Barbed Threads and Face lifting

Recently, I was given the opportunity to try out PDS barbed threads to rejuvenate the face. These threads are toted, as non-painful, low downtime, cheaper than a traditional facelift, with good results. I wanted to try this new technology. Though I did not see this as a replacement to a facelift, I wanted to see and try this new technology in action. I saw the place for this procedure in the same category as Restylane, Juvederm, Botox and other injectables. These injectable agents can serve as stand-alone procedures in patients that are not ready to undergo a surgical procedure, or as adjuncts to a surgical procedure. Furthermore, I have seen and heard of “thread-lifts” for the last 7-8 years, the thread-lift procedure had been touted on Dr. Oz, and various other TV shows, and I wanted to see what the newest iteration of this technology would yield.

After viewing all the surgical instructional videos, I found an appropriate patient to test the PDS thread lift technology on. The goals in this patient were to: (1) lift the brows, (2) Lift the midface/cheek fat pad, (3) tighten the jaw line, and (4) tighten the neck. These are normally the traditional goals of an endoscopic brow lift, and a face lift.

The thread lift procedure is usually done with only topical anesthesia spread on the face. As a surgeon, we applied numbing cream, but also performed nerve blocks. I also prescribed pain medication for the patient after surgery. I was told this was overkill, but I thought it appropriate.

The case went quite well. I was impressed at how easy the threads went in the skin. I was disappointed by the total amount of lifting, however. As a surgeon, I am used to significant tightening of the midface, neck, and jowls with significant lifting of the brow. The observers all marveled at the amount of lifting. I attributed the difference to what I knew my capabilities were in the operating room, and the fact that we were doing this procedure in 1 hour in the office.

The results….abysmal! The patient had significant pain during and after the procedure. The patient had contour irregularities that required a secondary revision surgical procedure. My face lifts usually only took 3-4 pain pills. The patient with the thread lift used >20 pain pills, and still complained of pain till several of the threads were removed. To add insult to injury, the overall results were not even close to what I can achieve in the operating room.

What I learned from all of this…I will look at new technologies. But I will judge new technologies against proven gold standards for the patient’s goals. If a patient desires: a tighter neck line, less jowls, with a lifted/fuller midface, I will recommend a face lift. I do not feel that the barbed thread lifts offer a single advantage other than cheaper cost to the patient. Furthermore, the cheaper cost is nullified by the poor overall result and the need to return to the operating room.

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