The History of Thread Lifts
The History of Thread Lifts
The history of thread lifts beings with the origins of facelifts, over 100 years ago.
In 1916, the surgeon Erich Lexer first performed the procedure with a method that persisted until modern times. By simply pulling on the sides of the face, the face was literally lifted into a new position.
The excess skin that arose from this pulling motion was then removed near the anatomical site of the ear, before sutures were employed to hold the skin in place.
Due to the rather unilateral movement of the skin, and the fact that the lack of underlying structure was not addressed, the skin was lifted but often had a stereotypical ‘look’. This look was still apparent in the late 80s and 90s as a result of overzealous patients and surgeons going too far with their efforts.
Unfortunately, patients were often left with a surprised or windtunnel expression – a relic of the skin simply being pulled up towards the ear to remove sagging. This technique was the only technique used for over 60 years and as time went on was deemed unsatisfactory in producing the return to youth that patients were looking for.
An Evolution of the FaceLift
An Evolution of the FaceLift
In response to the tight expression left by the original face lift, surgeons began experimenting with new techniques.
These sought to address the shortcomings of the historical procedure. Not only did they now seek to lift sagging skin, but also recognised that manipulation of the underlying structure and soft tissue of the face was also necessary.
In the 1970s, a French maxillofacial surgeon was becoming well known in the medical field for his work on clefts, bone grafts and innovation in ophthalmology.
Dr Paul Tessier would go on to become renowned as the father of modern craniofacial surgery. Due to his invention of techniques to plastic, maxillofacial and neurosurgery he became an honorary member of the American College of Surgeons, the Royal College of Surgeons at London, and the American Society of Plastic Surgeons.
His work highlighted the importance of utilising the soft tissue of the face to aid in the reduction of sagging and wrinkles, bracing the skin with repositioned tissue. This gave a more refined look that could target the specific anatomical needs of the patient, rather than a one size fits all approach.
The approach is still referenced today as SMAS – which stands for superficial muscular aponeurotic system. Over the following two decades, surgeons began using deeper and more invasive techniques to achieve desired results – but with this carried higher surgical risk and increased recovery times.
The Modern Thread FaceLift
The Modern Thread FaceLift
As the rise of less invasive treatments like Botox and fillers became mainstream treatment options, the invasive and costly surgical face lift began to fall out of favour.
Surgeons began to devise new techniques using threads under the skin to still give the effectiveness of surgery without the side effects of invasive treatment.
Although a significant step forward, basic threads were not giving an optimal look in all situations. Barbed, or cog threads began life as sutures as far back as the 1960s. By the end of the millennium they were being described as an APTOS LIFT suture by Marlen Sulamanidze.
So great were the results from using this new style of thread that there was an explosion in new thread development: the Isse Threadlift, which necessitated surgical dissection of the scalp and fixation of the unidirectional barbed sutures to the temporal fascia; the Contour threads, which were initially similar to Isse’s design; the cone sutures (silhouette lift); and many others.
Today, both dissolvable and non-dissolvable threads are in use, being able to be placed within the facial structure and provide lift and support to rejuvenate the face.
Ensuring Surgical Excellence
Ensuring Surgical Excellence
A review of thread lifts and surgical facelifts found that some practitioners can fall foul of thinking thread lifts are ‘easy’ or ‘simple’.
While from a patient’s point of view they are quick, effective and enjoy a quick recovery period, the clinician themselves must have a skilled eye and hand.
The journal review states that a good facial surgeon employing the use of threads “must have expertise in muscle kinetics, soft tissue anatomy, thread mechanics, and immunologic processes associated with suture placement.”
They concluded that while “Threadlifts look easy to perform, but obtaining stable and consistent results requires all of the above in addition to surgical skill, aesthetic judgement, practice, and experience that come from having performed many such lifts.”
PDO Threads: A non-permanent solution
PDO Threads: A non-permanent solution
Polydioxanone threads, better known as PDO threads, can last anywhere from 6 months up to a year.
Not only do these threads help align the skin, they promote collagen formation and other tissue changes to bring further benefit to the face. The insertion of the threads within the subcutaneous layer attracts the body’s immune system to granulate around the freign body.
This is what promotes new collagen formation.
Perhaps of even more interest to practitioners and patients alike is that the new collagen tissues have been shown to merge with existing underlying tissue, providing a stronghold for the new facial shape and structure.
Another type of cell, known as fibroblasts and myofibroblasts are generated, which are always seen within the remodelling of skin tissue. Their presence tells us that PDO threads have the ability to improve the elasticity of skin, thereby giving it a more natural movement and continued tightness under facial mobility.
Finally, adipose (fat) cells seem to be negatively affected by PDO threads. In this case, they have been seen secondarily affected by the generation of new connective tissue described above.
In practice, this means that areas of the face which are supported by new tissue are also thinned by the removal of some of the subcutaneous fat. This naturally refines the skin, facial contours and gives more pronounced angles and features associated with youth and beauty.
The Future of Thread Lifts
The Future of Thread Lifts
Threads used in facial rejuvenation now come in all shapes, size and function. They are in some cases used in conjunction with other beauty treatments to maximise outcomes for patients, including longevity and significance of effect.
Thread lifts have heralded a new era in facial rejuvenation, allowing quick, effective and relatively pain free treatments that can be accessed via skilled practitioners worldwide.
Future development will likely be concentrated on new techniques with threads that are now available, as well as innovating on post-treatment applications to further reduce downtime and improve appearance.