Dangers of mesothreads: what complications can occur after thread lifting

In the field of modern cosmetology, there is a whole range of techniques that can cope with age-related skin problems. One of these methods is mesothreads. This unique facial reinforcement technique is gaining in popularity. At the same time, it is still not known for certain how effective it is, and most importantly – safe. The same applies to possible side effects.

The editors of Estet-portal decided to understand this technique in more detail and turned to specialists for help. Practicing cosmetologists from Russia and Ukraine answered our questions.

Mesothreads in cosmetology: important information for specialists

2013 was marked by a literally explosion of interest in a new minimally invasive technique for rejuvenating the face, neck and décolleté using the implantation of smooth resorbable threads based on polydiaxone (PDO). This technique was developed and started to be used in South Korea two years ago, and quickly spread to the countries of Southeast Asia (China, Malaysia, Singapore, Vietnam, Japan, Philippines).

She is currently gaining her popularity in Russia and Ukraine.  There is still no established name for the threads themselves, nor for the method based on their application.

Most often, such threads are called “mesothreads”, but there are other terms: “microthreads”, “3D-threads”.

The technique itself is often called “threadlifting”. (A.A. Sharova, Ph.D., Associate Professor of the Department of Plastic and Reconstructive Surgery, Cosmetology and Cell Technologies, Russian National Research Medical University named after N.I. Pirogov, Moscow).

On the one hand, everything is correct – literal translation from English of the phrase “thread lifting” means “thread lifting”. However, the term “threadlifting” is not new and, according to the prevailing ideas, means a minimally invasive facelift operation using special threads with micro-notches / cones / teeth.

In Ukraine, these techniques are represented by the world's leading brands – Aptos Silhouette Lift. This technique is well known and recognized all over the world. It was approved by the US FDA in 2005.

Mesothreads:

• thread lifting technique: basic information about mesothreads;
• comments of the leading specialists of aesthetic medicine in Russia about mesothreads;
• comment by a practicing Ukrainian cosmetologist about mesothreads;
• important information about the safety and effectiveness of mesothreads;
• what makes the doctor opt for “mesothreads.

Thread lifting technique: basic information about mesothreads

It is worth emphasizing once again that "thread lifting" with the use of such certified and world-renowned brands as Aptos, Silhouette Lift is fundamentally different from the "mesothreads // 3D threads", which are actually discussed in this publication . Briefly about the technique  The system for installing the thread is a hollow flexible steel needle, in the lumen of which a piece of smooth thread based on PDO is freely placed.

Part of the thread is outside the needle and fixed with a foam ball or piece of foam rubber. Needles can have different caliber, their length – 25-120mm. An important condition for an adequate procedure is the correct level of implantation of the thread. If the needle is not inserted at an adequate level, there is no way to remove it along with the thread. The thread tucked into the needle is a monofilament structure, made from polydiaxone – The material, which has long been used in surgery for stitching tissues, biodegrades in tissues within 4-6 months.

After application anesthesia, the needle is passed subcutaneously to its full length along the intended trajectory. Then the needle is removed and the thread remains in the tissues.

When comparing the properties of five types of materials used for skin stitching, it was PDO that was characterized by the least manifestations of irritating action. A group of researchers analyzed the results of wound healing after applying more than 1500 intradermal sutures using PDO threads. Clinically, after the initial lifting is achieved, there is a slow increase in the effect and improvement in the quality characteristics of the skin over the next approximately 4 months.

Depending on the area of ​​injection and the number of threads inserted, the rehabilitation period takes about a week. The most common adverse events observed after the introduction of PDO threads are hemorrhages, soreness and swelling of the implantation zone. After the procedure, the patient may experience some discomfort with active movements in the places where the PDO threads are installed.

