Wednesday, December 28, 2005

Thread lifts - the jury is out

The "Thread-lift" procedure has become very popular recently. The concept involves a suture with uni-directional bards that's threaded under the skin and secured, producing points of vector-like pull. It's being heavily marketed, especially by many providers who don't perform traditional facelifts. The advantage of this procedure is rapid recovery with little down time, as well as being an office-based procedure under local.

However, nothing in life is free. What's becoming clear in physician to physician contacts is some of the limitations and complications associated with it. Namely - early relaxation, palpable threads, and unnatural looking vectors of pull. Some of this was highlighted in the New York times recently in an article that can be found at:
NY Times

I had the privledge of training under one of the early beta-testers for the original desighn of the threads & I have to say that the early results are very impressive. However, it's clear that a lot of problems have been seen. I think a lot of this is in patient selection. If you need a facelift, this isn't going to work (at least for long). It's particularly problematic for early relaxation when used for neck-suspension or brow elevation with "heavy" necks or brows.

The best quote about the threadlift (which is dead accurate) is that this procedure is for "Those who want a face-lift but don't need it." Those would be the late 30 to mid 40 year old with good skin and minimal laxity. This is a new and somewhat controversial area in lowering the traditional age-range for facial cosmetic surgery. What's going to happen as you age with permanent suture material holding focal points in your face? My guess is that you'll see some very bizarre looking people with laxity around the fixed barbs. Will this be an uncorrectable or difficult to treat deformity? No one knows yet. what we do know from anecdotal reports is that doing a face-lift after barbs is potentially more difficult do because of inflamation and scar.

Sticker shock is also something I noticed with this. These threads cost nearly $100/each presently and that is either marked up by the Physician or the charge for the procedure is increased to get the total. The bill on these comes pretty close to a full facelift at times and can be the source of some surprise when the patient is quoted on this.

The bottom line is the role for these is being sorted out. There are a lot of Physicians putting these in anyone and you're getting a lot of problems from it. Better patient selection is going to provide better & longer lasting results. These may in fact prove most ideal for patients showing early relaxation from a traditional lift of the brow, neck, of face rather then replacing those procedures


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