One of the largest growing trends in anti-aging — a hot trend in itself — is the simple use of altered absorbable sutures to lift and manipulate the facial skin and near underneath structures to provide a newly lifted and fresh look. It can even deal with some of the loose neck skin that haunts virtually everyone, eventually. Since the word “suture” connotes an incision, possibly resulting in a scar, we tend to call these “threads” as there is no open wound, no cutting, no healing, and no scar.
The suture is made rough to cling to the inner subcutaneous tissue so the tissue can be manipulated and directed to a tighter, lifted position and remain there. Over the next several months your body creates collagen around the thread as it is breaking the thread down into organic materials. The collagen is fresh and tightly wound so it naturally continues to lift the readjusted skin.
Using these PDO threads to give a minor face lift is relatively quick and easy. Occasionally someone will want a more defined jaw line, which is quite doable, especially if any unwanted fat can be removed prior to the lift. This is where Kybella® comes in.
Kybella® is deoxycholic acid, a substance that your own body produces to break down dietary fat. The molecule is identical but the product is of course synthetic. Kybella® was first FDA approved to reduce the fat under the chin that made someone appear like they had two (or more) chins. Off label practitioners today are using it in many various areas, including the jowls, bra fat, back fat, inner thighs, inner knees, etc.
Once the jowl area is treated with Kybella®, the threads can be even more effective at lifting a less-bulky area. The result is a beautifully sculpted and defined jawline, and a lifted and fresh appearance.
The process of inserting threads is not complicated, but does take a bit of time. In my practice the time is spent in consulting (finding out your desired effect), prepping, drawing, pictures (no one is exempt from pictures but they are not shown publicly for legal and ethical reasons), numbing, and finally insertion. A tiny puncture is made with a small needle, a cannula containing a thread is inserted into the tiny hole, the cannula advanced and finally removed leaving the thread in place. A brief massage of the area with a lubricant allows the thread to adhere to the appropriate layer and the thread is gently pulled back and cut. The thread is completely inside (leaving no open areas to allow for infection) and the skin closes practically immediately leaving no trace of insertion.
The number of threads needed for a desired result with of course vary with the goals of the patient and the expertise of the provider. One thread inserted on each side will most often result in no noticeable change whereas three to four threads on each side can result in substantial improvement. Occasionally more are needed but again that depends on the goals of the patient. Because these threads are absorbed naturally by the body, collagen is produced and placed around them, resulting in an even greater result than what was apparent at the initial treatment. While all patients are individual with individual results, the average effect is close to 18 months.