In the recent Plastic and Reconstructive Surgery Journal, March 2018, there was an article which was a review of the literature on thread lifts. What is a thread lift? A threadlift is a minimally invasive surgery which uses carefully placed sutures to lift sagging facial tissue. It was a way to do a facelift without the bruising, scars, and recovery of a facelift. Sounds amazing right? Variations of this have been around for years. The question is do thread lifts work?
This study is “Thread lift Sutures: Still in the Lift? A Systematic Review of the Literature.” This was done because the original review was in 2006, when the procedure was in its infancy and was thought to have great potential.
They looked for any studies with the words:
- facelift
- platysmaplasty
- rhytidectomy (ectomy = removal of, rhytids = wrinkles)
COMBINED WITH:
- barbed suture
- thread lift
- APTOS
- Suture suspension
- silhouette suture
- percutaneous facelift
what did they find?
They found 41 articles, but excluded some because they were case reports or sutures done with nonbarbed sutures like vicryl, prolene, or goretex.
When they reviewed these articles, they found little or no substantial evidence to support that thread lift sutures are promising. They found there was at best “very limited durability of the lifting effect.” The only two positive studies were sponsored by the manufacturers of the thread lift sutures.
My thoughts?
I have never been a fan of these. They are SO alluring- quick, easy, no downtime. But they are holding up the skin by marionette strings, like a puppet. If the string loosens or breaks, the effect is gone. This is different than a true facelift, where we tighten the deep layer below the skin (called the SMAS) and tighten the skin by actually cutting out skin. When this heals together, every point along the undersurface of the skin is “holding” up the lift, unlike a thread lift, where it is being held up by the barbs along a track of the suture. Sadly, there is truth to the idea that to get lasting change you will have downtime. They have tried suspension sutures like this before- there was the giampapa suture to try to give a tighter crisp neckline, there was a suture lift to lift the breast without the traditional scars. They all seem to fail because they are not doing deep sutures to support the change along a broad area and they are not tightening the skin.