Algorithm for selecting patients for thread facelift from an expert

The popularity of thread techniques in the field of aesthetic medicine is at its peak today. They successfully compete with surgical methods in terms of correcting moderately pronounced age-related changes, and allow achieving the best rejuvenation results. However, for thread lifting, as for any other aesthetic procedure, it is very important to correctly select patients. This is exactly what Georgiy Chemyanov, a plastic surgeon, Ph.D. Read the algorithm for selecting patients from an expert on estet-portal.com in an exclusive interview.

What classifications do you use when assessing patients' faces?

I had a talk today on this topic and told the doctors about the importance of choosing the right patient for any procedure.

Whether it is a surgical operation, a cosmetic procedure, or, in particular, APTOS thread techniques, the key to success – correct patient selection.

There are a huge number of different classifications for assessing a face. One of the most common is the classification of Daniel Baker – this is such a gold standard for classifying a patient's face. Daniel Baker divides patients into 4 types. For the first two types of patients with the first or second degree of age-related changes in the face, he recommends doing mini-lifts, and for the third or fourth degree, in the presence of more pronounced gravitational ptosis, the doctor recommends performing extended classic facelifts. If we are talking about thread lifting, then, of course, the first two types – these are patients with less pronounced age-related changes, and they are well suited for threads. But if patients have excess skin,  its tone is reduced, the oval of the face is broken, excess tissues appear in the neck – such patients are not suitable for threads, but for surgery. Therefore, if we act within the framework of the APTOS recommendations, and within the framework of the classification of Daniel Baker – we will get a good result and a satisfied patient.

Another classification I would like to draw your attention to – this is the classification of our compatriot Ilya Aizikovich Frishberg. He created it, of course, not for thread lifting, but it suits him very well. Ilya Aizikovich took into account the mobility of soft tissues. He suggested that before the procedure, manually check whether the tissues are moving, and this is very important for the threads. In any area of ​​the face, we can try whether it is possible to shift the oval of the face or, for example, the eyebrow with the help of fingers. And if we can manually move them, then the threads will also allow us to do this. And if, for example, the eyebrow does not move, then the threads will not be able to move it. And if we cannot manually press the subchin area, then the threads will not be able to press the tissues in this area. Therefore, the doctors who study with me,

What classification is used for the upper third of the face?

There are many classifications for this zone. From the visual ones, I can single out the classification of gravitational changes in the medial part of the face by T. Hester and F. Nahai. This classification distinguishes four types of patients with varying degrees of gravitational ptosis – from small to pronounced. And if we are talking about thread lifting – such techniques are recommended for the second and third degrees of ptosis. But if the gravitational changes are strongly pronounced, and the patient has the fourth degree of ptosis – Of course, surgery is recommended. Well, in the first type of patients, when the changes are not yet expressed, you can get by with botulinum toxin, or it's just too early to do anything.

How to choose the right threads for a particular patient?

There are many threads, there are more than 30 methods in APTOS, but conditionally all of them can be divided into two groups: reinforcing and lifting threads. In Ukraine, the official distributor of APTOS products is

Top cosmetics. The first group of threads gives a slight tightening and tightening of tissues. In APTOS, these are all Nano, Visage and Spring methods. The second group of threads allows you to tighten the tissues more powerfully, these are the APTOS Thread 2G and Needle 2G methods. With these techniques, we form a loop in the tissues, and create a fixation point, to which we pull the tissues. Based on what type of threads will be used, we select the patient. There is a classification that is difficult to tell, but we show it in the training. According to this classification, the main thing to pay attention to – it's the quality of the skin. If the patient is asthenic, and he has thin skin – it is enough to use reinforcing techniques. If the patient's skin is dense, thick, and there is a deformation type of aging – of course, reinforcement in this case simply will not work, and we use the second group of threads. But this is to tell in general terms, but for more detailed information, you need to come to master classes, where we tell everything, show the classifications, and already directly while working with the patient we explain why this particular thread should be chosen for this patient.

What are the main rules that doctors must follow when working with threads?

First – those are the rules  asepsis  and antiseptics. With threads, as with any injection technique, this is the law. But with thread methods, aseptic and antiseptic is even more important, because we touch threads and needles, and long threads touch everything around. Therefore, it is necessary to limit the patient's face with a sterile diaper, treat it twice with an antiseptic solution and put on sterile gloves. This is the basis, and without it it is better to simply not approach this procedure. Second – this is, of course, the choice of the patient.

If we chose the wrong patient – we are going to fail.

The right patient and the right technique must be selected. And the third – this is directly your work with your hands, that is, the skill of a surgeon or cosmetologist. And manual skill – it is not the basis, but one of the three components. High-quality and correct work in the correct layer, knowledge of anatomy and knowledge of methodology, a sense of tissues – All this can only be done with skill. Doctors need to start working, attend practical classes and master classes, be sure to attend cadaver courses in order to understand the layered structure of the face on the anatomical material, and, of course, watch it all on video portals. And about APTOS thread lifting (the official distributor of the brand in Ukraine

Top cosmetics) a huge amount of information is presented on the Internet.