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Thread Lift: Techniques and Effects of PDO Mono-Threads

Science has pushed the development of medical technology and techniques forward by measures of which we could hardly fathom in past - today, the progress of thread lifting techniques has improved ever so much that, if performed correctly, it is one of the safest and most reliable non-surgical procedures available.

Currently, there are many thread lift techniques with respect to the specific types of thread used on specific areas, such as mid-face, lower face, or neck area. Various studies have been conducted and reviews performed on thread lift techniques for specific areas according to type of thread, patient selection, and how to match the most appropriate to the patient. However, threads used in thread lifting procedures may generally classified into 2 broad category, namely, Mono and Cog.

Technique Using PDO Mono-Threads

While theoretical discussions suggest that mono-threads may be inferior to cog threads in terms of lifting effects, recent studies have evidenced that with the right techniques along with inserting the threads into the correct layers, PDO mono-threads can produce positive results even if used just by itself.

Mechanics: Some theories suggest that the effects of PDO mono-threads attach the sagged tissues inwards rather than pulling them with direction, and in doing so, lead to different possible outcomes. One of such possible results is that, due to the effects of fat denaturation from the insertion of PDO mono-threads and the effects of proliferation as well as contraction of fibrotic tissues, the size of the bulging fat may decrease, hence, resulting in a tightening effect.

In addition, PDO mono-threads are thought to also boost the production of new fibrotic tissues connected to the pre-existing surrounding fibrotic tissues, causing the structure of the subcutaneous fibrous connective tissues to become denser and stronger.

The effect of inserting PDO mono-threads under the skin is also theorised to cause myofibroblast to form around the threads, contracting the tissues, which explains the inward-pulling effect experienced by some patients. Lastly, some studies suggest that PDO mono-threads can potentially increase the size of the capillaries, in turn improving the skin environment.

Regardless of the theories, most clinical studies concur that the effect of PDO mono-threads can cause fat tissue contraction, strengthen the fibrous connective tissue and improve dermal environment.

Due to the shrinking effect to the sagged fat layer, some studies have suggested to insert PDO mono-threads into the subcutaneous fat layer and to pull the sagged skin so that the threads are inserted closely attached to the subdermis area. Considering the histological changes after the placing of PDO threads, in general, PDO mono-threads can potentially reduce fat layer by being inserted deeper while increasing contact for improved effectiveness.

Although the general idea is to place mono-threads into the deeper layers of the skin for better results and effectiveness, it is important that a practitioner understand that the mechanism and techniques will vary depending on the different part of the face due to anatomical differences.

Jawline: By inserting PDO mono-threads in a wave-like pattern passing through the subcutaneous fat layer and the SMAS layer to increase the areas covered by the threads, it is possible for a practitioner to create a more defined jawline as the threads undergo the process of fibrosis while they gradually dissolve over time. Through this process, the threads may cause contraction of the fat layer and conglutination of fibrotic tissues, delivering a lifted and perceived slimming effect in the jawline. In terms of design, it is suggested to insert PDO mon-threads, both above and below the jawline, for improved definition.

Jowl: When treating the jowl area with PDO mono-thread, it is important for a physician to take into consideration the anatomy of the face. Due to the empty space between the rigorous m. and zygomaticus major, the SMAS is not continuous - therefore, creating an empty space. Here, deep fat tissues which are stretched from ageing may push and cause the inner cheek area to appear bulgy. By using PDO mono-threads, a performing physician should be able to denature the fat, induce fibrosis effect and tissue contraction. In the case of twister/tornado type thread, a practitioner can expect to observe volumising effects in the treated area.

Cheek and Nasolabial Fold: Droopy frontal cheeks may aggravate the nasolabial folds and by placing PDO mono-threads in the area where the frontal cheek droops above the nasolabial fold, conglutination of fibrotic tissues and contraction of fat cells may be expected. As such, it may lead to the effect of pushing the bulging frontal cheek in slightly, and if a thicker and harder twister/tornado monofilament is inserted from the cheek to over the nasolabial fold area, it can potentially reduce the front cheek by pressing the PDO thread with gentle force.

Temples: Due to the effects of ageing, it is inevitable for the eye area to start sagging. The fundamental treatment in general, would be to perform a forehead lifting surgery or an eyelid surgery. However, many patients today, wish not to undergo surgical treatments, and thread lifting procedures using PDO mono-thread has proved to be effective in addressing the sagging of the eye area. In treating the eye area, if hard PDO mono-threads in a spring form are inserted in a radial shape in the temple area, it has been observed in some studies that there is some lifting effect to the eyebrows. This is thought to be attributed to the small volume in these spring-form PDO mono-threads and in addition, if advanced and proper techniques are applied, the PDO mono-threads would be able to anchor in the temple area to deliver better results.

PDO Mono-Threads: More than Meets the Eye

Since its introduction, PDO mono-threads has been viewed with a certain level for skeptic by physicians questioning its ability to lift and its effectiveness in rejuvenation procedures. However, studies have have shown time and again that PDO mono-threads are not only effective in delivering results, and the promotion collagen stimulation and synthesis, but has the potential to create some lifting when the correct technique is applied. Therefore, it is imperative for a practitioner to ensure that he is equipped with the latest and most advanced skills, knowledge and techniques.


The Art and Science of Thread Lifting (Springer, 2019)

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