Thread lifting is minimally invasive treatment procedure in which a surgical thread with barb is inserted into the subcutaneous fatty tissue. The connective tissue of the fat pads gets caught in the hooks. The subcutaneous fat tissue is thus slightly lifted. The procedure was first performed by a Georgian plastic surgeon in 2002 using specially developed surgical sutures (Sulamanidze M.A., 2002, Dermatol Surg). These filaments, called Aptos®, were already patented in 1999 and were made of polypropylene. However, the results of lifting with threads made of polypropylene were sobering. The sutures were visible and palpable under the skin (Rachel JD, et al, 2010, Dermatol Surg). The use in 2012 of polydioxanone (often abbreviated PDO or PDS) self-dissolving sutures produced significant improvement (Suh DH, et al, 2015, Dermatol Surg). Several studies followed showing positive results and rare complications with the use of PDO suture. PDO and PLLA are known collagen stimulants and are thought to stimulate long-term rejuvenation benefits.
The sutures are considered a medical device and are therefore not as strictly regulated and controlled as drugs, but they must have CE certification. Nevertheless, there is considerable variation in quality among CE-certified sutures (Aitzetmueller M.M., 2019, Plast Reconstr Surg).
There is currently no robust data for thread lifting, although smaller studies have been published and are promising. The use of thread lift is very popular because there are no scars left behind and the recovery is shorter than with a facelift. The fact should not obscure the fact that facelift results cannot be achieved with a thread lift (Gülbitti HA, et al, 2018, Plast Reconstr Surg). Significant amounts of marketing budget are allocated by companies to “train” non-surgically trained physicians in these minimally invasive lifting procedures in a one-day course. There is a risk that the technique will be used, even if it is unsuitable, because surgical treatments are not mastered. The risks of infection should not be underestimated, especially when these procedures are offered by physicians who are not familiar with sterile work from the operating room.