Minimally invasive cosmetic procedures are in increasing demand worldwide. Patients are constantly searching for office-based techniques that can help improve the signs of aging but without the morbidity of a surgical procedure. Thread lifting with polydioxanone (PDO) sutures is a cosmetic procedure where lax tissue is lifted and repositioned trying to create a more youthful looking facial contour. The threads are absorbable and come in different shapes and lengths. The rate of complications and the downtime of the procedure are low, which are something patients are looking for. Ideally, these procedures should be performed by trained specialists who have complete knowledge of the facial anatomy, thus enhancing and improving results. Thread lifting with PDO absorbable threads has become an excellent option for minimally invasive facial rejuvenation procedures with a high satisfaction among patients and very few complications. It is a new tool that can be introduced in the armamentarium of specialists who work in the field of facial plastic surgery and who can offer this option to their patients with improved outcomes.

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Use of Polydioxanone Threads as an Alternative in Nonsurgical Procedures in Facial Rejuvenation.

Background One of the most common nonsurgical options for facial rejuvenation is lifting using threads. Application of polydioxanone (PDO) threads is generally secure and effective procedure, but complications on the involved regions can occur. Objective In this study, we shared our experiences of efficacy and safety of PDO thread lifting for facial rejuvenation and presented our technique to prevent the migration of threads. Materials and methods Thirty-eight patients who underwent PDO cog treatment for facial rejuvenation were evaluated. Via 23 G/90 mm sharp needle, bidirectional barbed PDO cog thread was inserted into subcutaneous tissue. The outcomes of procedure were assessed by Global Aesthetic Improvement Scale (GAIS) and patient satisfaction. Results Thirty-eight patients were included in this study. Mean age of participants was 39.6 ± 7.5 years. The GAIS score showed satisfactory results (very much improved: 78.9%; much improved: 18.4%; improved: 2.6%). According to patient satisfaction, all patients were satisfied with the clinical outcomes of procedure (excellent: 76.3%; very good: 21.0%; good: 2.6%). No patient reported 'fair' or 'poor' result. Conclusions Our results revealed barbed PDO cog thread is highly effective in facial rejuvenation. Also, tying the PDO threads in same entry point to each other seems to be an effective technique to prevent thread migration.

Experiences of barbed polydioxanone (PDO) cog thread for facial rejuvenation and our technique to prevent thread migration.

Background:In 2006, Villa et al. published a review article concerning the use of thread-lift sutures and concluded that the technique was still in its infancy but had great potential to become a useful and effective procedure for nonsurgical lifting of sagged facial tissues. As 11 years have passed

Thread-Lift Sutures: Still in the Lift? A Systematic Review of the Literature.

Background Facial wrinkles are key signs of aging which affect one's quality of life and psychological well-being. Absorbable wedge-shaped polydioxanone (PDO) sutures are popular in the esthetic clinics of Korea and may be a treatment option for static wrinkles on the upper face. Objective To describe a novel technique applicable to deep static wrinkles on the upper face and to assess its safety and efficacy. Patients and methods A retrospective chart review was performed on the static wrinkle cases which were treated with folded, wedge-shaped PDO threads. A total of 33 Korean patients with glabellar and forehead wrinkles were included. All participants underwent a single treatment session. The results were assessed objectively using serial photography and subjectively based on the patients' satisfaction scores. Complications were also recorded. Results Our patients displayed moderate (15.2%), severe (39.4%), and very severe (45.4%) static wrinkles at baseline. The majority of patients (81.8%) considered the results satisfactory. Consensus ratings by two independent dermatologists showed that the objective outcomes at 2-month follow-up were very much improved (30.3%), much improved (30.3%), and improved (24.2%). The incidence of complications was low, and the complications were minor. Conclusion Wedge-shaped PDO sutures in a folded configuration ("solid fillers") are a promising treatment option for deep static wrinkles on the upper face. They may be applied as an adjunct, or as an alternative to conventional therapies such as botulinum toxin and soft tissue filler injection.

Wedge-shaped polydioxanone threads in a folded configuration ("Solid fillers"): A treatment option for deep static wrinkles on the upper face.

Various recently introduced minimally invasive treatment modalities are now widely used for enhancing the aging face. In a special, filler is used to increase the volume of tissue, and so understanding the regional thickness and distribution of the facial superficial fat is essential for optimizing minimally invasive procedures. The aim of this study was to establish the overall facial skin and superficial fat thicknesses using a three-dimensional (3D) scanning system. From 53 adult Korean and Thai embalmed adult cadavers, the undissected and serially-dissected facial specimens were scanned and reconstructed. The facial skin and superficial fat thicknesses on seven facial regions were calculated from the superimposed images. The facial skin tended to become thicker in the order of the radix and dorsum, and the temple, supraorbital, forehead, perioral, cheek, and infraorbital areas. The skin was thinnest at radix and dorsum (1.51 ± 0.55 mm), and thickest in infraorbital region (1.97 ± 0.84 mm). The facial superficial fat thickness tended to increase in the order of the radix and dorsum, supraorbital, forehead, temple, cheek, infraorbital, and perioral regions. The superficial fat was thinnest at the radix and dorsum (1.61 ± 1.07 mm), and thickest in the perioral region (5.14 ± 3.31 mm). The facial superficial fat thickness tended to increase in the order of the radix and dorsum, supraorbital, forehead, temple, cheek, infraorbital, and perioral regions. The present findings indicate that 3D scanning system can yield crucial anatomical information about depths of the facial skin and superficial fat layers for utilization in various clinical procedures. Clin. Anat. 32:1008-1018, 2019. © 2019 Wiley Periodicals, Inc.

Regional thickness of facial skin and superficial fat: Application to the minimally invasive procedures.

BACKGROUNDThread lifting is a minimally invasive technique for facial rejuvenation. Various devices for thread lifting using polydioxanone (PDO) are popular in aesthetic clinics in Korea, but there have been a few studies regarding its use.OBJECTIVETo describe PDO thread and techniques adopted to co

Outcomes of polydioxanone knotless thread lifting for facial rejuvenation.

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Outcomes of polydioxanone knotless thread lifting for facial rejuvenation.