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IMCAS World Congress 2022
Program

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FOCUS ON S151

Contributing lectures - Threads

Room: Room Passy - Level 1
Date: Sunday 5 June 2022 at 14:00 to 15:30
Format: CONTRIBUTED TALKS > session made up of abstract submissions that were carefully reviewed and selected by the Scientific Board

Chairs

Dr Albina KAJAIA

Dermatologist

Georgia

Dr Adriano SANTORELLI

Plastic Surgeon

Italy

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
14:00		Introduction		112462
14:02	Dr Mariam TSIVTSIVADZE	General principles of selecting "right threads for effective results’’	View	113236
14:10	Dr Murat TSINTSADZE	Thread lift "pour homme": how to receive and improve results?	View	113324
14:18	Dr Irina POLEVA	Multicentric observational study of the possible side effects of the COVID-19 vaccine in relation of absorbable thread insertion	View	113184
14:26	Dr Ahmet ATALIK	Facelift and neck tightening with permanent threads	View	114372
14:34	Dr Jose Vicente DE CAROLIS FRIEDMAN	Strong neck rejuvenation with threads - A deep mastoid sub-fascial anchoring in a hammock pattern	View	114374
14:42	Dr Daniel Mauricio AVILA CABALLERO	Treatment of flaccidity and sagging gluteus with calcium hydroxyapatite and polydioxanone traction threads	View	114999
14:50	Dr Nejat CAN	Double needle thread methods of the Ghost Lift for non surgical face lift	View	115132
14:58	Dr Ariel Martin ROMEO GENTILINI	Fat tissue reducement after PDO threads insertion, truth or myth?	View	116261
15:06	Dr Hussein ABOU KHALIL	Challenging facial asymmetry: threads methods	View	113627
15:14	Dr Clara SANTOS	The most versatile PDO threads	View	116263
15:22		Q&A		116804

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Threads

Neck & decolleté (non-surgical)

Facelift (non-surgical)

Combined treatments

Complications

Introduction

Dr Mariam TSIVTSIVADZE

Plastic Surgeon

Georgia

Other author(s) : Tsivtsivadze M, Sulamanidze M.

General principles of selecting "right threads for effective results’’

Objectives: Because of the diversity of threads, it is crucially important to take into the consideration all the criteria’s for selecting ‘’right Threads for effective results’’. The aim of this review was to analyze and compare threads by its structure and important physical parameters such as: design, length, diameters, type of the tips of Cannula and Needle, depending on this parameter we can perform comparative assessment of effectiveness, safety, lasting effect, techniques of procedure, tissue traumatization and risk of possible complications (depends on cannula or Needle preinstall into the thread)

Introduction: There is the true evidence that Minimally invasive aesthetic procedures have demonstrated outstanding growth over the past two decades. Among these procedures thread lifting has more possibility to achieve simultaneous rejuvenation and lifting effects and give a chance to patients to look young and beautiful, that’s why thread lifting is an alternative to surgery. Many manufacturing companies, pioneers of thread lift, and surgeons worldwide have their patents and thus in the global market there are represented different types of threads with variable composition, types, methods, and techniques

Materials / method: Different types of absorbable threads have been provided by the manufacturers; the most popular ones nowadays are those that is consists of Polylactic Acid with Caprolactone (PL/CL); Polylactic Acid with Glycolic Acid (PL/GL) and Polydioxanone (PDO). all these materials are resorbable, biocompatible and biodegradable.

Results: According to my lecture, I will show you how important to take into consideration all parameters for optimal results. As a result we can conclude that, a lot of patients have developed facial skin deformities, wrinkles, and folds which, cannot be effectively treated by tissue augmentation via biological or synthetic materials. Such cosmetic defects often need to be corrected by direct surgical removal of redundant skin (skin excisions/facelift); despite its long-standing cosmetic effect, this surgical strategy cannot be universally applied, cause it leaves scars and requires long rehab. period

Conclusion: As a result, thread lifting procedure plays an important role in minimally invasive techniques for facial rejuvenation and lifting. Selecting right thread for the right patient is vital to achieve the desired outcome as well as managing the patient’s expectations.

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 Murat TSINTSADZE

Plastic Surgeon

Georgia

Other author(s) :

Thread lift "pour homme": how to receive and improve results?

Objectives: The purpose of my lecture is to touch upon a popular procedure - thread correction among men. Based on the fact that male patients rarely use the services of aesthetic medicine, it is difficult to discuss topics, especially a thread lift, which they do not willingly go for. Although working with threads among male patients, we get too good results. It will be just about this, how to correct a man's face with threads, what threads to use in terms of structure and material, and how to improve their result using other combinations of aesthetic services.

