Objectives: There is a positive correlation between smiling face & attractive face. And 1st sign of ageing is the change of the facial shape, not wrinkles, so we should try to make smiling face for the facial rejuvenation.
When we smile, we can see that soft tissue movement occurs like this, anterosuperior movement of anterior malar area to make apple cheek and laterosuperior movement of paranasal and perioral area to make narrower lower face. So, smiling face means the oval face with natural cheek volume. And, I want to talk about how to use PDO barbed threads to make this oval and smiling face.
Introduction: We can see that this oval & smiling appearance can occur according to the posture change between sitting and supine position when taking a three-dimensional camera.
When we lie down with chin-up position, the loose tissues of lower face move naturally around our head and ears, such as lifting them. Lateral view after position change from sitting to lying shows that the double chin is pulled below the ear and the jawline is changed to be clear.
So, I think the role of barbed thread is to just hold the moved loose tissues when lying down and then to keep them from returning to sitting position
Materials / method: We should be aware of characteristics of threads. And there are 3 important factors in assessing the barbed threads.
Tensile strength is a measure of the strength of the thread itself, and shows how well the thread can withstand without breaking when it is pulled from both sides.
Tensile force is the value of seeing how strongly the barbs of the thread can pull on the tissue, initially.
Tensile stress is a value to see how well the barbed thread maintain the holding condition of pulled tissue after capturing.
Results: It is often said that the subcutaneous layer is good for barbed thread insertion because it has little resistance. But without the resistance, the barbs of the thread can’t catch the tissue. In fact, because there are these tough fibers between the subcutaneous tissues, the barbed threads can catch the tissue and make anchoring force. We just feel that the thread is moving smoothly through them.
Therefore, the barb of thread should pass the tight tissues to make pulling force to certain degree and we can change face to be more oval with mid-face volume restoration with elastic skin surface.
Conclusion: I think the purpose of barbed thread lifting is to move the loose tissue toward the tight tissue with supporting to the ligamentous structures. And these days, the target tissue and the way they are moved are changing from forced lifting of skin and subcutaneous tissue to natural traction and reposition of the SMAS layer and periSMAS tissue.
In addition, we also should try to find barbed threads type and lifting vectors to suit this SMAS layer repositioning technique.
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