Objectives: In contrast to barbed threading technique, we introduce a novel smooth threading technique with two dimensional contraction and tissue renewal as mechanisms for skin tightening.
Introduction: With increasing popularity of using barbed or cone threads as mechanical vectors pulling for the purpose of tightening skin of face, neck, arms, breasts, there are, however, no truly decreases in any dimension of skin that a younger self appeared to be. Using only smooth fine threads, I have provided hundreds of reappearing customers a more physiological rejuvenation to tighten their skin with very good patients compliance.
Materials / method: With only help from topical lidocaine ointment, we use only single strain, non-bared PLLA threads, lodged within 29G hypodermal needles, three rows of threads are transversely embedded strictly underlying dermal layer. The purpose is to evenly covers the treated areas with dermal needling stimulations and PLLA dose in the form of threads. The number of threads needed depends on area treated, in the case of bilateral jaw line to upper temporal level, we usually needs around 100 to 120 needles. Face, jaw, neck, inner arms and breasts are also common area of interests.
Results: In 5 years period, at least two hundreds customers had received this procedure, mostly as a recurring customer. Owing to 29G fine needles and strictly hypodermal position, the trauma is minimal with several painless bruises which completely resolved in one to two weeks. The other rare complication was painless dislodge of colorless threads which we could safely advise customers to remove it by themselves. No extra postoperative care was given. The immediate skin tightening and late onset (1-2 month) rejuvenation effect and minimal discomfort all contribute to customers popularities.
Conclusion: Contrary to intuition, smooth, single strain, fine threads are thought to be no mechanical pulling or fixing effects for skin and soft tissue, thus was largely ignored by most practitioners. Through the possible mechanisms of dermal nerve endings stimulations (immediate tightening last for about one month) and skin rejuvenation by dissolving PLLA starting around 3-4 weeks, this method has provided immediate even contraction in every dimension of skin and later tissue renewal. In an environment of almost free Medicare, repeated appearances of self financed patients had explained it all.
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