Skip to main content
Top
Published in: Aesthetic Plastic Surgery 2/2021

01-04-2021 | Face Lift | Original Article

Maximizing Thread Usage for Facial Rejuvenation: A Preliminary Patient Study

Authors: Young Jin Park, Jong Hyun Cha, So-Eun Han

Published in: Aesthetic Plastic Surgery | Issue 2/2021

Login to get access

Abstract

Background

Surgical facial rejuvenation techniques with thread lifting have gained popularity. To effectively rejuvenate an aging face, it is necessary to perform both soft tissue envelop repositioning and volume restoration procedures. With the trend toward less invasive techniques and long-lasting results with minimal complications, many surgeons have continued changing the techniques.

Objectives

In the present study, we developed the 4 M (Multi-target, Multi-vector, Multi-layer, Multi-material) thread lift technique for long-lasting results.

Methods

A prospective study was conducted on 73 patients who underwent the 4 M thread lifting procedure between January 2016 and February 2018. To evaluate the surgical outcomes objectively, two plastic surgeons compared photographs using a 5-point Global Aesthetic Improvement Scale (GAIS) at 1, 3, 6, 12, 18, and 24 months of follow-up.

Results

Based on the GAIS objective assessment, in most patients (85%) experienced better than 3 score (“improved”) changes. Approximately 42.5% of the patients experienced better than 4 score (“much improved”) changes. The mean GAIS grade improved significantly (p < 0.005) without decline throughout a period of 12 months. No serious adverse complication was observed except one patient, who experienced skin irregularities and dimpling for up to 9 months after the procedure.

