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Basics for threads: a beginner’s guide to perfecting techniques - (under an educational grant from Aptos)

Partner of the session

SOMALDEC

Société Marocaine de Lasers, Dermatologie Esthétique et Chirurgicale

Morocco

Focus program

Room: Webinar
Date: Wednesday 28 April 2021 at 11:00 to 12:30
Format: FOCUS SESSION > lectures covering a major topic of the congress

Chair

Dr Patrick J TREACY

Cosmetic Surgeon

Ireland

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
11:00	Dominique DU CREST	Introduction		108998
11:05	Dr Pierre NICOLAU	Anatomy review	View	108994
11:17	Dr George SULAMANIDZE	Importance of threads’ composition - Overview of absorbable and non-absorbable threads	View	108996
11:29	Dr Fatima Zahra BELGNAOUI	Booster with non-permanent threads	View	108995
11:41	Dr Thomas RAPPL	Threads for nose with non-permanent threads		108997
11:53	Dr Thomas RAPPL	Challenging thread case from IMCAS Alert		110250
12:01		Discussion and Q&A with the audience		108999

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Dominique DU CREST

Industry Representative

France

Other author(s) :

Introduction

Dr Pierre NICOLAU

Plastic Surgeon

Spain

Other author(s) :

Anatomy review

Objectives: To learn and understand the anatomical and physiological changes during facial ageing. This should allow for trying to compensate for these changes, without creating an abnormal anatomy

Introduction: Knowledge of the physiology of facial aging allows us to understand the changes in the "youth appearance" anatomy.

Materials / method: Changes involve muscles, which become thinner and permanently contracted, leading to displacement of peri-muscular fat compartments.
Superficial fat, accounts for 57% of total facial fat, and has two components: the Hypodermis, third layer of the skin, and the fat in superficial compartments. It does not change with age, but with weight.
Deep Compartment fat looses about 1% of its volume every year as from the age of 30,and is displaced through muscular movements and contracture.

Results: All these changes lead to the formation and deepening of the functional folds, naso-labial and genio-labial.
It has been well demonstrated by V. Lambros that skin does not move as we believed, but follows the changes of the deep fat structures. Therefore, we have to try to correct these changes, but without creating an abnormal anatomy.

Conclusion: Restoring volume losses can be achieved by deep, pre periosteal injection of volumizing fillers, to lift up the anatomical structures, and/or direct repositioning of the fat compartments through tensioning threads. The skin, which follows fat displacement, is therefore repositioned and tightened, in a physiological way that cannot be maintained through simple superficial pulling.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr George SULAMANIDZE

Plastic Surgeon

Georgia

Other author(s) : M. Sulamanidze, C. Sulamanidze, A. Kajaia

Importance of threads’ composition - Overview of absorbable and non-absorbable threads

Objectives: Recently, thread lifting methods are more widely applied in dermatology and aesthetic surgery areas. The main idea of thread lifting was always fighting against soft tissues sagging – Anti ptosis. But there is not enough just reposit the tissues mechanically for total face rejuvenation, it is required to influence the skin structure and quality as well. Different manufacturers using different type of thread composition.

Introduction: Unfortunately, chemical composition of the offered threads in the market (PDO, PDS, PGA, PLA, CL, Polypropylene, Silicone) is not always provided with the required effect. As of today, the best substance for this matter is hyaluronic acid. Knowing this fact, almost every specialist is combining thread lifting procedure with hyaluronic acid injections.

Materials / method: Since 2016, we apply P(LA-CL) threads with hyaluronic acid additionally in the thread composition (thread formula looks as P(LA-CL)HA). We have performed procedures for more than 100 patients. During this period some patients underwent the procedure twice or more. Mainly, threads were injected in the middle and lower face thirds per 5 threads per each side. Diameter of the thread is 2/0 with multi-directional barbs.
We have also performed histological researches in rats comparing P(LA-CL) threads and P(LA-CL) threads with hyaluronic acid addition in the thread composition.

Results: Histological researches of P(LA-CL) threads and P(LA-CL)HA comparison have provided with the following results in favour of threads with hyaluronic acid:
- Decrease of inflammatory process and joint capsule around the thread
- Decrease of elastin around the thread from the first week of implantation
- Increase of I and III type of collagen for 55% and 20% accordingly

Conclusion: This research and the results in patients have showed the application of thread with hyaluronic acid hastens rehabilitation process after the procedure, excludes risk of subcutaneous scars appearance, increases development of elastin and collagen naturally influencing upon skin quality and structure. Application of threads with P(LA-CL)HA and multidirectional barbs allows to receive as effect of soft tissues reposition as improvement of skin quality and structure.
By our practice P(LA-CL)HA thread composition is the best for skin stimulation effect we can get from thread lifting procedures.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No
Please specify entities (individual, company, society): Aptos

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
Yes
Please specify date...: Patent
and status : 1996

This work is presented thanks to the support of: Aptos

Dr Fatima Zahra BELGNAOUI

Dermatologist

Morocco

Other author(s) :

Booster with non-permanent threads

Objectives: to present and discuss the contribution of non permanent booster threads among the other esthetic procedures

Introduction: The esthetic fields is on constant evolution and it’s very interesting to see that people now are not only searching for reducing wrinkles, having volumization…..
Improving skin quality became one of the most frequent thing we are asked for by our aged or younger patients .

Materials / method: Multiple procedures can be suggested to improve hydratation, brighteness, firmness, surface … : Hyaluronic acid or other stimulating agents, remodeling lasers, peelings, microneedling, mesotherapy and booster threads.
In this talk, we are going to see wich type of threads can be used for this effect, how they work and which advantages they can give

Results: Composition of most known resorbable booster threads is PDO (Polydioxanone), PLA (polylactic acid) and/ or PCL (Polycaprolactone).
All of them are able to induce the constitution of connective dense tissue and then to achieve and maintain results obtained by threads, even after their complete resorption.
Many areas could be treated by these technics shown by videos and photos for results
In this field, the interest of using some lifting threads to improve skin quality is also discussed

Conclusion: advantages of using threads instead of other booster procedures are presented.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): I'm Aptos trainer

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Thomas RAPPL

Plastic Surgeon

Austria

Other author(s) :

Threads for nose with non-permanent threads

Dr Thomas RAPPL

Plastic Surgeon

Austria

Other author(s) :

Challenging thread case from IMCAS Alert

Discussion and Q&A with the audience

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IMCAS Academy International Program

Basics for threads: a beginner’s guide to perfecting techniques - (*under an educational grant from Aptos*)

Chair

Lectures of the session

IMCAS Academy International
Program

Basics for threads: a beginner’s guide to perfecting techniques - (under an educational grant from Aptos)