Thread lifts have become a minimally invasive alternative to the facelift for patients who are not ready to undergo more aggressive treatment options. Although the effects from a thread lift will be temporary and not as dramatic as a facelift, improvement in the appearance of fine lines and wrinkles can be seen gradually as the procedure stimulates natural collagen production.
PDO sutures are a type of material used for thread lifts. PDO, which stands for polydioxanone, is an absorbable polymer that is flexible and durable for minimally invasive thread lifts. PDO thread lifts, sometimes referred to as PDS thread lifts, come in a variety of textures. There are three main textures of PDO sutures: mono, cog, and screw threads. Mono threads are singular, smooth sutures that are anchored to the face that provide a small lift to the face. Cog threads have a barbed texture that provide better lift and increased collagen production. Screw threads have 1-2 intertwined threads which provide volume to the treated area. For patients who only desire skin tightening and rejuvenation, mono threads may be sufficient. Patients who desire more lifting and volume will better benefit from textured cog or screw threads.
A thread lift procedure is a shorter procedure type that focuses on targeting the signs of aging on the lower face and involves subcutaneous placement of PDO threads which are pulled to achieve the desired skin lift effect. Although it can address eyebrow sagging and cheek sagging, thread lift often focuses its attention on midface, jowl, and neck-lifting.
What is the Goal of a Thread Lift?
The goal of a thread lift is to reposition skin tissues, thus restoring youthful proportions and appearances to the face, neck, and body. This lifting and tightening are done by a plastic surgeon who inserts a needle into the skin, threading it bi-directionally through the soft tissues of the face, neck or body to grasp, lift and suspend the facial area. Surgeons use a “cross-hatch” or “basket weave” pattern to achieve the desired lifting effect in the targeted areas. The minimally invasive procedure provides immediate results, but its greater purpose is to encourage new collagen production to stimulate long term results and restore a youthful appearance in the treated areas.
Technical Description of a Thread Lift
Before a thread lift begins, patients will receive local anesthesia in the area where the thread-lifting will be performed—the midface, jowl or neck. A plastic surgeon then inserts a pre-threaded needle into the subdermal level of the facial tissues, which simply means that the needle will go underneath the visible layer of skin. The needle is inserted in a curved direction into the area to be lifted. Directly above this first needle, a second needle will be inserted approximately 1-1.5cm above the existing needle.
The purpose of each needle is to insert bi-directional threads into the targeted areas. These threads are made of polypropylene and are often referred to as PDO threads. The procedure itself is often called a PDO thread lift. The most widely-known PDO threads are Novathreads, but your plastic surgeon may prefer to use another type. PDO threads are equipped with small barbs along the surface that act as cogs (small gears or mechanisms) to grasp, lift and suspend the facial area undergoing treatment. As the needle is slowly withdrawn, it creates a suture lift causing the tissue to “gather” over the thread until the desired effect is achieved and the long ends of the thread can be cut off.
New collagen and fibrous tissue forms around the PDO sutures and continues to hold up and tighten the skin tissue. This growth happens to help naturally heal the treated areas, but because there are threads in place, new growth will take place around the threads in the repositioned areas. This achieves the longer term results a thread lift offers.
There is no need to worry that threads are left underneath the skin. They facilitate the new growth and dissolve completely on their own, without leaving residual material, in about 6 months through a natural process called hydrolysis. Hydrolysis is painless and simply refers to a chemical breakdown caused by a reaction with water. After the threads have dissolved, the new collagen and fibrous tissues will have already formed in the treated areas and will continue to show a lifted effect, restoring youthfulness to the area.
Before Treatment Care for a Thread Lift
Although it is always best to meet with your plastic surgeon to determine the best plan of action for your specific skin type, professionals agree that thread lift candidates should avoid all alcohol and discontinue smoking for at least a week before the procedure as these things will dehydrate the skin and interfere with the anesthetic. All aspirin-based products should be avoided as well as cause unnecessary bleeding leading to unwanted complications and side effects. Blood-thinning products include Ibuprofen, Neurofen, and Naproxen/Naprogesic.
After Treatment Care for a Thread Lift
Some thread lift patients might feel nausea associated with the after-effects of the anesthesia or the procedure itself and can sip small amounts of clear liquids until it passes. It is also helpful, especially if your skin tends to swell or bruise, to ice the area for 30 minutes 4-5 times a day for the first 5 days.