Introduction: The aesthetic industry competes for a predominantly female patient population.
More than 11 million minimally invasive cosmetic procedures were performed on women in 2013, representing 92 percent of all procedures.
The same year, over one million procedures were performed on men, representing only a fraction of the market.
Less statistics of a men thread lift procedures leads to a less information on a results and guidelines of thread lift among men patients. Above mentioned facts does not exclude wish of men to undergo thread lift procedures for their rejuvenation.

Materials / method: Threads with PLLA/PCL and PLLA/PCL/HA were used in my patients for correction and rejuvenation of middle and lower thirds of the face. Their structure were different taking into account zones and request of the patient. By structure following threads were used: Screwed thread, multidirectional thread, bidirectional threads, twisted threads.
Before, in between and after the procedures, PRP therapy, TCL peels, Mesotherapy and some other treatments were used for improvement the results.

Results: Although, there are some difficulties performing thread lift in male patients, the results were extremely good and what is important - all results were natural.
We received: Lifting and volumization of different zones with natural results prevention of the aging process, framing of the subcutaneous area, rejuvenation and improvement of the skin quality and texture.

Conclusion: Based on the results and based on the fact that men prefer more mine invasive quick-restoring procedures, then thread lifting in this category has a very good future. Especially multidirectional barbed threads, which lead to a strong fixation of heavy male tissues and in addition continuous revitalization of tissues with the help of HA and PLLA materials.

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 Irina POLEVA

Dermatologist

Italy

Other author(s) : Eszter Szomolai, Beata Hegedus, Olga Zhukova

Multicentric observational study of the possible side effects of the COVID-19 vaccine in relation of absorbable thread insertion

Objectives: The objective of our investigation was to understand if any adverse reactions have been observed in the patients who underwent threads implantation before and after the vaccination.

Introduction: Recently some reports appeared about the association of adverse reactions following soft tissue filler injections and the COVID-19 vaccines.
This fact raised the concerns of the aesthetic practitioners regarding the possibility of the association of the COVID-19 vaccine and adverse effects in other aesthetic treatments. Many of us wonder if neurotoxin injection, biostimulation or other procedure could trigger the same or other adverse reactions after the COVID-19 vaccination. Many colleagues postpone aesthetic treatments cancelling the appointments.

Materials / method: Four medical centres have collected the data of the patients treated with absorbable threads before the vaccination and after vaccination for COVID-19. The dossiers of the patients were evaluated. A questionnaire describing the conditions after thread implantations was administered 1 week, 1 month and 3 months after thread implantation.

Results: There were no significant adverse reactions in the groups of patients under monitoring. Only 1 patient presented signs of inflammation and infection but they more probably were attributable to the contamination during thread insertion.

Conclusion: The results of the observational study give evidence that in the group of the patients treated with absorbable threads there were no significant adverse reactions related to the COVID-19 vaccination

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 Ahmet ATALIK

Turkey

Other author(s) :

Facelift and neck tightening with permanent threads

Objectives: Background: 10 Years’ experience with permanent thread applications and last 6 years study in the country as the complication management expert.

Objectives: To develope & promote facelift and neck tightening with permanent threads. To reduce short and long-term complications. To increase patient expectation and happiness. Demonstrating strong, long-lasting, and satisfactory results of permanent threads

Introduction: You can achieve satisfactory results in face lifting and neck tightening with permanent threads.

Materials / method: My material body is polyester and covered by medical silicon. Medical grade polyester and silicone used are perfectly biocompatible materials. Implanted for over 60 years, they are stable and inert. The patients were selected from people with 1st and 2nd degree facial sagging. The patients were selected from those with 1st and 2nd degree neck loosening.

Results: There are a few permanent threads in the aesthetic market. Most of the doctors are using these threads with different techniques for face, eye borrow lift and neck tightening. In such practices, vectors, lifting effects and case selection & patients’ expectations are studied in my presentation

Conclusion: Permanent threads appears to be a satisfying alternatives for grade 1- & 2- degree sagging areas. Long duration and strong lifting effect can be satisfactory for doctors and patients. Permanent threads are a minimally invasive but powerful and long-acting alternative

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 Jose Vicente DE CAROLIS FRIEDMAN

Plastic Surgeon

Chile

Other author(s) :

Strong neck rejuvenation with threads - A deep mastoid sub-fascial anchoring in a hammock pattern

Objectives: To describe the evolution and current status of an original neck rejuvenation technique designed by the author, based on permanent tensor threads that works making a continuous suspension of the neck by anchoring at the mastoid fascia. The technique has significantly changed since its date of publication.

Introduction: In 2014 the author published at the APS Journal an original technique of neck rejuvenation technique based on tensor threads that are anchored from mastoid to mastoid, making a closed arch on the neck. The original technique was performed as an open approach, with general anesthesia and utilized two threads. Since its publication, the technique has experienced significant advances. The present technique has evolved to a closed approach, with local anesthesia and utilizes 6 threads in a hybrid combination of smooth and barbed threads. I currently categorize it as a new technique.

