47.8 Suspension and Suture Techniques

47.8.1 Thread Lift Guide

A thread lift addresses sagging underlying tissues of the cheek and jaw line by threading 4–12 barbed sutures into the skin and deeper soft tissues. The nonabsorbable threads stay within the deep tissues and provide support. A thread lift is often referred to as a minimally invasive surgical procedure. This is a relatively new procedure developed in Russia in 1999 by Sulamanidze [14] who pioneered the technique. The thread lift procedure can use Aptos threads (blue nylon) or clear sutures such as the contour thread lift that contains a series of cogs or microbarbs. Contour lifts may be best for a fair skin tone, since the Aptos threads may appear visible through the skin. In cases of more severe sagging or facial folds and furrows,

a traditional face-lift may achieve more dramatic results.

During the procedure local anesthetic is used. A hollow stainless tube with a needle-sharp end is inserted under the skin at specific entry points on the face and through the fat layer under the skin along a designated path (Fig. 47.10). The exit point is then made and the thread is inserted into the tube. The thread is pulled through the other side of the tube, the tube is removed, and the thread stays in place. The threads are positioned, tugged into the desired placement, anchored, cut just at the skin, and then inserted under the surface of the skin. Where the thread ends are inserted into your face, they are taped for a few days to prevent movement. Excessive movement can dislodge the intended placement of the threads, altering the desired thread lift result. For endobrow lifting the thread lift can be adapted to lift the brows using suspension and in this technique the sutures are tied to the temporal fascia.