Between injectables and a facelift

In modern aesthetic medicine, the thread lift is a fascinating example of the interplay between biological craftsmanship and an artistic eye. It closes the gap between minimally invasive injectables (such as hyaluronic acid) and the classic surgical facelift.

How a thread lift works

The main function of a thread lift is to support sagging tissue. Using ultra-fine, special threads, sagging tissue in the areas to be lifted is raised again, while the skin tissue gains new support and elasticity.

Under local anaesthesia, tiny punctures are made in the skin and the threads are placed in the subcutaneous tissue like a net. The nature of the threads prevents them from slipping or tearing and at the same time creates the supporting effect that counteracts renewed sagging of the skin.

Mode of action

The treatment is based on a combination of two effects:

• ◆Biological effect (tightening): the threads stimulate the body’s own production of collagen, elastin and hyaluronic acid.
• ◆Mechanical effect (lifting): the threads – especially those with barbs (bidirectional, 360°) – exert a pulling force to lift and reshape sagging soft tissue directly.

Thread materials

We use absorbable threads made from different materials. The choice between PDO (polydioxanone), PLLA (polylactic acid) and PCL (polycaprolactone) determines how long the result lasts and how intensely new collagen is formed.

PDO threads

PDO threads are the most commonly used. They have been used as surgical suture material for years and have proven themselves, as they have the special property of stimulating the skin’s own collagen formation. The thread material stimulates the subcutaneous tissue to form a new supporting cushion for the skin while it gradually dissolves within 18 to 24 months.

Here, the thread has a very large number of small barbs, which ensures an even more precise fit and hold in the subcutaneous tissue. The multitude of small barbs provokes an even stronger tissue response and thereby increased formation of new collagen and elastin tissue. Ultimately, this increased tissue response creates more volume in the lifted skin area.

Mono threads

The thread consists of a single ultra-thin filament. It mechanically induces firming in the deeper skin layers by stimulating fibroblast activity. Crinkle lines and laughter lines on the face can be plumped up in this way, and the fine lines around the mouth can also be smoothed.

Spiral (screw) threads

Wound around a cannula, this thread smooths the skin thanks to its spiral, more voluminous geometry. It is well suited to areas subject to strong facial movement and induces increased collagen production.

Cog threads (moulded) or lifting threads

Unlike ‘classic’ cog threads, the barbs are not created by cutting into the thread during manufacture; instead, the thread and its barbs are produced together by injection moulding. The thread and barbs are therefore more stable and offer greater holding power. The shape and arrangement of the barbs are available in many variations.

We use moulded cog threads with bidirectional, 360°-positioned, three-dimensional barbs to ensure strong tightening and a safe treatment.

Indications

This method is suitable for tightening the entire face, the neck and the décolletage. Particularly good effects can be achieved by lifting the eyebrows, tightening the facial contours in the midface, on the cheeks or along the jawline by tightening and lifting the lower half of the face, and by reducing a double chin.

Combination with liquid lifting

To balance the overall appearance optimally, it can also be beneficial to combine the thread lift with other non-invasive methods, for example from the field of liquid lifting. These are the procedures most people are familiar with when it comes to smoothing wrinkles: so-called fillers such as hyaluronic acid are injected under the skin. Restoring volume creates a lifting effect and smooths finer lines.

Example: full-face thread lift

• ◆Midface lift using 6 PDO lifting threads per side
• ◆Brow lift using 3 PCLC lifting threads per side

The goal

A successful thread lift is like an invisible scaffold. Precision ensures that biostimulation (collagen formation) is triggered, while the aesthetic eye ensures that the harmony of the face is preserved.

Limits and duration

A thread lift is not a procedure that can replace a classic facelift. This also makes it clear where the firmest limit of this technique lies. It is less a question of age than of the condition of the tissue. Significant excess skin is a contraindication.

Results last between 12 and 18 months. This has less to do with the absorption of the threads than with the natural changes in the tissue.

Aftercare

• ◆Avoid any kind of mechanical strain in the first week after the procedure.
• ◆Sleep on your back for at least 5 days, ideally one week.
• ◆Avoid facial massages for at least 3 weeks so as not to loosen the anchoring of the threads in the skin.
• ◆The same applies to sports involving rotational movements of the head, such as yoga or Zumba.
• ◆Avoid the sauna for as long as there is any swelling.

Risks and complications

A thread lift is considered very low-risk. In principle, however, every procedure – however minimally invasive – carries certain risks, such as wound-healing problems, bruising and swelling. When the technique is performed correctly, undesirable outcomes – such as threads being placed too superficially, being palpable or even showing through and causing unevenness – can be avoided.

Haematomas may form at the puncture site, and small skin indentations are not uncommon; these disappear after a few days. Small granulomas can also develop at the puncture sites, although this is largely avoidable with the correct technique. Asymmetries can occur and are easy to correct. Infections can occur in rare cases, and nerve injuries even more rarely.

Ultracol 200 PDO Powder Filler

Ultracol 200 is an innovative biostimulating filler based on high-purity PDO (polydioxanone) in powder form – the world’s first microparticle filler – developed for non-invasive skin rejuvenation and tightening. Reconstitution with physiological saline creates a homogeneous suspension that is injected precisely into the skin using fine cannulas.

There, the PDO stimulates new collagen formation, improves skin texture, increases the density of the connective tissue and leads to visible firming and rejuvenation of the treated area. Ultracol 200 is ideal for lax, tired or structurally damaged skin.

Why Ultracol 200?

• ◆Patented PDO microsphere technology: safe, biocompatible PDO in micronised form – free from toxic cross-linkers such as BDDE.
• ◆Long-lasting effect: the biodegradation of the PDO particles promotes new collagen formation over several months.
• ◆Versatile use: ideal for delicate areas such as dark circles, glabellar lines, fine perioral lines or restoring volume in the cheeks.

Indications for Ultracol 200

In practice, Ultracol is an effective collagen stimulator and well suited to difficult indications such as dark circles and wrinkles under the eyes. It is also the optimal solution for area injections, for example in the cheek or mouth region.

• ◆Eye area (e.g. dark circles, tear trough)
• ◆Frown line (glabella)
• ◆Cheeks and chin to improve contours
• ◆Lip and nasolabial area (fine lines)
• ◆Décolletage and neck (for skin laxity)