Comments of the leading specialists of aesthetic medicine in Russia about mesothreads

The method threadlifting smooth PDO-threads has appeared quite recently, we are just starting to accumulate our own clinical experience, develop scientifically and clinically based approaches to the placement of threads. The technique still requires a detailed study, clinical and experimental studies, as well as an analysis of possible long-term effects, both positive and negative. Only a calm, reasonable attitude to the method, without prejudice, but without unnecessary euphoria, will determine its place in the arsenal of therapeutic cosmetology. (A.A. Sharova, Candidate of Medical Sciences, Associate Professor of the Department of Plastic and Reconstructive Surgery, Cosmetology and Cellular Technologies, Russian National Research Medical University named after N.I. Pirogov, Moscow, 2013).

I have little experience with niitei yet. Limited to 3 months. I did not observe any adverse events in my patients, with the exception of swelling and soreness during the first week after the procedure. However, patients came for a consultation both with complications of an infectious and inflammatory nature, and those associated with the migration of the thread to the skin surface. The euphoria associated with the use of “mesothreads”, of course, will soon pass, and it will be replaced by balanced recommendations and proven methods of setting threads. (E.I. Karpova, Ph.D., plastic surgeon, “Danischuk Clinic”, Moscow, 2013).

My experience with threads does not exceed a year, and observations of patients indicate that the cosmetic effect lasts for 2.5-11 months. To achieve a lasting effect, we carry out an additional procedure 1-3 months after the first one. A very important point in the prevention of infectious complications:

• careful make-up removal of the entire face;
• double treatment of the skin, including the hairline, with an antiseptic solution;
• isolation of hair and neck with fixed sterile drapes;
• after the threads are implanted, the skin is carefully treated with an antiseptic;
• before the procedure, quartzization is carried out in the office.

Typical adverse events after – local hemorrhages and edema. At the stage of mastering the technique, one of my patients developed an extensive hematoma in the temporal region, which “slipped” on the cheekbone The patient complained of pain during articulation and chewing. Another patient developed severe edema that persisted for more than a week.

As for other undesirable phenomena, only two cases have been noted in my practice: displacement and thread eruption 3 days after the procedure. We removed the "cut" thread, the displaced – could not remove, we are monitoring the patient.

A patient of one of my colleagues had an infectious complication – abscess of the soft tissues of the cheek. The abscess was surgically treated against the background of antibiotic therapy, anti-inflammatory and desensitizing therapy. Also, once I consulted a patient with the visualization of the threads under the skin when they were implanted too superficially (shone through with blue stripes). Threads have been removed.  In my experience, the most common – this lack of results!  Summarizing, I would like to say that the method and materials are promising, but need further study. Of course, we want the promises that companies give us and that we broadcast to patients to come true. (M.A. Shirshakova, Ph.D., dermatovenereologist, assistant of the department “General Medicine” RMAPE,

Indeed, when implanting threads such as Aptos or Silhouette Lift, they are fixed to the skin or fascia. And due to the tension due to the presence of micro-notches or micro-cones, a pronounced lifting effect develops – moving the array of soft tissues upward, against the vector of gravitational ptosis. When using smooth threads, direct tissue displacement is not possible. Today, the implantation of PDS threads is a "fashionable sentence".

In the future, I expect a significant increase in the number of these procedures. This is due to the availability of the technique for cosmetologists. The clinical experience accumulated over time will allow us to improve the methodology and clearly formulate indications and contraindications for aesthetic threadlifting. It is possible to discuss the real possibilities of the procedure, its advantages and disadvantages only in the future. (M.I. Barannik, Ph.D., plastic surgeon, associate professor of the Department of Plastic Surgery of the FPCVR RUDN University, head of the clinic “Diamand”, Moscow, 2013).

Comment by a practicing Ukrainian cosmetologist about mesothreads

As a practicing doctor, I want to draw attention to a number of facts and share my own opinion about the "revolutionary technique - mesothreads":

The methodology was developed and started in South Korea two years ago; leading specialists in the field of aesthetic medicine in Russia have less than a year of experience in applying this technique.
In Ukraine, the widespread use of the methodology began even later than in Russia, therefore, there is no question of having significant practical experience and, as a result, understanding the effectiveness (feasibility) of the methodology, the risks of developing immediate and long-term consequences.
At the time of writing this article, "mesothreads" are not widely used both in Western Europe and in the USA, the technique is not certified by the FDA, the USA, which is a good form rule for ALL cosmetic products, equipment and methods, medical products; every doctor in his practice is constantly faced with certain weights “result / safety”, making a decision on the appropriateness of a particular treatment method, a particular procedure.

