Longevity is a triangle: material, method, indication
Objectives: Longevity is a triangle: material, method, indication
To challenge the concept of a fixed “thread duration” and redefine longevity as a multifactorial outcome. This presentation aims to demonstrate that long-term results are not determined by time alone but by the interaction between thread material, surgical method, and correct indication. Clinical variability—from durable outcomes to early loss of effect—will be explained through this triangular model.
Introduction: Thread lifting has been widely discussed in terms of years of persistence. However, clinical reality contradicts this simplification. Since 2016, and more intensively after 2018, a wide spectrum of outcomes has been observed: some threads placed in 2017 remain effective, while others performed in 2023 lost efficacy within a year. This inconsistency suggests that longevity is not an intrinsic property of the thread itself.
Materials / method: Patients treated between 2016 and 2025 with absorbable and non-absorbable threads were retrospectively evaluated. Variables included thread type, anchoring strategy, vector design, depth of placement, tissue quality, and indication. Techniques evolved over time, allowing comparison between identical materials used with different methods and in different clinical scenarios.
Results: Longevity varied widely despite similar materials. Durable outcomes correlated with correct indication, appropriate vector planning, and stable tissue engagement. Early loss of effect was predominantly associated with borderline indications, insufficient mechanical support, or technique–tissue mismatch. Material choice alone did not predict long-term success; identical threads showed divergent outcomes depending on method and indication.
Conclusion: Thread longevity cannot be defined by years or material lifespan. It is the result of a triangle: material, method, and indication. When one side is weak, durability collapses regardless of thread type. Understanding and respecting this triangular balance allows predictable, long-lasting results and reframes the discussion from “how long does it last?” to “why does it last?”.