Conclusions

This 4 M thread lifting is the multiple layer lifting and rejuvenation using different materials in addition to the multiple targets. Using the concepts of structural rejuvenation, the 4 M thread lifting technique presented modest to significant improvement, maintaining good results at 12 months after procedure.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Appendix
Available only for authorised users
Literature
1.
go back to reference Fenske NA, Lober CW (1986) Structural and functional changes of normal aging skin. J Am Acad Dermatol 15(4 Pt 1):571–585CrossRef Fenske NA, Lober CW (1986) Structural and functional changes of normal aging skin. J Am Acad Dermatol 15(4 Pt 1):571–585CrossRef
2.
go back to reference Bosset S, Barre P, Chalon A (2002) Skin ageing: clinical and histopathologic study of permanent and reducible wrinkles. Eur J Dermatol. 12(3):247–252PubMed Bosset S, Barre P, Chalon A (2002) Skin ageing: clinical and histopathologic study of permanent and reducible wrinkles. Eur J Dermatol. 12(3):247–252PubMed
3.
go back to reference Hinderer UT (1992) The sub-SMAS and subperiosteal rhytidectomy of the forehead and middle third of the face: a new approach to the aging face. Facial Plast Surg 8(1):18–32CrossRef Hinderer UT (1992) The sub-SMAS and subperiosteal rhytidectomy of the forehead and middle third of the face: a new approach to the aging face. Facial Plast Surg 8(1):18–32CrossRef
4.
go back to reference Pepper JP, Baker SR (2011) SMAS flap rhytidectomy. Arch Facial Plast Surg 13(2):108CrossRef Pepper JP, Baker SR (2011) SMAS flap rhytidectomy. Arch Facial Plast Surg 13(2):108CrossRef
5.
go back to reference Floyd E, Perkins SW (2019) The past, present and future of facial plastic and reconstructive surgery: facelift. Facial Plast Surg 35(4):353–357CrossRef Floyd E, Perkins SW (2019) The past, present and future of facial plastic and reconstructive surgery: facelift. Facial Plast Surg 35(4):353–357CrossRef
6.
go back to reference Jost G, Lamouche G (1982) SMAS in rhytidectomy. Aesthet Plast Surg 6(2):69–74CrossRef Jost G, Lamouche G (1982) SMAS in rhytidectomy. Aesthet Plast Surg 6(2):69–74CrossRef
7.
go back to reference Kamer FM, Frankel AS (1998) SMAS rhytidectomy versus deep plane rhytidectomy: an objective comparison. Plast Reconstr Surg 102(3):878–881CrossRef Kamer FM, Frankel AS (1998) SMAS rhytidectomy versus deep plane rhytidectomy: an objective comparison. Plast Reconstr Surg 102(3):878–881CrossRef
8.
go back to reference Rammos CK, Mohan AT, Maricevich MA, Maricevich RL, Adair MJ, Jacobson SR (2015) Is the SMAS flap facelift safe? A comparison of complications between the sub-SMAS approach versus the subcutaneous approach with or without SMAS plication in aesthetic rhytidectomy at an academic institution. Aesth Plast Surg 39(6):870–876CrossRef Rammos CK, Mohan AT, Maricevich MA, Maricevich RL, Adair MJ, Jacobson SR (2015) Is the SMAS flap facelift safe? A comparison of complications between the sub-SMAS approach versus the subcutaneous approach with or without SMAS plication in aesthetic rhytidectomy at an academic institution. Aesth Plast Surg 39(6):870–876CrossRef
9.
go back to reference Savoia A, Accardo C, Vannini F, Di Pasquale B, Baldi A (2014) Outcomes in thread lift for facial rejuvenation: a study performed with happy lift revitalizing. Dermatol Ther (Heidelb) 4(1):103–114 Savoia A, Accardo C, Vannini F, Di Pasquale B, Baldi A (2014) Outcomes in thread lift for facial rejuvenation: a study performed with happy lift revitalizing. Dermatol Ther (Heidelb) 4(1):103–114
10.
go back to reference Tang S, Sun Z, Wu X, Wang YY, Zhang J (2018) An innovative thread-lift technique for facial rejuvenation and complication management: a case report. Medicine (Baltimore). 97(21):e10547CrossRef Tang S, Sun Z, Wu X, Wang YY, Zhang J (2018) An innovative thread-lift technique for facial rejuvenation and complication management: a case report. Medicine (Baltimore). 97(21):e10547CrossRef
11.
go back to reference Han SE, Go JY, Pyon JK, Oh KS (2016) A Prospective evaluation of outcomes for midface rejuvenation with mesh suspension thread: “REEBORN lift”. J Cosmet Dermatol 15(3):254–259CrossRef Han SE, Go JY, Pyon JK, Oh KS (2016) A Prospective evaluation of outcomes for midface rejuvenation with mesh suspension thread: “REEBORN lift”. J Cosmet Dermatol 15(3):254–259CrossRef
12.
go back to reference Sapountzis S, Kim JH, Li TS, Rashid A, Cruz PC, Hwang YS (2012) Successful treatment of thread-lifting complication from APTOS sutures using a simple MACS lift and fat grafting. Aesthet Plast Surg 36(6):1307–1310CrossRef Sapountzis S, Kim JH, Li TS, Rashid A, Cruz PC, Hwang YS (2012) Successful treatment of thread-lifting complication from APTOS sutures using a simple MACS lift and fat grafting. Aesthet Plast Surg 36(6):1307–1310CrossRef
13.
go back to reference Sulamanidze M, Sulamanidze G (2008) Facial lifting with aptos methods. J Cutan Aesthet Surg 1(1):7–11CrossRef Sulamanidze M, Sulamanidze G (2008) Facial lifting with aptos methods. J Cutan Aesthet Surg 1(1):7–11CrossRef
14.
go back to reference Sulamanidze M, Sulamanidze G (2009) APTOS suture lifting methods: 10 years of experience. Clin Plast Surg. 36(2):281–306CrossRef Sulamanidze M, Sulamanidze G (2009) APTOS suture lifting methods: 10 years of experience. Clin Plast Surg. 36(2):281–306CrossRef
