Ageing causes loss of facial fat, especially around the cheeks, the eye area, the jowls and the neck. Accompanying this is skin ageing where the elastic fibers in the skin become thinner resulting in loss of facial elasticity? The two processes result in a longer face and wrinkles due to the “facial scaffolding”not being able to provide as much support.
In this guide, we review the following:
- How many types of thread lift are there?
- How many threads are used in a thread lift?
- What is the best PDO thread for lifting?
- What are the different types of PDO cog threads?
How many types of thread lift are there?
Thread liftssuture lifts
There are three main types of threads currently available; polydioxanone (PDO), polylactic acid (PLA) and polycaprolactone (PCA). PDO threads have been around the longest and are made of a synthetic biodegradable polymer that has been used in surgery for many years. PDO threads are absorbed into the body over 6 months by hydrolysis and work by triggering fibroblasts to produce more collagen in a targeted area. There are three main types of PDO threads used; mono, cog and screw threads. Mono threads are smooth without barbs and are anchored to a point on the face or the scalp. They mainly tighten the skin and provide a small amount of lift.2 Cog threads have barbs which hook onto the skin to provide support and lift the sagging tissue. Screw threads have one or two intertwined threads around the needle and provide good volume restoration to sunken areas of the skin. The production of collagen around the threads and their barbs helps to restore volume and improves the skin texture and elasticity resulting in a natural aesthetics outcome.
After PDO threads, PLA threads were developed. They are made from a biocompatible polymer derived from lactic acid that has been used in many applications such as orthopaedic pins and sutures. PLA threads are resorbable and regenerate collagen over a longer time than PDO threads. PLA threads use cones to hook to the tissue and increase the volume of saggy areas therefore helping to restore shape to the facial area as well as providing a lift.
PCA threads are the newest threads and are bio-absorbable, monofilament suspension threads of synthetic origin (caprolactone).3 They work by regenerating collagen over a longer time than PDO and PLA threads. They leave behind a collagen structure that provides support for the skin, tightens the skin and prevents it from sagging. Due to the fibrotic reaction caused by the threads, the lifting and stretching action will continue even after the threads have been resorbed. The process of thread breakdown produces molecules of small molecular weight which subsequently induce the production of collagen and Hyaluronic acid by the skin. The resulting skin is more moisturized, revitalized and firm with a long lasting result.
Before deciding what type of thread to use we must consider the treatment indications and what we are trying to achieve; facial lift or facial rejuvenation.4 If a patient wanted tissue lifting PDO monofilament threads would be unsuitable as they are placed superficially, are completely smooth and without barbs. While they produce a regenerative and firming effect that visibly improves skin quality they do not provide an effective amount of tissue lifting.5 To achieve a powerful lift with improvement in facial tightening and rejuvenation, barbed threads must be used. The barbs along the threads act as cogs to clasp the skin creating tension in the thread which lifts and suspends the facial area. Collagen is formed around the threads and their barbs resulting in an increased effect.6,7 Consider now a patient, who requires a facial lift, there are further factors which ensure efficacy and longevity of the results (barb length, angle, spatial distribution and direction of barbs or cones, resorption time and the collagen-stimulating ability of the thread).
The barbs must have a length that enables them to hook onto the skin tissue and maintain the lift required. If they are too long then they become too flexible and incapable of lifting the facial tissue. On the other hand, if the barbs are too short they will not be able to hook onto the facial tissue in the first instance. Furthermore, we need to consider how densely the barbs are placed along the thread length. Threads with a low barb density will not be able to lift the same amount of tissue as threads with a high barb density and therefore will not result in the desired facial lift. In addition, low barb density threads will be less effective at lifting larger volumes of tissue or heavier tissue and restrict the practitioner to working only with small amounts of soft tissue. Of course, a thread must have smooth areas that are barb-free to ensure there is adequate anchoring and to avoid any puckering of the skin.
The angles of the barbs also have a place in how much hold is achieved. If the angle is too small then the lift will be weak, conversely, if the angle is too big the barb may dig into the thread causing it to break. The manufacturing process for some threads can result in the barbs actually digging into the thread, reducing its thickness or gauge in areas. Ideally, the length of the base of the barb should be equal to the thickness of the thread. The spatial distribution of the barbs along the thread will also vary and the more contact there is between the barbs and the facial tissue, the better the hold. Some threads have barbs at different angles in order to achieve a 3600 lift; some have cones to maximize tissue contact, while others have all the barbs lined up in one line only.
Threads can come as either mono-directional or bi-directional. To achieve effective lifting of facial tissue the bi-directional threads are preferred as they provide immediate anchoring to the tissue and the thread cannot move either way due to the two-way direction of the barbs. Some mono-directional threads are anchored on both ends at fixed points to enhance stability.8 The final consideration to make is how long the thread will last in the tissue. PDO threads will stay in the tissue for around 6 months, PLA threads around 12 months, and PCA threads will stay in the tissue for 12-15 months. The longer the thread lasts the more collagen is stimulated and therefore the result is much better and longer lasting. PDO and PLA threads cause fibrosis in the surrounding area and create type 1 collagen. PCA threads stimulate the production of type 1 and 3 collagen which helps to improve the condition of the skin giving a youthful appearance.
