Aesthetic Threads for Anti-Aging

This transcript was exported on July 18, 2023 -view latest version here.

Skin care can sometimes feel overwhelming, whether it’s finding the right products, ingredients or treatments. There’s a lot out there, but not always for people of African, Hispanic, Middle Eastern and Eastern South Asian descent. That’s why I set out to educate myself and others, so that we can all feel beautiful in our skin. Hello and welcome back to The Skin Report. I’m Dr. Simran Sethi, an internal medicine doctor, mom of three and CEO and founder of Skin By Dr. Sethi and RenewMD Medical Spas. On today’s episode, I’d like to chat about PDO threads and the thread lift, what it accomplishes and why. Sometimes called the lunchtime lift, this quick non-surgical procedure may just be right for you and your skin. We’ve talked about varying levels of anti-aging approaches from topical products like my Retinol Lipid Complex to undergoing the traditional surgical facelift. However, sometimes you want an extra little boost with without going under the knife. This is where PDO threads come in.

PDO stands for polydioxanone, a biodegradable suture that’s been used in a surgical setting since the 1980s. We have a lot of data to back up the safety of polydioxanone, and it tends to have a low risk of allergic reactions. More recently, however, PDO threads have been used to provide skin tightening and a moderate facelift for those interested in a non-invasive, non-surgical cosmetic treatment that can be completed in about an hour without very much recovery or downtime. The way a thread lift works is twofold. First, by physically lifting and tightening the skin with colorless dissolvable threads that are crisscrossed underneath the skin and second, by triggering an increase in collagen production to refresh and rejuvenate the skin. If you look at PDO threads on a microscopic level, you will see that they have small hooks or are barbed, which allows the thread to lift and grab skin tissue from below when it’s inserted underneath the skin.

These hooks lift up the skin, which gives an instant lifting effect on the face. Over the course of weeks to months, the threads will start to dissolve, but also trigger a surge of growth factors to make collagen in the areas the threads were placed. Threads are safe for any skin type and tone, and can really be used at any age, but like anything in aesthetics, there are people who are better candidates than others when it comes to choosing who is best served with threads. There are also a variety of types of threads and when we return, we’ll discuss the differences in types of threads and which ones are best for lifting versus plain collagen building. Depending on your desired outcome, you can choose one of three PDO thread categories. First, we have PDO smooth threads, which are silky smooth threads that help bolster the skin’s appearance by stimulating collagen.

They can be used to treat areas like the forehead, cheeks, and really any area where you want to improve texture and reduce fine lines. This is the most basic kind that still gets the job done. I use these threads on patients when they don’t want to undergo a full face skin rejuvenation laser like PicoSure or get microneedling, but just want to address small areas where they’re seeing fine lines like the forehead or above the lips. I don’t think it’s cost-effective to insert threads on the full face, and prefer to do microneedling or laser if we’re addressing the full face. Next, there are PDO COG threads or barbed threads that have tiny barbs that hook into your skin to offer more support and to physically pull up different areas of the face. This type of thread provides more of that moderate facelift I mentioned earlier.

We’ll go into the different types of lifts later in the episode, but for example, this thread would be used to lift and tighten the eyebrows by the temple to create that cat eye look. Lastly, is something called the PDO screw threads, which sound much scarier than they actually are. They are still non-surgical and non-invasive, and are actually made of multiple threads woven together. The purpose of the PDO screw threads is to help plump up areas of the face that can hollow out with age such as the cheek. While fillers may be able to restore more volume, they cannot be used in all parts of the face. When working in areas where fillers can’t be used, but we need a small amount of volume, screw threads are an option. For example, I tend to use these threads when someone has very deep lines between their eyebrows and they need some filling, but this is an area that is dangerous to use filler in due to the number of important blood vessels in the area.

Instead, PDO screw threads can be safely inserted and do a great job at minimizing these lines. There’re also polylactic acid threads and polycaprolactone threads known as PLA and PCA respectively. These variations are newer than PDO threads. PLA and PCA threads tend to last a little longer in your body and stimulate more collagen production. But I will say that after working with threads and looking at data, the difference is not very significant. In my practice, I only use PDO threads and do so in only a few specific scenarios, which we’ll discuss later on. A thread lift can be used to address sagging skin and expression lines on both the face, neck, jaw and chin. There are different types of thread lifts available to help you achieve your desired results. You can have an eyebrow thread lift, which tightens furrowed or sagging eyebrows.

