A Meta-Analysis and Systematic Review of the Incidences of Complications Following Facial Thread-Lifting

Thread Lifting Materials: A Review of Its Difference in Terms of Technical and Mechanical Perspective

Thread lifting involves the use of slender materials, reminiscent of threads, for aesthetic procedures. These materials are distinct from traditional sutures and vary in composition, purpose, and performance. The introduction delves into the literal and material significance of threads, establishing the broad concept of thread lifting materials. The article revisits the evolution of thread lifting materials, emphasizing the preexistence of cog threads for tissue manipulation before their widespread adoption in plastic surgery. Observations regarding the efficacy and longevity of absorbable versus non-absorbable threads are discussed, stressing the efficiency of high-quality absorbable cog threads. The conclusion underlines the proliferation of thread lifting materials beyond PDO, highlighting the importance of considering multiple factors beyond duration when selecting threads for lifting procedures.

What are filling (volumizing) threads?

Facial aging prompts a shift in the demands for lifting procedures, transitioning from targeted improvements in younger individuals to overall facial contour enhancements as skin elasticity declines in later years. This paper examines the evolution of PDO volumizing threads, delineating their development from initial limitations to contemporary innovations aimed at addressing tissue deformation and maintaining thread integrity post-insertion. Categorizing these threads based on elasticity, shape, and functionality underscores their versatility and application nuances, catering to specific wrinkle correction, contour sculpting, and facial volume restoration. The discussion emphasizes the pivotal role of thread characteristics in achieving optimal outcomes while minimizing potential complications. By delving into historical contexts, mechanisms, effectiveness, and thread classification, this paper equips practitioners with a comprehensive understanding to make informed decisions in selecting threads for volumizing thread procedures. Recommendations for future research directions, including long-term safety assessments and patient-specific outcomes, seek to enhance the clinical utility and applicability of this analysis.

Experimental investigation of biostimulatory effects after polydioxanone thread insertion in a pig model

BACKGROUND

Polydioxanone (PDO) threads have been widely used to tighten and lift the facial soft tissue.

OBJECTIVE

This research aims to determine the collagenation and inflammation changes that occur in the adipose tissue over time when different types of threads are implanted.

METHODS & MATERIALS

Three threads types, PDO, poly glycolic-co-lactic acid (PGLA), and nylon, were inserted in the subcutaneous fat of 12-month-old Bama miniature pigs. Collagen production and inflammatory response were evaluated by hematoxylin and eosin and Masson trichrome staining at 1, 4, 12, 24, and 48 weeks.

RESULTS

The integrity of the PDO thread lasted up to 24 weeks with mild inflammation and collagen production. The PGLA thread integrity lasted until 12 weeks and had a strong inflammatory response. The nylon thread's integrity was maintained for 48 weeks and showed minor inflammation and collagen production.

CONCLUSION

Our data suggest that PDO thread is the best choice for clinicians, as it has a mild action process with minimal irritation, moderate collagen production, a reasonable explanation time, with obvious bridging fibrous tissue, and thickening action for the superficial fascia.

Antimicrobial Photodynamic Therapy in the Approach of Complication After Implantation of Spiculated Polydioxanone Threads

The present manuscript is a clinical case report in which antimicrobial photodynamic therapy (aPDT) - using a low-power laser (660 nm) associated with methylene blue photosensitizer (0.01%) - was considered for treating a case of complication after implantation of spiculated polydioxanone (PDO) threads, an aesthetic procedure worldwide performed in facial cosmetic non-surgical procedures. A 72-year-old female patient presented an infection in the face region where the PDO thread was implanted (mandible angle). After divulsion and local drainage, it was decided to associate aPDT using a low-level laser associated with a 0.01% methylene blue photosensitizer. Two sessions of aPDT were performed - on sequential days - and within 48 hours the region was dry and without signs of secretion. The use of aPDT seems to be a promising and effective option in cases of infections after implantation of PDO threads, consisting of a safe technique, of low execution complexity and without adverse effects.

A Rare Symptom of Secondary Infection After Facial Thread Lift and Its Treatment

Facial esthetics is concerned with the harmonious beauty of the face. The skin, soft tissues, and bone tissues of the face degenerate as people age. Facial thread lift is a new minimally invasive esthetic technique that uses threads embedded within different tissue layers to reposition and support lax tissues. The authors report a 35-year-old female patient who developed an infection after undergoing facial thread lift, presenting with facial flushing and swelling, fever, and poor sleep, which was tested for Nocardiopsis dassonvillei infection. The patient was later cured by thread removal, local injection of 5-fluorouracil and triamcinolone acetonide. Postthreading infections have been documented in the past, but it is significant to note that, first, this patient's postinfection symptoms were distinct because she experienced both mild local symptoms and serious systemic symptoms, and second, the authors looked into a quick and efficient treatment option.

Complications Following Thread Rhinoplasty

BACKGROUND

The debate on thread rhinoplasty (TR) has never stopped owing to its complications. However, few studies have reported the clinical characteristics of TR complications, as well as their treatment.

AIMS

We aim to summarize the clinical, ultrasonographic, and histopathologic characteristics of TR complications.

PATIENTS/METHODS

This retrospective case series study included consecutive patients presenting with TR complications. Patients demographics, medical history, complications, ultrasonography, treatment, histopathology, and follow-up outcome were collected through the electronic medical record.

RESULTS

A total of 30 patients (28 females) with an average age of 28.7±6.8 years were included. The most common complication leading to consultation was infection (46.7%), followed by thread extrusion (30%), chronic inflammation (16.7%), and dimpling (6.7%). Most patients who developed complications received TRs at illegal non-medical places (70%). Ultrasonography of infection showed multiple dotted heterogeneous hyperecho signals surrounded by a hypoecho area. 20 patients (66.7%) received debridement, thread removal, or release of dimpling. Threads could be completely removed within one month of TR. Histopathological examination showed multifocal crystal-like material surrounded by excessive inflammatory cells in hyperplastic granulation tissues. All patients were satisfied with the clinical outcomes over a follow-up of 25.6±14 months.

CONCLUSIONS

Infection is the most common complication that always warrants thread removal. Ultrasonography is helpful in detecting the remaining threads and delineating the infection area. We do not recommend threading as a regular method for rhinoplasty owing to its complications for an expedience with short-lasting effect.

Barbed PDO Thread Face Lift: A Case Study of Bacterial Complication

Procedures with polydioxanone (PDO) threads are increasingly used for aesthetic indications. To date, eight cases of serious complications following the use of PDO threads have been published. In this case report, we present a case of a serious bacterial complication after a procedure with four PDO threads. A 52-year-old female patient presented to our center 1 month after undergoing the procedure at another center. Despite early symptoms, no treatment had previously been implemented. Perforating abscesses were found along the course of the threads. After 5 days of antibiotic therapy (amoxicillin 875 mg and clavulanic acid 125 mg p.o. every 12 hours), the threads were surgically removed due to skin rippling. During the procedure, the threads were found to be fragile, and several incisions were necessary to remove them. After 1 month, no signs of inflammation were reported. However, persistent deformities occurred due to delayed treatment implementation. Bacterial complications seem to be a typical complication following the procedure with PDO threads. PDO threads can be difficult to remove due their fragility. The possible need for surgical removal of the threads should be considered when selecting areas for application.