Important information about the safety and effectiveness of mesothreads

The safety and effectiveness of using mesothreads depends on many factors, and the decision to use them is made only by a specialist.

Security:

in the vast majority of patients, the rehabilitation period takes about a week;
The most common adverse events observed after the introduction of PDO threads are hemorrhages, pain and swelling of the implantation zone;
only for the last 5 months of 2013. we observed more than 20 patients who underwent the procedure of setting "mesothreads" in various institutions of Donetsk and the region with more serious complications. Such as: purulent inflammation along the threads (violation of the rules of asepsis and antisepsis during the procedure), aseptic inflammation that developed a few weeks after the threads were placed (probably, we are talking about an allergic reaction of the body to the introduced suture material) – the most complex complication, which is extremely difficult to correct even by surgery, is the contouring and protrusion of the ends of the threads under the skin (violation of the method of setting the threads, or the nuances of the technique itself); and these are only those cases when the doctor,
Efficiency:

manufacturing companies announce two effects achieved when setting “mesothreads” – lifting (skin tightening and improvement of facial features) and improvement of the qualitative characteristics of the skin.

• in modern aesthetic medicine, there are at least two directions aimed at achieving a
lifting effect
• (threads with protrusions or cones are more effective in this respect - Aptos or Silhouette Lift; hardware technologies that work at different levels – CO2 lasers, radio wave lifting; ultrasonic SMAS lifting), which have a more pronounced effect and, importantly, – understandable, high safety profile, confirmed by both European certificates and the US FDA; improvement of the qualitative characteristics of the skin: for the purpose of “reinforcing” for a long time, technologies such as intra- and subcutaneous injections of stabilized hyaluronic acid, calcium hydroxyapatite preparations have been successfully applied to the skin for a long time in order to moisturize and improve the processes in the dermis – injections of unstabilized hyaluronic acid (biorevitalization) and mesotherapy to improve microcirculation, fibroblast functioning and the quality of skin metabolic processes – injections of PRP (Platelet Rich Plasma – Plasmalifting)… and this is not counting the whole arsenal of various methods of hardware cosmetology. Isn't that enough?! The main thing is that each of them has an achievable result understandable to the doctor, a confirmed safety profile.
What makes the doctor opt for “mesothreads”

On the one hand – this is a desire for a new, more perfect, effective (but you should be objective and differentiate the promises of manufacturers from the results of clinical studies, documented evidence of efficacy and safety by quality committees in Europe and the USA).

On the other – I will only express my assumption - the cost of one thread is 20-60 UAH. (depending on the manufacturing company), 30-40 threads are usually used for face treatment, the average cost of the procedure in Donbass is 7.500 UAH. I think the math is interesting.

If you intend to perform the procedure of aesthetic correction of appearance with the help of “mesothreads” worth reading the material above.

CV:

Perform this procedure under appropriate sterile conditions (requires operating room conditions indeed);

• the procedure performed is purely medical, and the physician must be adequately qualified and certified;
• make sure that the threads to be implanted have a registration certificate of the Ministry of Health of Ukraine;
• weigh the pros and cons by getting comprehensive information about possible alternative methods of aesthetic correction;
• they are often more gentle and effective;
• like everything new, convincing data on the effectiveness and safety of “mesothreads” will appear over time;
• I am convinced that every patient expects a high-quality, safe, effective procedure, there are more than enough of them today.

The editors of Estet-portal do not incline you to this or that procedure. We just care about the health and beauty of our readers. Therefore, I would like to note that, regardless of the type of procedure, it must be approached carefully. This applies to both patients and doctors.

March 2015