Materials / method: Starting in 2009 a total of 455 cases has been intervened with continuous mastoid spanning threads. Progressively since 2014 two more threads were added to support the mandibular floor. Since July 2020 major changes were implemented. The open access was replaced for a closed approach, suturing through stab incisions and with local anesthesia. A group of 93 cases has been performed with the new technique of which 52 cases have been performed with a new hybrid formula of four permanent smooth threads and two silicon-barbed threads.

Results: Aesthetic outcome: initial changes are frequently perceived as surpassing expectations. Near 80 % of patient experienced a full recovery of youthful cervical-mental angle aesthetics. Results with the open and close approach were similar. Request for a secondary threads or facelift have occurred not earlier than 5 years most of them at year 7. The main complications have been persistent retro auricular pain in 19 cases (4,1%) and infection with thread removal in 3 cases. Structured long-term follow up has not been implemented yet.

Conclusion: The hammock neck rejuvenation technique has been highly successful as an aesthetic outcome with a very low complication rate. The recent changes replacing the open approach and general anesthesia have produced similar aesthetics results. Perceived as less traumatic by the patient the willingness to go through the procedure has increased.

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 Daniel Mauricio AVILA CABALLERO

Spain

Other author(s) : Francisco Nieto

Treatment of flaccidity and sagging gluteus with calcium hydroxyapatite and polydioxanone traction threads

Objectives: We present a new approach for the treatment protocol for gluteal flaccidity by injection of Calcium Hydroxiapatite and the placement of traction threads.

Introduction: Flaccidity is one of the challenges in current cosmetic medicine. The injection of calcium hydroxyapatite (CH) and the use of polydioxanone (PDO) threads is one of the tools used to treat flaccidity. These techniques stimulate fibroblasts which generate the extracellular matrix, principally collagen and elastin, generating a lifting effect.

Materials / method: Firstly, every gluteal muscle is divided into four quadrants. The two upper gluteal muscle quadrants and external lower quadrant are treated with a hyper-dilution of hydroxyapatite with a ratio of 1:3 distributing the product with a linear fan retrograde technique via cannula.
The possible dimple marks of cellulite were treated cutting through the septa via cannula and filling them with the hypeer-dilution.
Subsequently, two threads were placed in each upper quadrant. The Threads were positioned up to the middle section of the gluteal muscle to preserve the integrity and function of the thread

Results: This new protocol, at the outset elevates the upper part of the gluteal muscle thanks to the effect of the traction threads. Whereas the use of CH boosts a tensor effect and improves the quality of the skin as observed over time.

Conclusion: This protocol shown an efficient and safety way to treah flaccidity of gluteus in two phases. First with effect of threads and after with redensification caused by Calcium hydroxiapatite

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 Nejat CAN

Cosmetic Surgeon

Turkey

Other author(s) :

Double needle thread methods of the Ghost Lift for non surgical face lift

Objectives: Double needle invisible thread a minimally invasive face lift procedure, is a good choice to achieve long-lasting, satisfactory results in selected patients with a saging face position and a more v shape face appearance. The significance of this technique lies in the fact that it is one of very few office-based minimally invasive alternatives for aesthetic surgery, with a recovery period of two to three days.

Introduction: Although the results of surgically performed smas lift facelift operations often require revision, the difficulties in post-operative care make patients nervous. The delay of patients from their social life may affect job loss and interpersonal relationships. Patients are now more interested in short procedures under local anesthesia and in an outpatient setting with low cost, low risk and fast recovery time. Double needle invisible thread a minimally invasive face lift procedure, is a good choice to achieve long-lasting, satisfactory results in selected patients with a saging face position.

Materials / method: The author has successfully performed a non-surgical facelift with Invisible thread using the double needle technique with PDO or PLCL double needle threads.
All of the patients chose not to undergo any aesthetic operation, but requested facelift and improvement of the v shape face.
In the method, the traction point was the subcutaneous tissue in front of the ear and the fixation point was the temporal fascia.

Results: The results were satisfactory in all but 8 of the 58 cases based on satsifacation surveys. 3 patients did not find the result satisfactory and the procedure was repeated after 6 months. 5 patients found the results inadequate and those patients underwent face lift surgery afterward. Double needle invisible face lift procedure was also extraordinarily effective in young patients. The operation duration was under 30 minutes. Our longest follow-up was 12 months, We have not seen any complications related to the absorbable thread, such as palpability or visibility through the skin.

Conclusion: Double needle invisible thread a minimally invasive face lift procedure described herein is one of very few minimally invasive alternatives for aesthetic smas face lift surgery. For selected patients, our method can be used as a simple, office-based procedure that can be performed under local anesthesia without any significant morbidity, a very high patient satisfaction, and a recovery period of only two to three days. The absorbable thread serves as an internal splint, and the permanent result is attributable to tissue fibrosis.

