Absorbable tension threads - an alternative to surgical facelift?

The demand for non-surgical rejuvenation techniques in the field of aesthetic medicine is constantly growing. The placement of tension threads under the skin is successfully used to reposition sagging tissues of the face, neck and some other parts of the body. The so-called "suspension" sutures (absorbable and non-absorbable), consisting of biocompatible materials, are used to correct moderate tissue ptosis. The procedure is performed under local anesthesia and is associated with minimal risks for the patient. Recently, tension (tensor) threads made of biocompatible materials are often used, which are completely absorbed over time, while allowing the effect of tissue regeneration and tension to be achieved. 

Mechanism of action of absorbable threads based on polydioxanone and polylactic acid

Polydioxanone or polylactic acid can act as the main component of bioresorbable tension threads. At the same time, notches are applied to polydioxanone threads along the entire length, and threads made of polylactic acid – cones. Both types of threads are absorbable and bidirectional, which ensures their fast fixation to the subcutaneous tissue.

Polydioxanone is absorbed within 6 – 8 months, polylactic acid – within 12 months. At the same time, the lifting effect after the installation of polylactic acid threads lasts up to 18 months.

The new generation of bioresorbable tension threads has two main properties:

1. Mechanical tightening of sagging tissues. The lifting effect is achieved instantly and looks natural.
2. After being placed under the skin, these materials of exogenous origin trigger the physiological action of the body's defense system – local inflammatory reaction in response to a foreign body. Such threads are gradually reabsorbed, dissolving in biological tissues, and stimulate the synthesis of procollagen molecules, as well as reactive fibrosis, due to which the results are preserved after the resorption of the threads.

Recent studies have shown that polylactic acid and polydioxanone stimulate collagen synthesis in the dermis and increase fibroblast proliferation.

Features of the use of absorbable threads: indications and contraindications

Absorbable threads are used to correct sagging skin of the face and body, as well as to reposition tissue volume without increasing it. The technique is used in specific cases in women and men around the age of 40, but can be used at a younger age, depending on the condition of the face. Most often, the correction is carried out in the face and neck area in order to:

• raise sagging eyebrows along the entire length;
• tighten the area of ​​the cheeks and cheekbones;
• eliminate cheek ptosis;
• smooth nasolabial folds;
• eliminate sagging neck tissues;
• raise upper lip;
• correct the oval of the face.

Patient, 62 years old. Before (A) and after (B) placement of absorbable threads in the lower jaw area (2 threads on each side).

Installation of absorbable tension threads – non-surgical solution to correct moderate sagging of the skin not only on the face, but also in certain parts of the body, such as:

• buttocks;
• neck;
• belly;
• knees;
• inside of arms;
• inner thighs.

This procedure is also excellent for patients who are contraindicated in surgical facelift.

Medical contraindications:

• pregnancy and breastfeeding;
• sagging skin as a result of a surgical procedure;
• taking anticoagulants;
• skin infections in the treated area;
• autoimmune diseases;
• allergic to yarn materials;
• preliminary injection of non-absorbable materials into the target area.

It is recommended to refuse the procedure to patients:

• with too thin skin – in such a case, the threads may be visible;
• with too tight skin – the effect may not be sufficiently pronounced;
• with lots of wrinkles – procedure may not be effective;
• if there is excess skin and fat.

In all of the above cases, it is better for the patient to be advised a surgical facelift. If the patient still wishes to undergo a thread lifting procedure, it is necessary to warn him about the high probability of unsatisfactory results.

How is the thread lift procedure carried out?

Before the procedure, the doctor must conduct a preliminary consultation in order to:

• assess the patient's condition
• to make sure that this method of facelift is appropriate;
• exclude possible contraindications;
• Tell the patient about the procedure
• determine the required number and type of threads.

The procedure itself is performed on an outpatient basis in accordance with the rules of hygiene and asepsis. No special preparation is required for the placement of absorbable threads, however, for several days after a facelift, patients are not recommended to take aspirin or anti-inflammatory drugs.

For patient comfort, an anesthetic cream can be applied to the treated area of ​​the body one hour before the procedure or a local anesthetic can be injected at the points of insertion and withdrawal of the needle (cannula) at the beginning of the session.

Using a thin needle or a small cannula, the doctor inserts the threads one by one under the skin, following the previously applied markings, and fixes them in the dermis.

Thread placement takes 30 to 60 minutes depending on the type and number of threads and other indications. Multiple zones can be corrected at the same time. 

After the procedure, the doctor gives the patient recommendations:

• avoid active facial movements;
• avoid physical overexertion;
• do not visit the sauna and bath;
• Don't massage your face.

The thread lift procedure has a number of advantages over surgical lifting because it is performed:

• outpatient;
• under simple local anesthesia;
• no notches;
• with a minimum recovery period;
• safe;
• in combination with fillers or botulinum toxin (sometimes).

Like any medical procedure, a thread lift comes with certain risks. As a rule, temporary local reactions can be observed after the procedure:

• small bruises;
• swelling;
• redness;
• skin tightness;
• small folds of skin;
• slight asymmetry.

The effect of a facelift with absorbable tension threads

After inserting absorbable sutures, the results appear in two stages:

1. Immediately after the – visible lifting effect of the skin, which gradually decreases a week after the insertion of the threads.
2. Gradually as new collagen is synthesized; the threads dissolve after about 6-12 months, however, due to fibrosis, the aesthetic result is maintained for 12-18 months.

After the threads have been absorbed, the procedure can be repeated.

The success of a thread lift largely depends on the technique and protocol of the procedure, but there are other factors that can affect the quality and duration of the result:

• age;
• patient lifestyle;
• the quality of the patient's skin.

To obtain a more pronounced and lasting result, the author (Catherine de Goursac) often combines threads based on poly-L-lactic acid with threads based on polydioxanone.

Implantation of resorbable tension threads provides a temporary natural lifting effect, however, this procedure cannot replace a surgical facelift in case of severe signs of aging. 

Lifting with absorbable tension threads – a relatively new rejuvenation technique used in aesthetic medicine, the result of which largely depends on the knowledge of anatomy, the practical skills of the doctor and the correct choice of the patient. The implantation of resorbable tension threads provides a temporary natural lifting effect, however, this procedure cannot replace a surgical facelift in case of severe signs of aging. 

According to Prime magazine.