (such as polypropylene), they are permanently retained in the subcutaneous tissue.
Absorbable – They are made of absorbable materials that can be decomposed by enzymes in the skin. Polydioxanone (PDO), poly-L-lactic acid (PLLA), polyglycolic acid, and poly(lactic-co-glycolic acid) (p(LA-CL)) are some examples of absorbable materials. The stability of the thread in the skin depends on the structure of the polymer used to make the thread. Polydioxanone thread takes about 6 months to be absorbed.
The design of the material used will also affect the expected results, which are generally divided into smooth and non-smooth lines. Non-smooth lines are sutures with protruding portions that radiate outward from the center. These protruding portions can be barbs (such as Definisse™ threads, Aptos threads, and Mint lift™ threads) or cones (such as Silhouette soft®), which can anchor and reposition soft tissues. Barbs open up like an umbrella to form a supporting structure, repositioning loose skin. The thread is inserted into the tissue in the opposite direction of the barbs, allowing it to slide without being anchored to the tissue. When pulled in the opposite direction, the barbs tighten, grabbing the fibrous tissue in the fat and pulling the dermis and skin upward. Therefore, threads with barbs are anchored in the tissue, suspending the tissue.
Depending on the direction of the barbs, they can be divided into two-way barbs and one-way barbs:
Two-way barbs provide barbs in opposite directions to ensure traction; there is usually a smooth area in the middle of two-way barbs to facilitate grasping the thread and promote tissue accumulation in the middle of the thread. Two-way barbs cannot move freely because the barbs are fixed in the tissue in both directions. Examples of two-way barbed threads include Happy Lift Definisse™ free-floating threads and Happy Lift Double Needle dual needle threads.
All the barbs in one-way barbed threads are angled in the same direction. Examples include Ultra V Lift and Happy Lift’s Definisse™ Ancorage.
Different thread materials require different techniques and methods, and the results achieved are also different. But the things that patients need to pay attention to before and after the procedure are very similar.
Who is not suitable for thread embedding treatment? If a patient has a serious systemic disease, such as severe liver disease, heart disease, etc., and is worried about triggering their own condition, they are not suitable for thread embedding treatment. Thread embedding is an invasive treatment, and there is a chance of bleeding. If the patient is taking anticoagulants, there is a chance of prolonged bleeding. People who are sensitive to thread materials or anesthesia are not recommended to undergo thread embedding, otherwise acute allergies may occur. It is best for people near the embedding site or who are currently experiencing systemic infections to wait until the infection is under control before undergoing treatment to avoid bacterial invasion of the thread. Because anesthesia needs to be injected and it is an invasive treatment, it is not suitable during pregnancy and breastfeeding. To avoid the problem of hypertrophic scars, people who have slow wound healing or who have conditions such as psoriasis, hypertrophic scars, and diabetes should avoid thread embedding treatment. Some people with high expectations for thread embedding results or people with body deformities may not be suitable for this treatment.
Post-care for embedded sutures
Embedded sutures are a traumatic treatment, and post-operative care is crucial. The site of the embedded sutures may experience swelling and pain, which can be controlled with anti-inflammatory and pain medication as prescribed by the doctor for two to three days. Short-term antibiotics may also be prescribed if needed. Within three days after the surgery, it is recommended to sleep with the pillow facing upwards. During the first week, when washing and moisturizing the face and applying skin ointment, it should be done gently without rubbing or massaging. Avoid excessive exposure to direct sunlight, tanning beds, or saunas to reduce the chance of pigmentation. Avoid facial and neck massages and beauty treatments. Ice packs can be used to reduce swelling and bruising after surgery. It is advised to avoid makeup for the first 24 hours to prevent bacteria from entering the body through the incision. Avoid excessive facial and neck activity, such as laughing or dental work, as the sutures may move or be damaged.
Risks and side effects
Like other invasive treatments, embedded sutures may have some risks and side effects, but they are generally temporary and not severe.
These risks and side effects include:
Swelling and pain
Swelling and pain are common side effects of injection/needle insertion and suturing. In most cases, they are mild and temporary, lasting for several days. Pain medication can be taken as directed.
Redness, swelling, and bruising
These reactions are more common in people with thinner and more easily reddened skin or in areas with a high concentration of blood vessels. These reactions usually subside within a few days, but bruising may take up to two weeks to disappear completely. If you are taking medication or eating foods that may cause bleeding problems, such as aspirin, non-steroidal anti-inflammatory drugs, warfarin, ginkgo, and vitamin E, notify your doctor first.
Since the sutures are a foreign material, bacteria may adhere to them and cause infection. If necessary, the doctor may prescribe prophylactic antibiotics to prevent possible infection.
Before treatment, the doctor will determine the symmetry of your left and right sides and balance them as much as possible during the treatment. However, it is also possible to increase asymmetry, which can be corrected by inserting more sutures if necessary.
Tactility of Threads
Threads can be felt by touch if they are placed in relatively shallow subcutaneous tissues. If necessary, consult a doctor to see if removal is needed.
If a patient has a significant amount of sagging tissue, threading may pull the tissue up and cause skin folding. Typically, this will disappear within two weeks. This problem usually occurs in older individuals and/or those with noticeably loose skin.
Protrusion and Extrusion
The movement of threads interacts with the local skin tissue. Overactivity can cause the hooked position to shift. The thread end may have a chance to protrude from the skin. If necessary, the doctor will cut off the protruding end.
Damage to Skin Tissue
Different people’s tissues have different positions. Threading surgery may damage some facial tissues, such as blood vessels, salivary glands, and nerve lines. These damages are generally temporary and will naturally recover over time.
Avoid exposure to sunlight after threading because the placement of the threads may cause some inflammation and lead to the appearance of hyperpigmentation.
In some patients, the tissue at the entry or exit wound of the thread may appear depressed. If necessary, the doctor may need to adjust it.
In Hong Kong, threading is commonly used for contour reconstruction (slimming the face), tightening, and even nose augmentation. Thread lifting is a minimally invasive and effective treatment, but it uses more complex threads. Different threads require different techniques and are applied to different parts of the body, achieving different effects. Patients should have a doctor diagnose which type of thread is suitable for them before making a decision.