Minimally Invasive Facelift

In Singapore, there is a wide array of aesthetics treatments that help with restoring skin firmness and facial contouring. However, injectables (like fillers) and skin resurfacing treatments can only help to restore firmness to some degree. As the skin starts to sag, only a scalpel also known as facelift surgery, is said to be the best option to help reverse that condition. But not everyone is willing or able to go through surgery. 

This is why thread lift has been developed to fill in the gap between facelift surgery and non-invasive facial contouring. Although less radical than a surgical facelift, the minimally-invasive thread lift procedure can visibly boost sagging skin, giving way to a more defined and V-shaped facial contour that many Asian women covet. Over all, the lift will also make you appear less tired, more rejuvenated and youthful. It is a good option for those looking for an easy, less costly option for facial rejuvenation but willing to accept a result less dramatic than a face lift. 

WHAT IS THREAD LIFT?

A non-surgical thread lift is a procedure where temporary sutures are used to produce a subtle yet visible lift in the facial skin. Rather than physically removing the patient's loose facial skin surgically, the medical doctor simply does minor ‘stitching’ on parts of the face. The threads placed under the skin are so fine the sutures will not be felt once the skin has healed around them. The effect is skin slightly pulled back, lifted and tightened around the face. This procedure also makes for an ideal treatment that combats signs of aging as it triggers the body's natural healing response, causing large surges of collagen to be directed to the treated areas. 

The threads are made from various compounds such as polydioxanone (PDO), polylactic acid (PLA) and polycaprolactone (PCA). PDO threads are surgical threads made from polydioxanone which is a colourless, crystalline, and biodegradable synthetic polymer and are absorbed into the body over six months by hydrolysis. PLA threads are made from a bio-compatible polymer derived from lactic acid that has been used in many applications such as orthopaedic pins and sutures. PCA threads are the newest threads and are bio-absorbable, mono-filament suspension threads of synthetic origin (caprolactone).

Popular absorbable PDO threads like Silhouette Soft threads are made of 82% poly-L-lactic acid (PLLA) and 18% glycolide polymer (PLGA), which features bi-directionally oriented cones along the length of each suture. The bi-directional cones anchor on the higher side of the skin tissue, while hooking onto skin and fat on the lower side to lift and reposition sagging skin. Another PDO thread is Happy Lift which is made of poly-L-lactic acid and caprolactone (PCA) with resorbable filaments that are woven into the tissue of your face to tighten and tone any sags and bags. 

The non-absorbable threads include APTOS thread, Contour thread, and Polypropylene thread.

There is another type of thread lift - IDS Aesthetics Thread Lift (ITL) is a unique, needleless facial treatment that is suitable for all skin conditions except acne-prone. Consider this 90-minute ITL your lunchtime treatment with no side effects. This aesthetic facial includes deep exfoliation, permeation of dissolvable silk protein threads and therapeutic serum infusions to give you the effects close to that of a thread lift without zero downtime. The result is immediate firming, lifting, brightening and moisturizing. For optimum results, it is recommended once a week (or once every 10 days for sensitive skin) for the first month.

HOW DOES THREAD LIFT WORK?

There are three main types of PDO threads being used; mono, cog and screw threads. Mono threads are smooth without barbs and are anchored to the face or the scalp. They mainly tighten the skin but do not significantly lift it. Cog threads have barbs which hook onto the skin to provide support and lift the sagging tissue. Screw threads have one or two intertwined threads around the needle and are good for restoring volume, creating a V-shape face and improving skin texture and elasticity.

In Happy Lift, the barbed elastic threads under the skin will literally lift the tissues upwards, essentially “pushing” up the bulk of your lower face, sculpting and contouring your facial silhouette to one that’s more V-shaped. The barbs on the threads also trigger the fibroblasts and new blood vessels, inducing collagen stimulation over the next six months to a year through a low-grade inflammatory response.

Polylactic acid (PLA) threads use cones to hook to the subcutaneous tissue (5mm under the skin), giving the effect of pulling the skin back slightly and thereby lifting and tightening the face. In addition to being ideal for lifting the skin, threads combat aging by inciting the body's natural healing response, causing the body to send large surges of collagen to the treated areas as the body fights to "heal" and expel the sutures. This natural biological reaction takes place every time the body senses any foreign object present within the dermis. PLA threads regenerate collagen over a longer time than PDO threads.