15.
go back to reference Sulamanidze MA, Paikidze TG, Sulamanidze GM, Neigel JM (2005) Facial lifting with “APTOS” threads: featherlift. Otolaryngol Clin North Am 38(5):1109–1117CrossRef Sulamanidze MA, Paikidze TG, Sulamanidze GM, Neigel JM (2005) Facial lifting with “APTOS” threads: featherlift. Otolaryngol Clin North Am 38(5):1109–1117CrossRef
16.
go back to reference Mishra A, Husein B, Lecky B, Hancock K (2011) Silhouette thread lift as an ancillary procedure in an unusual case of necrotizing myopathy of the face. Plast Reconstr Surg 128(2):589–590CrossRef Mishra A, Husein B, Lecky B, Hancock K (2011) Silhouette thread lift as an ancillary procedure in an unusual case of necrotizing myopathy of the face. Plast Reconstr Surg 128(2):589–590CrossRef
17.
go back to reference Isse N (2008) Silhouette sutures for treatment of facial aging: facial rejuvenation, remodeling, and facial tissue support. Clin Plast Surg 35(4):481–486CrossRef Isse N (2008) Silhouette sutures for treatment of facial aging: facial rejuvenation, remodeling, and facial tissue support. Clin Plast Surg 35(4):481–486CrossRef
18.
go back to reference Schwarcz RM (2007) Techniques in midface-lifting. Facial Plast Surg 23(3):174–180CrossRef Schwarcz RM (2007) Techniques in midface-lifting. Facial Plast Surg 23(3):174–180CrossRef
19.
go back to reference Stuzin JM (2007) Restoring facial shape in face lifting: the role of skeletal support in facial analysis and midface soft-tissue repositioning. Plast Reconstr Surg. 119(1):362–376 discussion 377-368CrossRef Stuzin JM (2007) Restoring facial shape in face lifting: the role of skeletal support in facial analysis and midface soft-tissue repositioning. Plast Reconstr Surg. 119(1):362–376 discussion 377-368CrossRef
20.
go back to reference DeFatta RJ, Williams EF (2011) Midface lifting: current standards. Facial Plast Surg 27(1):77–85CrossRef DeFatta RJ, Williams EF (2011) Midface lifting: current standards. Facial Plast Surg 27(1):77–85CrossRef
21.
go back to reference Hachach-Haram N, Kirkpatrick WN (2013) Midface-lifting: evolution, indications, and technique. Facial Plast Surg 29(4):289–294CrossRef Hachach-Haram N, Kirkpatrick WN (2013) Midface-lifting: evolution, indications, and technique. Facial Plast Surg 29(4):289–294CrossRef
22.
go back to reference Roxanna E (2017) Effect of annealing on the mechanical properties and the degradation of electrospun polydioxanone filaments. J Mech Behav Biomed Mater 67:127–134CrossRef Roxanna E (2017) Effect of annealing on the mechanical properties and the degradation of electrospun polydioxanone filaments. J Mech Behav Biomed Mater 67:127–134CrossRef
23.
go back to reference Chang Gun Lee (2018) Histological evaluation of bioresorbable threads in rats. Korean J Clin Lab Sci 50(3):217–224CrossRef Chang Gun Lee (2018) Histological evaluation of bioresorbable threads in rats. Korean J Clin Lab Sci 50(3):217–224CrossRef
24.
go back to reference Jung JS, Song H (2019) A innovative form scaffold type of thread lift: its satisfactory performance and safety. Hong Kong J Dermatol Venereol 27:121–126 Jung JS, Song H (2019) A innovative form scaffold type of thread lift: its satisfactory performance and safety. Hong Kong J Dermatol Venereol 27:121–126
25.
go back to reference Park YJ, Cha JH, Bang SI, Kim SY (2019) Clinical application of three-dimensionally printed biomaterial polycaprolactone (PCL) in augmentation rhinoplasty. Aesthet Plast Surg 43(2):437–446CrossRef Park YJ, Cha JH, Bang SI, Kim SY (2019) Clinical application of three-dimensionally printed biomaterial polycaprolactone (PCL) in augmentation rhinoplasty. Aesthet Plast Surg 43(2):437–446CrossRef
26.
go back to reference Stuzin JM, Rohrich RJ, Dayan E (2019) The facial fat compartments revisited: clinical relevance to subcutaneous dissection and facial deflation in face lifting. Plast Reconstr Surg 144(5):1070–1078CrossRef Stuzin JM, Rohrich RJ, Dayan E (2019) The facial fat compartments revisited: clinical relevance to subcutaneous dissection and facial deflation in face lifting. Plast Reconstr Surg 144(5):1070–1078CrossRef
27.
go back to reference Sinno S, Mehta K, Reavey PL, Simmons C, Stuzin JM (2015) Current trends in facial rejuvenation: an assessment of ASPS members’ use of fat grafting during face lifting. Plast Reconstr Surg 136(1):20e–30eCrossRef Sinno S, Mehta K, Reavey PL, Simmons C, Stuzin JM (2015) Current trends in facial rejuvenation: an assessment of ASPS members’ use of fat grafting during face lifting. Plast Reconstr Surg 136(1):20e–30eCrossRef
28.
go back to reference Trepsat F (2001) Volumetric face lifting. Plast Reconstr Surg. 108(5):1358–1370 discussion 1371-1359CrossRef Trepsat F (2001) Volumetric face lifting. Plast Reconstr Surg. 108(5):1358–1370 discussion 1371-1359CrossRef
Metadata
Title
Maximizing Thread Usage for Facial Rejuvenation: A Preliminary Patient Study
Authors
Young Jin Park
Jong Hyun Cha
So-Eun Han
Publication date
01-04-2021
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 2/2021
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-020-01919-4

Other articles of this Issue 2/2021

Aesthetic Plastic Surgery 2/2021 Go to the issue