The use of absorbable threads inserted beneath the skin can serve a dual purpose: that of stimulation (as an alternative to injections) or that of tissue suspension.
Biostimulation threads
Biostimulation is carried out using PDO (polydioxanone) threads, which are positioned through carrier needles to stimulate and revitalize the skin, resulting in a mildly lifting effect. These are monofilament synthetic suture threads composed of polydioxanone (a derivative of glycolic acid), which are employed in surgery for subcutaneous and deep structure suturing. Characterized by their prolonged durability and low bacterial colonization, they encourage collagen production and undergo a gradual and complete absorption. Due to these properties, PDO threads are indicated for the non-invasive or minimally invasive treatment of skin sagging on both the face and body, for both prevention and correction purposes. For this intent, they can be inserted in various areas including the forehead and brow region, periocular area, zygomatic/malar region, cheek, jawline, and chin. They can also be applied on the neck, décolletage, inner arms and thighs, and generally on the body's skin wherever the indication arises.
Microthreads are inserted into very fine needles and implanted into the dermis, following the natural lines of skin tension. This arrangement creates a network that tightens the tissue and partially repositions sagging skin. However, the intended effect of these threads is not a lifting one; rather, it aims to gradually enhance the skin's firmness over time. After an initial improvement of around 30-50%, there is an additional 20-30% enhancement in the following 2-3 months. Roughly after 4-6 months, the threads completely dissolve due to hydrolytic action, but thanks to significant endogenous stimulation, the benefits remain visible for a longer period.
Generally, the procedure is well-tolerated and minimally painful, but local anesthetics can be applied if needed. Following the treatment, patients can immediately return to their daily activities; any potential bruising can be concealed with camouflage.
Therapeutic approach: Typically, an initial treatment is performed, followed by a second one after 4-6 months, and a possible touch-up after 1 year.
Major risks and complications: Technically, there are no significant risks or complications. However, it's important to avoid treating individuals with acute infectious diseases, those undergoing active tumor treatments, blistering skin disorders, known allergies or intolerances to the product (extremely rare).
Possible side effects include bruising, hematomas, or minor local inflammations, which typically resolve spontaneously within a few days. Any potential asymmetries might necessitate follow-up checks. In rare instances, a thread might become slightly visible beneath the skin for a period ranging from a few days to 2-3 weeks. It is also possible for a local infection to occur, requiring the use of antibiotics.
Suspension threads
In the case of suspension threads, the insertion of absorbable threads beneath the subcutaneous layer aims to lift and reposition facial tissues that are starting to sag (jawline, neck, cheekbones), in a non-invasive manner and for an extended duration.
The threads are inserted through punctiform incisions, which require a few days to heal. Discomfort or pain might be felt during the treatment. It's necessary to sleep in a supine position for the first three nights after the procedure. Applying cold compresses to the treated areas is recommended. Facial movements should be minimized in the first week; caution is still required in the following three weeks. Throughout this period, excessive chewing and forcibly opening the mouth should also be avoided.
Side effects and complications are not common and may include: bruising, swelling, infection, and bleeding. As the treatment is superficial, it is unlikely to cause damage to deeper structures like nerves, blood vessels, or muscles. Complications can be exacerbated by smoking and alcohol use, which should therefore be suspended.
During the healing process, it's possible that the treated area might temporarily appear lighter or darker. Therefore, appropriate sun protection is advised during the post-operative period. Minor asymmetries, redness, or visibility of sutures might necessitate further treatments or the removal of the sutures themselves.