You can capture the cat eye or fox eye look by raising the eyebrows up from the temples. A thread lift is also an option for lifting sagging skin around the jawline and minimizing [inaudible 00:06:15]. When I do do a thread lift in my practice, this is probably the most common scenario I do it in. Finally, the lines in your neck can also be smoothed by a thread lift by lifting up the skin and stimulating collagen, but you’re probably wondering what a thread lift treatment feels like. First, your face would be cleansed of any dirt, oil and makeup before having a numbing cream applied. This is more for your comfort during the procedure, but isn’t necessary. As threading isn’t surgical, you don’t need anesthesia, and you should only feel a few needle pokes on your skin. Threads come wrapped on a needle so that when you are inserting them, you introduce the needle into the skin, take it all the way below the skin and pull the needle out, leaving the thread in place.

While this is being done, the practitioner will gently tug at the skin to ensure proper thread placement and allow the thread to anchor. For additional support, your provider may crisscross the threads from different angles. But in general, you will only feel slight needle pokes and a little tugging under the skin. The treatment is relatively painless with most patients reporting only a little discomfort from the needle entering the skin. For a few days after, you may experience mild swelling or bruising. For about a week afterwards, I would stay away from retinol and exfoliants. I’d also avoid drinking from a straw, chewing gum or opening the mouth all the way for extended periods of time, like when you get dental procedures done, for two weeks to allow the thread to settle into place. As with any treatment, you will want to avoid alcohol and smoking. When we return, we’ll discuss how long threads last for different patients.

Before we wrap up, I want to talk about the results and effects of the thread lift. The great thing about threading is that you see results almost immediately. In fact, you generally don’t need multiple rounds of treatment to reach your desired goals. However, the threads will dissolve with time. At this point, I want to explain why I don’t use threads frequently in my practice and feel it is very important for patients and consumers to understand the mechanism of threads. Patients are always very happy to see an instant lift after their threads are inserted. However, as the threads dissolve, that lift will gradually start diminishing in a span of a month. And while there is still a moderate amount of lift remaining months later, the loss of that instant lift can be disappointing for many. I usually consider threads only when a patient wants an instant lift for a special event and cannot wait for three to six months to get lifting results from more long-lasting treatments like all therapy.

Also, as we’ve discussed before on the show, nothing permanent should be injected or put into your face. Not only is this dangerous, but it also doesn’t allow customization as your face changes over time. Depending on your age expressions and the type of thread you get, the treatment will last varying amounts of time. The threads themselves usually last up to six months before being absorbed into the skin. However, the effects of the treatment can last for over a year or even a few years, according to a study published in the Aesthetic Surgery Journal. The younger you start the treatment, the longer it last in general. But again, there are many other options available for longer lasting results. PCLs overall, however, take longer to dissolve than PDO threads, usually about a year. Therefore, the effects left behind last a little longer. Another benefit of threading is that it can be done in conjunction with another aesthetic treatment such as fillers.

So who is a good candidate for a thread lift? The answer truly is most adults looking for a minor lift and a collagen boost. Generally, I think smooth threads can be used for focal and small areas to achieve collagen production to smooth fine lines. Barbed threads are an option for a temporary lifting in older adults who have thinner skin. This is because believe it or not, when people have tighter skin, the threads do not have enough strength to actually pull the skin. A thread lift can also be used as a touch up treatment following more involved processes like a surgical facelift. Overall, whether threads are worth it, is up to you and your aesthetic goals. They’re a great option for boosting the skin and providing a temporary lift. However, if you’re hoping for more dramatic results, you can either pair threading with another option like fillers or opt for a more involved procedure.

I hope you enjoyed and find this episode on thread lift helpful. If you’d like more of this content, let us know. We are a women of color owned brand and any likes, reviews, ratings and shares truly help to boost the podcast and get it in front of others like yourself. Thanks for listening, and until next time, love the skin you’re in and celebrate your beauty.

If you’d like to learn more about science backed skin care or medical aesthetic treatments, please subscribe to and turn on notifications for The Skin Report, so you always know when a new episode is up. We have a newsletter that you can sign up for on skinbydrsethi.com, so that you can stay up to date on all our latest products and more. Additionally, if you have a skin care question or want to make an episode topic recommendation, please message me at theskinreportbydrsethi.com, which is linked in my show notes. And I’ll be sure to answer your question in an episode soon. We’ve received some great questions so far, and I will try and answer them at the end of every episode, so keep them coming.

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