Resumo

Objectives: To present a tridimensional facial lifting technique using molded PDO threads with fixed bidirectional barbs, combining dual calibers (18G and 19G) and lengths (100 mm and 70 mm), in anatomically planned crossing vectors. The aim is to enhance traction, improve thread stability, and provide natural, predictable outcomes in non-surgical facial rejuvenation. Introduction: Facial aging leads to ptosis of deep tissues and loss of contour. While thread lifting is a valid option, challenges remain in achieving stable, long-lasting, and natural results. Molded threads with bidirectional barbs offer superior mechanical grip. This technique combines different thread calibers, strategic vector crossing, and knot burial to enhance lifting precision and patient safety. Materials / method: The protocol uses solid PDO threads with fixed bidirectional barbs: 19G x 70 mm threads for superficial lift and biostimulation, and 18G x 100 mm threads for deeper anchorage. Threads are inserted through blunt cannulas in intersecting anatomical vectors. Knots are buried subcutaneously to reduce palpability and improve stability. Target areas include the jawline and malar region. Results: The technique showed immediate and natural lifting, high patient satisfaction, and minimal downtime. The synergy between thread calibers and lengths improved traction and support. Knot burial minimized discomfort and complications. Mild edema was the only transient side effect, resolving spontaneously. No major adverse events were observed. Conclusion: This vector-based lifting protocol, using dual-caliber and dual-length PDO threads with bidirectional barbs and subcutaneous knot anchoring, is a safe and customizable alternative to surgical lifting. It offers structural precision, enhanced mechanical performance, and natural results in facial rejuvenation.