摘要

Objectives: Identify facial ptosis resulting in formation of nasolabial folds, marionette folds and jowls causing squaring of the face. Identify laxity of neck and submental area resulting in a "double chin" and neck folds. The use of permanent non-absorbable threads to achieve a great lift of the face and neck comparable to surgery that lasts 3-5 years Introduction: A main requirement of patients seeking cosmetic treatments is to achieve a lift of the lower face and neck to give a youthful appearance. There are very few non-surgical procedures that produce an immediate lift of the face and neck which is long lasting. I have demonstrated achieving a surgical level lift with a minimally invasive procedure using non-absorbable threads. This treatment is suitable for patients with moderate ptosis and laxity who don’t want surgical lifting or have had a surgical lift previously with results starting to fade. The results are expected to last 3-5 years. Materials / method: A flexible and elastic thread made from silicone and polyester and containing 24 tiny cogs per cm that point in 4 directions was used. It is 300mm in length with long blunt-end needles at each end. The thread suspends the underlying skin tissue thus lifting sagging skin. The procedure is carried out using local anaesthetic infiltration without sedation. 3 threads are place on each side of the face terminating at nasolabial, marionette and jowl region. The proximal ends are fixed into the scalp. 3 threads are placed on each side of the neck terminating in midline and also fixed to scalp. Results: The patient achieved remarkable lifting of the nasolabial fold, marionette fold and jowls. The repositioning of cheek also improved the tear trough region. By lifting the nasolabial fold, the upper lip is slightly everted making it appear fuller. The lifting of the neck resulted in reduction of “double chin” and softening of the platysmal bands. The overall effect of the face and neck lift gave the patient a youthful appearance with transformation of a square face into a V shape and tightening of the neck. Conclusion: The permanent thread helps to fill the gap between the dissolving PDO / PLLA threads and surgical facelift. It can be performed under local anaesthetic, has a low downtime, the lift produced is substantial and the results can last over 3 years. The procedure is well tolerated by patients and the technique is relatively easy to master. The risk profile is broadly similar to PDO and PLLA. The two biggest factors that stand it apart from dissolving threads is the longevity and the amount of lift achieved. This makes it a true alternative to a surgical facelift.