Thread lift procedure uses a technique that has been around for many decades but has slowly gained more recognition in the cosmetic industry. Used for lifting skin that has sunk due to aging or weight gain, the technique is raved on by many. However there are still many unanswered questions that leave many in confusion and they miss out on a procedure that can be great for them. This is mainly due to there being so many different threads available and the prices for the threads affect the price of the procedure available. The following section will explain the threads available and which are used commonly.
The categories the threads are divided in:
There are 3 categories for threads: Absorption, length and surface texture (Smooth vs barbed)
When a thread is absorbable it means that over time it can be safely broken down by the body and either be used by the body or gotten rid of. Depending on the effect wanted, absorbable or non-absorbable thread can be used. The main absorbable thread used is Polydioxanone (PDO) thread which has traditionally been used for surgical stitches and is the thread used in Asian cosmetic procedures like South Korea's HIKO nose thread lift. This thread is commonly used as it has been proven to be extremely safe and dissolves around 6 months after the treatment.
There are other absorbable threads as well such as Silhouette Soft thread (popular in Europe and the US) which uses PLLA (Poly L Lactic Acid) and lasts around 12 months and PCL (Polycaprolactone) which is absorbed 24 months after the treatment.
Generally the threads stimulate collagen while they are in the skin tissues so the longer they are in the skin, the longer the collagen is being stimulated. However the thread being there for so long may not suit some people so the thread used is depending on the person being treated. Furthermore they serve slightly different functions such as PDO thread lifting is more for lifting skin while PLLA gives a more volumised affect. So, as an example, a person wanting a nose lift will not go for PLLA as they don't want volume in their nose but those with hollow cheeks may want volume.
Finally non-absorbable thread is available as well and is used for the same procedures but permanently hold the sagging skin up while absorbable threads will eventually dissolve and the skin will lose that tightness. Non-absorbable threads like Aptos (one of the original threads developed for threadlifting), Woffles thread and Contour all use the base of polypropylene (a type of material that the body can't absorb).
The preference for threads will depend on the individual, what treatment they want and what results they want.
The texture of threads, both absorbable and non-absorbable, is really important to get effective results. Depending on the treatment area, some textures might work better than others or a combination of threads may be used.
The threads can be barbed in one direction only (Uni-directional barbed threads), barbed in two directions (Bi-directional barbed threads) or non-barbed. Bi-directional threads are favoured by doctors to give the general structure for the lift because the thread is locked in to the tissue in both directions.
These barbs are really important because they make sure the thread doesn't move in the soft tissues and they cause small 'injuries' in the tissues which triggers the skin to produce more collagen to repair itself. This collagen forming around the new shape of the face or facial feature then make the treatment more long lasting.
Uni-directional and non-barbed threads can be added to support this structure or create the mesh shown in the diagram in the following section. These two threads are also useful as they can be moved to make adjustments and corrections after the procedure but they have to be anchored at some point in the tissue otherwise they will move.
With non-barbed threads, there are two types: monofilament plain and monofilament spiral. Both types are smooth and are used in regions with thin tissue such as around the eyes where you don't want the skin to scrunch up on the surface.
For PDO threads, which are the most popular in South Korea, there are 3 main textures: Mono, Cog and 360 Cog. These textures are similar to the above textures but have small differences that are unique to PDO. Mono threads have smooth texture and are usually used in combination with other thread types as on their own the effect is not that strong. Cog threads have similar structure as uni-directional barbed thread while Cog 360 has a similar structure to bi-directional barbed thread.
Finally, as research grows in the field, more and more textures are emerging that play on the above basic textures. Sometimes these threads can be braided and then inserted in to the skin to give a different structure and effect. All these techniques are usually unique to the clinic you get the treatment at.
The length of the threads are categorised as being long or short. PDO and all its thread types usually are short in length which is why it is really good for procedures like HIKO nose thread lifting while barbed threads tend to be longer in length and can be used across the face, neck, chest and even parts of the body.
Thread Lift in Korea
Thread lift in Korea mainly uses absorbable threads, particularly PDO. The common thread types used are Mono, Cog, Cog 365, Silhouette and Blue Dia. Often the difference between Blue Dia and Cog 365 can be confusing but this is shown in the above diagram. Cog 365 is formed by the PDO thread being cut to form the cogs while Blue dia thread is formed using a mold to give the shape of the cogs - not cuts are made. The mold is shaped to have cogs and the liquid version of PDO is poured in to the mold and once it sets in, the Blue Dia thread is formed. This type of thread is very popular in Korea because the effects last around 2 years while other PDO threads last around 1 year. These threads are also stronger than other PDO threads.
Another popular thread used is Silhouette which uses PLLA, another type of absorbable thread that contains small bidirectional cones that holds on to the skin tissue and stops the thread from shifting. The cones also stimulate the collagen production in the skin and is used for lifting skin that has deep wrinkles and sagging. Clinics will often use a combination of the threads and combine them with other ingredients such as vitamins that are good for the skin and can help with the collagen regeneration process or using fillers to get the desired result.
Application of Thread Lift Procedure
With aging, skin and facial fat tend to sink downwards due to gravity and the skin cannot hold itself up. Youthful skin has a lot of collagen present which holds the skin up firmly, giving the skin a plump look. Thread lifting techniques essentially use threads to pull the sagging skin upwards and depending on the thread used, the effect can be permanent or semi permanent. As mentioned above, they also stimulate collagen to support this lifting effect.
As shown in the diagram above, the threads can be arranged in a crisscross pattern - always going upwards and to the side of the face, never downwards. This is to create a support network for holding the sagging skin up and this smoothes out deep set wrinkles. For a natural lifting effect and smaller regions such as nasolabial folds, short threads such as PDO threads are used while long threads are used for when there is major lifting needed such as the full face.
However if the effects of sagging are severe then surgical options may be better suited for the individual. This is especially the case with older, thinner skin that will not be able to work with the threads to give the lifting effect. This is because thread lifting relies on the skin to have at least some strength to support the lifting effect.