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 Ariel Martin ROMEO GENTILINI

Spain

Other author(s) : Francisco Nieto

Fat tissue reducement after PDO threads insertion, truth or myth?

Objectives: The use of threads for facelift procedures is not a new idea. This procedure involves the passage of sutures under the skin of the face and neck to compensate for sagging and flaccidity tissues, fat excess, avoiding large incisions and reducing recovery time.
For this reason, our main goal is to achieve a protocol based on histological changes, in which we can reduce, compact and decreased mild to moderate fat exces

Introduction: The increased interest in minimally invasive treatments, such as the thread lifting, with lower risk of complications, minimum downtime period and effectiveness in laxity, ptosis and aging characteristics has led many specialists to adopt this technique, but many doubts about its effectiveness in reducing fat tissue still remain.
The use of threads for facelift procedures is not a new idea. This procedure involves the passage of sutures under the skin of the face and neck to compensate for sagging and flaccid tissues, avoiding large incisions and reducing recovery time.

Materials / method: Four patients, between 35- to 55-year-old, were treated, in order to improve mild to moderate laxity, sagginess and fat tissue excess in the lower face, specially focusing on the double chin.
We used 60-80 absorbable PDO threads on each one, placed subcutaneously, creating a scaffold created by meshing threads.

Results: In these four patients, every treatment is followed by its consequent triggering of inflammatory response and production of fibrosis around each thread, and in addition we can achieve some fat loss.
As we can show in images, it is important to emphasize that we can observe improvement in tension, fat loss and compaction of tissue.

Conclusion: The interest in threads as a rejuvenation method is currently high, besides PDO sutures cause specific changes to the surrounding tissues that result in neo-collagenesis, a fibrous effect, fat reduction, tissue contracture, and an improved vascular environment.
These results can be explaining the positive changes described in histological models by Yoon et al.
Although detailed studies in fat tissue treatment are mandatory, we suggest that it should be at least considered before undergoing more aggressive 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

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 Hussein ABOU KHALIL

Plastic Surgeon

Lebanon

Other author(s) :

Challenging facial asymmetry: threads methods

Objectives: CHALENGING FACIAL ASYMMETRY

Introduction: Facial asymmetry is common in the overall population and is often presented naturally; also significant facial asymmetry is remarkable not only in aesthetic, but also in functional issues. Management of asymmetry is a challenge in our practice.

Materials / method: aethiology of facial asymmetry should be carefully investigated; classifications and multidisciplinary collaboration are helpful in order to achieve an adequate aesthetic treatment plan

Results: carefully selected cases of facial asymmetry were treated; we adapted thread lifting methods to each case: unilateral light lift, different number of threads, depth, direction, manipulation, tension, and sometimes combination of fillers and toxins with threads to achieve good results.

Conclusion: applying tips and tricks using threads is a serious alternative for treating facial disharmony, experts are treating successfully special cases like bell’s palsy, the main idea is to select correctly the right treatment for the right patient, combining with fillers is a logical option in major volume asymmetries, It is important to clarify the limits of indication for any aesthetic treatment and also to discuss our expectations with our patients.

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 Clara SANTOS

Dermatologist

Brazil

Other author(s) :

The most versatile PDO threads

Objectives: Attendees will gain new perspectives on the wide applicability of PDO threads. They will learn about multiple techniques for its use throughout face and body which beautifies as well as rejuvenates one's appearance.

Introduction: Aging affects skin and deep tissues. Conventional non-surgical procedures such as botulinum toxin and dermal fillers have limitations. For instance, they do not provide an improvement of deep wrinkles and they cannot lift skin tissue. Furthermore, dermal fillers carry a propensity for vascular accidents.
Polydioxanone (PDO) threads are a highly efficient method that offer anti-aging and lifting effects while promote collagen production. They offer great safety to patients and physicians alike.
Threads are highly versatile and can be used to improve body flaccidity, sagging face, and wrinkles.

Materials / method: Polydioxanone threads of barbed, mono, and screw types. Patients are women and men aged from 25 to 70. Applied intradermally and subcutaneously.

Results: The use of PDO threads show improvement in the texture of the skin by reduction of wrinkles through collagenesis. It can also bring lifting effects in sagging tissues.

Conclusion: This is a widely used method to enhance the appearance of aging skin that is highly applicable throughout face and body, it is also a very safe and simple procedure to perform.

Disclosures

Did you receive any funding to support your research for this TOPIC?
Yes
Please specify entities (individual, company, society): Globalderma

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

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IMCAS World Congress 2022 Program

FOCUS ON S151

Contributing lectures - Threads

Chairs

Lectures of the session

Recommended sessions

IMCAS World Congress 2022
Program