How many threads are used in a thread lift?
There’s no question that both cosmetic injectables and plastic surgery can work wonders when it comes to reversing the unwanted side effects of facial aging. For patients looking for something a little longer-lasting than injectables but less invasive than surgery, however, there haven’t been many options until recent years. Now, the PDO thread lift offers men and women a convenient and long-lasting way to turn back the clock and achieve youthful, natural-looking results that are almost instantly visible. At Bay Area Cosmetic Dermatology in San Francisco, CA, our award-winning team of aesthetic experts is proud to offer advanced thread lifting to help patients look and feel better and more confident than ever. Keep reading for a closer look at how thread lifting works, and find out how many threads you may need to lift and tighten your sagging skin.
WHO SHOULD GET A THREAD LIFT?
The thread lift, also called a PDO lift, can be beneficial for patients of virtually all ages who are experiencing sagging or drooping skin, particularly in the mid-to-lower face and/or the neck. In particular, patients who are seeking a less invasive alternative to facelift surgery – but one that lasts longer than cosmetic injectables – may be best suited to thread lifting. Some of the most common concerns that can be dramatically improved with a PDO thread lift include:
- Sagging facial skin
- Skin laxity
- Drooping jowls
- Undefined jawline
- Downturned mouth
- Hollow cheeks
- Loose neck skin
- Saggy neck skin
HOW DOES A PDO THREAD LIFT WORK?
At Bay Area Cosmetic Dermatology, patient comfort and satisfaction are key. Each PDO thread lift is performed in one of our private treatment rooms and takes about 30 – 45 minutes to complete. Prior to the thread lift, the provider will cleanse the skin and apply a topical numbing cream to minimize any discomfort that may be experienced during the treatment. The provider will then identify the target insertion sites and mark them accordingly. Finally, tiny, dissolvable threads will be inserted beneath the skin using a fine gauge needle. Using these threads, the skin can be almost instantly lifted, creating a firmer, smoother, more youthful look. Over the next 4 – 6 months, the threads will boost collagen production and continue to tighten the skin from within as they dissolve.
HOW MANY THREADS ARE USED IN A PDO LIFT?
Because every person’s concerns, goals, and anatomy are different, our knowledgeable team takes great care to customize each thread lift to meet the patient’s needs as an individual. During your initial evaluation for thread lifting, your provider will thoroughly discuss your concerns, assess your skin laxity, and determine how many PDO threads you may need to achieve your desired outcome. On average, patients require between 2 – 4 threads on each side of the face for a mid-face thread lift. An additional 2 – 4 threads may be needed for the lower face and/or neck.
HOW LONG DOES A THREAD LIFT LAST?
Believe it or not, the results of a thread lift can last for 1 – 3 years before a repeat treatment may be needed, making this a fantastic solution for patients seeking a relatively long-lasting alternative to cosmetic injectables.
What is the best PDO thread for lifting?
The “facial scaffolding” does not provide as much support as it formerly did, which results in wrinkles and a longer face. Upon doing thread lifts or suture lifts, it is necessary to use threads or sutures manufactured from the materials typically used in surgery to close wounds.
It is possible to reduce the signs of aging by having threads implanted beneath the skin, where they have the power to work. They are also capable of giving the face a youthful glow. Now, let’s take a look at the best PDO threads for you.
Three Types of PDO Threads
Polydioxanone (PDO), polylactic acid (PLA), and polycaprolactone are the three basic varieties of threads that may be acquired right now (PCL). PDO threads have been the most popular choice for use in surgical procedures for a good number of years now. They are manufactured using a synthetic biodegradable polymer that has been utilized in the treatment industry for many years.
PDO threads are hydrolyzed and absorbed into the body over the course of six months. Once there, they perform their role by stimulating fibroblasts to produce more collagen in a particular area of the body.
Mono Threads
Smooth threadsmono threads
In most cases, the number of mono threads implanted for each treatment region ranges between 10 and 20. The “anchoring point” of the scalp or face is where the threads are fastened to maintain the lift achieved. Mono threads may be used to contact the skin, but they do not provide significant lifting; as a result, they must be combined with cog threads to improve face regeneration and tightening.
Screw Threads
It is possible for there to be one or two threads that are entwined together around the inserting needle in the form of screw threads. The use of screw thread can significantly impact the appearance of fullness in depressed areas of the skin. The term “Multi Screw,” which refers to the usage of two intertwined threads, has a more powerful effect than a screw thread. Generally speaking, screw threads are utilized in the process of face-lifting. You can “construct” your screw threads just by placing a mono thread in a twisting manner.
