Thread lifting: Top topic of the Journal Aesthetic Surgery

In her very informative basic article “Thread lifting – limits and possibilities”, dermatologist Dr. Daniela Greiner from Oberursel describes very clearly the development of so-called thread lifts, the different techniques and materials, possible indications but also risks and limits. I would like to summarize Dr. Greiner’s thoroughly researched statements, which are backed up by numerous sources, here for those interested.

Development of thread lifting

About 20 years ago, non-absorbable nylon threads were used for the first time to lift the cheeks and thus achieve a certain lifting effect. The threads were passed from the temples in a large loop with long needles to the cheek and back again and then knotted. This technique appears very simple and direct, but very quickly reached its limits, as it was characterized by disturbing strand-like elevations and a lifting effect that only lasted for a short time. Subsequently, attempts were made to get to grips with these problems in two main ways: Firstly, the threads were provided with differently shaped, differently sized hooks and secondly, the “plastic threads” were replaced by absorbable (i.e. self-dissolving) materials made of different materials.

Resorbable sutures have proven their worth in surgery for a very long time, although it is actually logical that the mechanical hold is lost when the sutures dissolve. This dilemma is countered by the hypothesis that every foreign body in the organism triggers a certain amount of new connective tissue formation, a so-called “capsule formation”. Some users of the threads even promise a significant stimulation of new connective tissue formation, which in itself is said to have a rejuvenating effect. The newly formed connective tissue should even replace the mechanical holding function of the dissolved sutures. However, this is largely a hypothesis that has hardly been demonstrated in practice or has not yet been scientifically proven.

Interim conclusion on thread lifting

Based on the current state of knowledge, the value of the thread lift method cannot yet be definitively assessed. It is quite possible that thread lifts can be used sensibly if the indication is precisely defined, the expected result is realistically assessed and the procedure is carried out correctly. However, it is certain that only relatively young patients with very limited facial aging can expect success and that this will only last for a maximum of 6 to 12 months. It remains to be seen whether this will change in the foreseeable future as a result of further development of current technologies.

Dr. Greiner’s comments largely coincide with my own experiences. My visit to South Korea a year ago (photo) in particular gave me many valuable insights into this topic. In South Korea, thread lifts have been used very frequently for a number of years, whereby not just 2 to 4 threads are used per side of the face, as is usual here, but 10 to 20! Even then, however, patients are not promised a longer shelf life than approx. 6 to a maximum of 12 months!