Non-Surgical Treatments
PDO Threadlifts

Thread lifting, sometimes known as a thread facelift, is a minimally invasive procedure designed to lift and support the soft tissues of the cheeks, jowls and neck as well as improving facial skin quality. The idea is not new, it was originally introduced in the early 2000s using barbed non-dissolving nylon sutures. The results were not, in general, as good as had been hoped and the popularity of the technique declined. More recently a combination of using a slowly dissolving material for the threads (rather than a permanent one) which will induce new collagen formation, and simplification of the insertion techniques has improved outcomes and regenerated interest.

The material used is Polydioxanone (PDO). I, and many other surgeons, have used this for over 25 years as a slowly dissolving “internal” suture known by the trade name PDS (Ethicon). It has a long track record, is safe, creates very few problems and will dissolve over a period of approximately 6 months. It is both biodegradable and biocompatible.

There are essentially two different types of PDO threads:

  1. Those that are used to physically lift sagging tissues have tiny PDO cogs along their length which grip soft tissues allowing some gentle tension to be applied to them. These are mostly used in the cheeks, jowl and neck.
  2. Finer threads of PDO without cogs are used, not to physically lift, but to provide a supportive mesh beneath the skin which stimulates collagen formation to create tissue support and tightening.
    These are used in the neck but also around the mouth and lips.

Both types of thread can be used in combination and frequently are to produce the best outcome.

PDO threads are generally most effective in relatively younger patients (under 55) in whom skin slackness is not severe. The procedure is carried out under local anaesthetic as an outpatient, has little or no downtime and leaves no scars. Some improvement is likely to be seen almost immediately but the maximum effect will be apparent after 3-4 months. The duration of the improvement will vary with physical factors including age at the time of treatment, skin quality, the establishment of an effective skin care maintenance programme and lifestyle factors such as smoking, sun exposure and general health, but generally is said to be in the region of two years.

I am confident that PDO threads do produce significant improvement in properly selected patients. The technique has the great benefit of being relatively simple, carried out under local anaesthetic with little inconvenience or downtime. As with all medical procedures, however, it is important that expectations are set at a realistic level. Thread lifting is not, as it is often portrayed, a “nonsurgical facelift”. It is not intended to replace surgery nor to recreate the effects of a modern surgical facelift, which depend upon freeing deeply placed ligaments attaching facial skin to the underlying bone in order that deep tissues (fat and muscle) can be repositioned as well as sagging skin.

Careful physical examination and a full discussion before any treatment is carried out will identify the procedure which is most appropriate for you, both physically and to accommodate your lifestyle.

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