Otherwise, limit facial motion for 24 hours, avoid facial creams or makeup for 48 hours, do not drink with a straw, keep the head elevated (including bending lower than heart-level) at a 45-degree angle for 5-7 days, eat soft foods or drink liquids for 7-10 days, avoid chewing gum for 2 weeks, avoid heavy exertion for 2-3 weeks and avoid pulling down on face or massaging it for 3 weeks.
Pros & Cons of a Thread Lift
Pros - Short procedure - Quick recovery time - Minimally invasive
Cons - Not as effective as other methods - Does not address excess skin - Lower success rate
Recovery from a Thread Lift
A thread lift requires very little recovery time because of its non-invasive nature, but it is still helpful to have a basic idea of when you can expect to return to normal living. The following list provides an idea, but you should always follow your surgeon’s instructions if they differ in any way from what is listed here.
When Can I Start Working Again?
This depends on your job type and environment. You should expect to return to work within 1 day to 1 week of your treatment, but that will vary from job to job. A job that doesn’t require a lot of activity could be resumed in 1-2 days. A more strenuous job or a job that requires a lot of movement and activity, such as nursing or personal training, would require more time off.
When Can I Shower?
You should refrain from washing, wetting and touching your face or the treated area for at least 12 hours after your procedure. Once you do start showering and cleansing the area, be careful not to massage or scrub with a washcloth for 3 weeks after your thread lift.
When Can I Resume My Regular Skin Care Routine?
You can gently resume a basic wash, dry, lotion routine about 48 hours after your thread lift, but avoid any type of scrubbing, tugging or exfoliation, and check with your surgeon before applying any prescription strength creams or topical medications.
When Can I Wear Makeup?
After waiting 48 hours after your thread lift, you can apply makeup as needed. Makeup will help cover any remaining bruising.
When Can I Exercise Again?
You can resume light forms of exercise, such as walking, 1 week after the thread lift, but be careful to avoid any exercise that strains the treated area. Weightlifting, for example, should be avoided until you are cleared by your surgeon. Yoga, which requires your head to be below your heart, should be avoided for 7 days.
When Can I Have Sex?
Sex and exercise have very similar rules. You can resume light sexual activity about 1 week after most thread lift procedures, but it is determined by the area that was lifted. If your thread lift was performed to lift the buttocks, you will need to wait much longer than if your thread lift treated your marionette lines. You should ask your surgeon for specific guidelines to follow.
When Can I Go Swimming?
You are not advised to wet your face for 12 hours after your thread lift, but before swimming, it is better to wait until the suture site has completely healed. Follow the same guidelines for hot tubs and saunas.
Expected Results from a Thread Lift
The majority of people will notice minor immediate results directly after receiving a thread lift. As the face heals, new collagen forms in the treated areas creating a more obvious difference. While the results are more long term than some of the other facial rejuvenation options, such as surgical facelifts, the results are temporary and it is necessary to receive maintenance treatments every 6-12 months, depending on your specific age-reversal needs.
Texturized threads will achieve results more instantaneously than the smoother threads; however, it is important to remember that each thread type aims at producing collagen over a longer period, which is the overall goal of a thread lift procedure.
Side Effects from a Thread Lift
Most of the side effects of a thread lift occur in the first 24-48 hours after the procedure takes place, and will often resolve quickly. Some of the potential problems take a few weeks, or possibly even months, to resolve. These potential side effects include infection, bruising, swelling, tenderness, numbness, and slight asymmetry (small unevenness). Sometimes a suture will show itself just below the skin, as well.
Some important questions to ask during a consultation:
- Am I a good candidate for a thread lift procedure?
- Why should I consider this procedure over another procedure (insert the other procedure(s) you might be considering?
- What will be expected of me to achieve the best results?
- What happens if I am not satisfied with my results?
Risks and Complications of a Thread Lift
As with any procedure you might choose to undergo, some risks and complications might arise, and it is worth it to educate yourself before determining if a procedure is right for you.
A thread lift is a newer procedure whose techniques are still being improved upon and developed. Although rare, patients may experience such things as infection, sensitivity or numbness, PDO suture movement, slight asymmetry, scar tissue, visible sutures or unnoticeable results.