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CosmeticSurg Blog

Dr. Rodriguez discusses Plastic Surgery, Medicine, and Stem Cell Research


A lot of my patients have been asking about threadlifts. The threadlift is a mini-facelift which can be done under local anesthesia in the physicians office.

At our last national meeting in Chicago (American Society of Plastic Surgeons), the opinions seemed to be split into two camps. The first proponents were easily visible because the “threads” are a product to be sold and the companies want to create a buzz. The detractors were in the multiple closed door meetings, po-pooing both the medico-industrial complex and the myriad “me-too!!!” early adopters.

The threadlift suspends the soft tissue differently
The argument really is about what are effective ways to move “soft” tissue from one spot to another. When I was trained, I was instructed that suspension sutures “don’t work.” I was taught to lift and separate tissues widely so when I redraped them in the desired way there would be minimal tension. After redraping and stretching of the tissues to eliminate wrinkles there would be some excess skin and fat tissue to remove. In this way you reshaped the face and got rid of “excess tissue” which caused some areas of skin and fat to “hang”. Trying to reposition that hanging tissue with “suspension sutures” would not work.

More recently, surgeons tried suspension sutures again, but with a difference. Instead of using a regular suture, surgeons now used sutures with multiple barbs so each of the barbs “catches” the tissue.

The threadlift uses special sutures
The principle behind the sutures is sound. With a regular suture, the suture “catches” the tissue at one spot, then that spot is pulled in the direction you want. All the tension is at that spot. Suppose you have a suture that has 6 pounds holding power. You suture it to tissue that has 3 pounds holding power. Since the pull of the suture (6 pds) at that spot is greater than the strength of the tissue itself (3pds), the suture will tear through the tissue. Now suppose the suture catches the tissue at three different spots. The strength of the pull is now divided along the three different spots. Now the pull at each of the three spots is weaker(2pds vs 3pds) and the likelihood of tearing through the tissue is minimized.

The thread lift suture has multiple little barbs or mini-hooks so that the suture “catches” the tissue at multiple points. This way the strength of the pull is never enough to tear through the tissue. Better yet, instead of pulling only at one or two spots, you pull along the entire path of the suture. This can potentially improve your ability to shape the tissues over a larger area.

Threadlift is promising
Although this is a new technology, I think the thread lift holds a lot of promise. The quandary for the patient is whether he/she wants to be a beta tester until all the bugs are worked out.

Plastic Surgery goes periodically through waves like this where a product of great promise is pushed hard by the medico-industrial complex and the plastic surgeons adopt it enthusiastically. Potential troubles or shortcomings show up later and the procedure falls into disfavor or is used much less than at first. Examples of plastic surgery techniques which were initially adapted enthusiastically, only to discover shortcomings later are CO2 Laser and Ultrasonic Liposuction.

Posted in Face

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