THREADLIFT
   

Barbed Sutures for Facial Rejuvenation
 

Face-lifting is one of the most common procedures performed in our office. In the early part of the century most of the techniques involved removal of skin around the ear or the laugh lines. In the late 1960’s and early 1970’s more advanced techniques of lifting involved dissection and repositioning of neck muscles (e.g. Platysma) and fascia (SMAS). Many variations of this technique now exist. As these procedures have become more extensive, the recovery has become longer as well.

Dr. M. Sulaminidze of Russia first introduced the concept of facial tissue repositioning with barbed sutures. The barbed sutures are Prolene (polypropylene) stitches that have cogs (spikes) in them. When inserted under the skin the cogs embed in the underlying tissue and allow repositioning in a higher position. I met Dr. Sulaminidze for the first time in May of 2002 with a handful of other surgeons who attended a course in which he demonstrated his APTOS sutures and technique. American manufacturers then improved upon these Russian made sutures and the lift became known as the Feather Lift. We started performing the Feather Lift at Inland Cosmetic Surgery Medical Center in late 2002. We hosted two courses at our facility with Dr. Sulaminidze on the APTOS Feather Lift in March and October 2003. Some of our results were submitted to the FDA as part of the clinical studies for these sutures. Our initial results were very impressive with the APTOS sutures. The procedures were performed under local anesthesia, recovery was short and the results were very natural looking. As time progressed some of the result was lost due to relaxation of the skin. We recently carried out a long-term analysis of our results and found out that only about 56% of patients were satisfied with their long-term results. The results of our study can be found in the December 2005 issue of the American Journal of Cosmetic Surgery.

Aptos feather lift to bows, cheeks, jowl
with submental liposuction

Aptos feather lift to cheeks

Endoscopic brow lift, lower blepharoplasty, submental liposuction
and Aptos to cheeks

Since the introduction of the concept of barbed sutures there have been many modifications to the suture and the technique. One modification was limiting the barbs to one end of the suture and allowing the other end to act as a regular stitch that can be tied under the hairline, behind the ear or under the scalp. These sutures have gained FDA approval in the last year. Two of the sutures that have gained approval are the Contour Threads, and Endo Isse sutures.

For patients who do not want to go under anesthesia or the knife we are offering the Contour Thread Lift. The Contour Barbed sutures approved by the Food and Drug Administration (FDA) are used in a minimally invasive way, under local anesthesia, to elevate and reposition the sagging tissues of the brows, cheeks, jowl and neck. The Contour Thread Lift has been found to give modest improvement in facial contours. The advantages are minimal down time (1 to 3 days) and minimal discomfort. Though there is insufficient data as to the longevity of the Contour Thread Lift effects, they are believed to last from two to five years. The contour thread lift is not suitable for patients that have a lot of skin laxity and need skin removed for rejuvenation. In fact, patients that have a significant amount of loose skin end up with bunching of the skin after the procedure which usually resolves spontaneously within a few weeks.

Contour Threads to Midface
3 Threads per side

We have combined our endoscopic technique with placement of barbed sutures. The endoscopic technique uses optical telescopes with video imaging to allow visualization of the surgical site. The muscles of the forehead, frown lines and the brow are treated and freed. Then usually the outer portion of the brow is elevated and fixed in a higher position with sutures. No skin is removed with this technique. In addition, we can place additional barbed sutures in the mid face to treat the laugh lines, as well as sutures in the jowls and the neck. This has resulted in a natural harmonious rejuvenation of the face with a shorter recovery.

Endoscopic Brow Lift
Contour Threads to the cheeks
with a full face TCA peel

Q. What are Contour Threads?
A. These are barbed sutures that were recently approved by the FDA for facial rejuvenation.

Q. What does the Contour Thread lift achieve?
A. The Contour Thread Lift is a procedure that uses these sutures in a minimally invasive way, under local anesthesia, to elevate and reposition the sagging tissues of the brows, cheeks, jowl and neck.

Q. How long does the effect last?
A. There have been speculations that the lift may last 2-5 years, but since there are insufficient long-term studies, the longevity of the lift is unknown at this time.

Q. Who is suitable for this procedure?
A. This procedure is suitable for patients who are seeking a modest improvement in facial contours with minimal downtime and are not ready for a facelift.

Q. How long does the procedure take?
A. Between 30-60 minutes depending on the number of areas that are being treated and patients can go home after the procedure.

Q. How long is the recovery?
A. Down time is minimal, on average 3 days, and patients may have some swelling and bruising that resolve spontaneously.

For further information on this new non-incisional technique of facial rejuvenation call Dr. Haiavy at Inland Cosmetic Surgery for a consultation.