Polydioxanone thread lifting: considerations and patient expectations

Abstract

The thread lift is becoming an increasingly popular treatment within the field of aesthetic medicine. The procedure can be performed using polydioxanone (PDO) threads to lift, tighten and rejuvenate areas of sagging skin, and minimise fatty tissue. This allows for the non-surgical redefinition of facial contours and enhancement of skin integrity. Thread lifting with PDO can also provide certain aspects of the much sought after surgical facelift in a clinic setting. PDO threads aim to promote targeted lipolysis of fatty areas and neocollagenesis in sagging skin, as well as lift the treated areas. However, it is important to note that the extent of these enhancements varies between individuals, and can carry unwanted side effects. The author draws on his experience to discuss the importance of managing patient expectations pre and post PDO thread lifting, describe the treatment's mechanisms of action, and highlight important considerations for aesthetic practitioners who wish to pursue these treatments.

The Efficacy of the Absorbable Polydioxanone (PDO) Thread Lift in Lower Face (Marionette Line) Rejuvenation

“…PDO threads have bioabsorption period of about 6 months. Thread lifting is reliant on two mechanisms: physical thread strength to lift and hold sagging tissues, and the biological processes to improve skin and soft tissue quality as a reaction to the threads [16,17].…”

“…Histological studies have demonstrated the thicker dermal papillae following PDO thread insertion, suggesting interstitial growth of new collagen components (neocollagenesis). All of these changes aid in the reduction of tissue laxity and help to rejuvenate the structure and appearance of skin, enhancing the lift obtained up to the endpoint of treatment (about 1-year post treatment) [17].…”

Neck rejuvenation with thread lift

“…When reduction in volume due to a double chin was desired, monofilament PDO threads were used in a crosshatch technique to aid in lipolysis, along with tightening the skin, thus attempting to restore the optimal cervicomental angle. [6] To improve sagging and severe wrinkling, more stretch in the horizontal plane was desired, and hence to redrape the skin, we used PDO bidirectional barbed or PLLA bidirectional cone threads.…”