As the human face ages, it experiences an increased severity of wrinkles, loss of skin laxity, and repositioning of fat. The synergistic effect of these factors are the root concern of many patients.
Elective surgical interventions, like the facelift, give patients immediate, significant, and long lasting outcomes—but come at a cost.
First, downtime of an elective surgical intervention can be approximately two weeks. Second, the cost of the procedure may range from $10,000 to $25,000. The cost of downtime and actual dollars creates a barrier to a large portion of patients who may benefit from these elective surgical interventions.
However, the past few decades have given rise to incredible, non-surgical alternatives such as PDO lifting that still offer patients exceptional results at a fraction of the cost and stress of surgery.
A study conducted by Dr. Marcelo Hochman in 2005 examined 70 suture lift procedures that focused on repositioning the fat malar pads (cheeks) and the jowl area (chin and jaw). Among the patients that underwent the procedure, less than 1% experienced extrusion of the suture.
Unacceptable results, which include dimpling and poor results were seen in 3 procedures. After 12 months from the procedure, a large portion of patients experienced and maintained the lifting outcomes seen immediately after the procedure.
Eighty five percent (85%) of patients reported continued satisfaction of results even after 12 months.
Dimpling is a complication where the skin appears to dimple at a point along the suture thread. The dimpling of the skin is due to the suture being placed too close to the surface of the soft tissues. Correction of dimpling includes removal of the suture and re-introducing the suture at a deeper plane.
Extrusion occurs when the ends of the barbed suture can be visible seen through the skin. If the barbed suture does extrude from its place, it will typically become visible at the entry and exit incisions.
Correction of this complication involves trimming the suture and or dissolving the suture. If dissolving the suture is performed, then a new suture must be reapplied.
Foreign Body Reactions
Early techniques of suture lifting used sutures that were permanent and nonabsorbable. A review of these techniques has demonstrated that using permanent sutures may activate the body’s immune system and reject the barbed suture.
Complications involving foreign body reactions are resolved by removing the sutures. The latest suture lifting techniques use polydioxanone that are absorbable by the patient’s body.
Using absorbable sutures prevents foreign body reactions but requires patients to undergo additional procedures every one year because the body absorbs the suture over time.
Specialized suture lifting procedures may offer patients a solution for wrinkles, laxity, and overall aging of the face. Patient selection and counseling is important for positive results and patient satisfaction.
Ideal patients are typically aged 40 – 55 and have moderate laxity of the cheeks and chin. Suture threading is ideal for patients who have well developed but drooping malar pads and are not interested in a more invasive surgical procedures.
Patients must be willing to undergo maintenance treatments on a yearly basis for continued lifting outcomes. Patients unwilling to undergo yearly procedure are recommended a more long lasting and surgical intervention (e.g. facelift).
Suture lifting should not be introduced as an alternative to surgical interventions such as a surgical facelift.
Suture threading, in its current form, will not reproduce facelift outcomes—however, for many patients PDO lifting is all they need to see the results they desire.