Cog Threads
Cog threadscog threads
Should You proceed with using PDO threads?
In 2018, the Food and Drug Administration gave its approval for the PDO Thread Lift. However, the polydioxanone it is made of has been extensively and effectively used in heart surgery and other therapeutic diagnoses for far longer. Thread lifts are a non-invasive treatment option that is gentle on the skin and won’t do any damage to it.
The Role That Texture Plays and Its Importance
The flexibility of the treatment has been increased because of the availability of threads in a variety of different textures. For instance, straight, smooth lines might be injected in a cross-hatch or mesh-like design to serve as a foundation for collagen to grow on. This would allow the collagen to develop more quickly. Barbs on other threads can catch skin that has come free from underneath and then pulls it back into place. When patients want to increase the volume in their faces, screw-type threads are usually employed in the procedure.
The Total Amount of Threads
Altering the number of threads that are used can also provide a variety of different effects. In the majority of cases, several lines are put on either side of the face; nevertheless, the degree of lifting or volume achieved can be changed by using either more or fewer threads than originally planned.
Why Should I Give Serious Consideration to Getting a Thread Lift?
PDO Thread lift proceduresThread lifts
Progressive Outcomes
The instantaneous tightening that this operation delivers is a benefit that many of our patients value, and the fact that the outcomes will continue to get better over the next few months further adds to this. Because of this, no one will ever suspect that you have recently undergone cosmetic surgery. It’s possible that close friends and family members have picked up on the fact that you’ve been feeling more refreshed and calm over the past few weeks, but they won’t be able to explicate why this is the case.
An Alternative That Does Not Involve Surgery and Is Both Practical and Successful
Many patientstime
Results Tailored to the Individual
There is no such thing as a universally applicable thread lift that works for everyone. It is possible to tailor the usage of threads to the specific aesthetic goals and concerns of each patient by taking advantage of the fact that there is a wide selection of threads to choose from and that they can be injected at a variety of angles. In addition to this treatment, our practice also provides additional cosmetic therapies, such as laser resurfacing, dermal fillers, and botulinum toxin injections, all of which can be coupled with this treatment.
Long-Term Benefits
PDO threads stand out among injected beauty treatments because the effects they generate are known to stay for a significant amount of time. Injections of botulinum toxin and the majority of dermal fillers produce effects that, on average, last for much less than one year. Thread lifts often persist for 18 months or longer, though this varies from patient to patient.
Now is the time to start the treatment that will eventually result in younger-looking skin. A thread lift can be exactly what you need to improve the appearance of your skin so that it is more polished, tighter, and younger looking after you.
What are the different types of PDO cog threads?
Dealing with drooping eyebrows, sagging jowls, or deepening forehead lines? One of the latest solutions to aging skin is PDO threads. Polydioxanone (PDO) therapy is a growing cosmetic technique that involves tightening and lifting saggy skin tissues by inducing collagen production. At the Cutis Laser Clinics, we use several different types of PDO threads with the Cutis Lift for a comprehensive approach to aging.
Mono Threads
Mono threadsmono threads
After entering the skin, the threads activate collagen synthesis for a gradual skin tightening and skin rejuvenation effect. While mono threads tighten the skin, they do not significantly lift it.
These skin tightening treatments can be used to rejuvenate collagen treating neck sagginess, forehead lines, and facial wrinkles. The threads can also add volume to the cheeks and an average of 10 to 30 mono threads is typically used for each individual treatment area.
If you desire a nonsurgical wrinkle treatment that offers both tightening and lifting benefits, mono threads can be combined with cog threads.
Cog Threads
Cog threadsmono threads
Cog threads can be used on their own or in combination with mono threads to mechanically suspend tissue structures for skin that looks and feels firm and smooth. These types of threads are often used to create a slimmer face by lifting sagging skin in the jawline. In addition to being a thread lift for jowls, cogs can offer an eyebrow thread lift and a thread lift for nose.
Screw Threads
If you’re looking to give areas of your face more volume, screw threads are an excellent option. Screw threads are available with one or two threads that have been intertwined around the inserting needle to amplify the results.
To create a V-shape face, screw threads help to reverse sunken areas and give the face a non-surgical facelift. When two threads are intertwined, the method is known as a “multi screw”.
Many people desire a nonsurgical V-shape face but are unable to achieve it without the help of a professional skin doctor. PDO threads are able to tighten, lift, and support aging tissues without invasive methods like surgery. The procedure takes at least one hour or more depending on the areas to be treated with minimal pain. The results of PDO threads typically last between 18 and 24 months on average.
If you’re concern with mild facial sagging, PDO threads may help you achieve a more youthful appearance. For more information about the different types of PDO threads, contact our skin specialist and US Board Certified physician, Dr. Sylvia Ramirez in Singapore at the Cutis Laser Clinics.