Polycaprolactone (PCA) threads work by regenerating collagen, where the lifting and stretching action will continue even after the threads have been resorbed, over a longer time than PDO and PLA threads. During the process of thread breakdown, it produces molecules of small molecular weight which induce the production of collagen and hyaluronic acid. The result is that of skin that is more moisturized, revitalized and firm.

WHAT CAN THREAD LIFT DO FOR YOU?

Manage your expectations as thread lifts will generally only lift the face by a few millimeters, creating a subtler and more natural looking result than facelifts. You will first see an instant 1-2cm lift and a rejuvenating effect due to increased production of collagen during the breakdown of the thread, about six to eight weeks after your treatment. The threads are completely biodegradable and will be safely absorbed by the body over 10 to 11 months.

The ideal thread lift candidate is usually between the age of late thirties to early fifties, and thread lift makes a good facelift alternative for older patients (55 and above) who are unable to have surgery due to medical or age-related conditions such as high blood pressure, type two diabetes and cardiovascular disease.

Thread lifts can restore volume to hollow cheeks, tighten loose jowls, lift mild to moderate sagging of cheeks, smoothen folds and lines around the nose and chin caused by slipping fat pads in the face due to aging.

Nose augmentation or rhinoplasty (also known as nose job) is a highly popular procedure in aesthetic or plastic surgery clinics in Singapore. But for those unsuitable for surgery or afraid of going under the knife, nose fillers and nose thread lifts make great non-surgical alternatives. Traditional or Korean PDO threads may be used by inserting into the nose to give it immediate support and lift for a more defined nose bridge, more nose height and a slightly sharper nose tip.

PROCEDURE AND TREATMENT 

One week before procedure, thread lift candidates should avoid all alcohol and discontinue smoking as these can dehydrate the skin and interfere with the anaesthetic. All aspirin-based products such as Neurofen, Naproxen, Ibuprofen, should also be avoided as well as they can cause unnecessary bleeding leading to unwanted complications and side effects.

Prior to procedure, local anaesthesia will be applied to the treatment area to numb the skin. After which, depending on the type of threads used and what you wish to achieve, a long needle syringe or cannula holding the thread is inserted into the specified area, targeting underlying fat layer. One end of the thread is carefully tied to firmer underlying internal structures while the other end goes underneath the skin, along the predetermined lines to reach the end point. As the doctor withdraws the needle, filaments on the sutures are deposited into the sagging parts of the face. The doctor then tugs on the thread to elevate droopy skin and sets it into a more lifted position. The whole procedure takes 20 to 30 minutes to complete. Sensations like prickling of a needle or ant bites as well as tugging or dragging may be felt but altogether painless.

RISKS AND SIDE EFFECTS

Unlike surgical facelifts, threadlifts are low risk with virtually no risk of scarring, severe bruising, bleeding or other complications, so recovery time is also much reduced. That said, the results of facelift surgery can last up to a decade, whereas a threadlift will generally last from one to three years and can be repeated once the old sutures are absorbed by the body.

Although some patients may experience a little soreness, redness and swelling after having a thread lift, strong pain-relieving medication is seldom needed. While most can return to work immediately, it is best to take the rest of the day off. But in rare cases, patients may experience irritation, infection or their sutures becoming visible under their skin. If this occurs, the sutures can simply be removed and the patient's face will return to its prior state.

Although thread lift recovery is not intensive, patients are advised to take minor precautions. If your skin is prone to swelling or bruising, ice the area for 30 minutes several times a day for the first five days. Limit facial motions for the first 24 hours, avoid facial creams or makeup for 48 hours, don't rub your face vigorously and be as gentle as possible during cleansing or applying moisturizer for at least a week, do not drink with a straw, try to keep the head elevated when sleeping so that you don't roll over directly onto your face, eat soft foods or drink liquids for seven to 10 days, avoid heavy exertion and facial massages for three weeks.

As with most medical procedures, certain associated risks and side effects include pain or discomfort during and after the procedure, risk of infection, bruising and swelling. As PDO threads are not created equal and depending on your doctor’s training in the procedure, some side effects may be related to the technique of insertion, and the types of threads used - threads being felt under the skin, thread migration, extrusion or breakage, facial asymmetry, surface depressions, prolonged pain, and prolonged dimpling.

More serious side effects, though rare, include infection, nerve damage, formation of nodules, and damage to the salivary ducts.

WHO IS NOT SUITABLE FOR THREAD LIFT?

• Currently pregnant or breast-feeding
• Suffers from cystic acne or rosacea
• An allergy or hypersensitivity to any ingredient used in the threads