The Debate

Shriyal Sethumadhavan connects with three dermatologists to get their perspective on the same.

Shriyal Sethumadhavan

“Different types of threads can be combined to achieve multiple outcomes.”

Dr Gulhima Arora, Dermatologist and Aesthetic Dermatologist, Mehektagul Dermaclinic

“Any aesthetic procedure yields the best clinical outcome when combined with a complementary procedure. It is no different with threads. Having said that, however, the evolution in the materials, techniques and delivery systems of threads has led to superior clinical outcomes even when they are used as a single modality. Our understanding as clinicians of the anatomy and mechanics of ageing, has led to devising better techniques of insertion ensuring increased patient satisfaction and longevity of the procedure.

Using better anchoring points and techniques, materials which have better tensile strengths and longer half-lives and understanding the parameters of an “ideal patient”, have brought us to a satisfactory level of using threads without combining them with other aesthetic treatments. Threads not just lift, but also volumise, contour, help create a symmetry, tighten pores and give a facial glow. Different types of threads can be combined with each other to achieve multiple outcomes. Body threads can tackle different aesthetic indications on the body.

With less downtime to the procedure, no major complications or side-effects when used by a skilled doctor and versatility, threads have become a favourite tool in the aesthetic toolbox. When an adequate number is used and the right technique is used, the longevity of the clinical outcomes is favourable for the patient and doctor. If there is a need to combine threads with any aesthetic procedure, I would recommend them to be used as the last treatment layer.”

“I recommend threads predominantly in the lower face.”

Dr Madhuri Agarwal, Dermatologist and Founder & Medical Director, Yavana Aesthetics Clinic in India

“Thread lifts are revolutionising the market by providing instant lifting and natural-looking results. Furthermore, modern technology has allowed physicians to come up with novel techniques to use thread lifts both alone and in combination with other cosmetic rejuvenation treatments, resulting in their resurgence as a viable aesthetic treatment choice. I find threads to be more efficacious when used in combination with other non-invasive treatments or energy-based devices.

Combining threads with other treatments creates a superior result because it not only repositions tissue and lifts it, but it also fills hollows and adds volume, all of which contribute to a lifting effect. The combination helps to treat complex skin conditions. For instance, Patients with skin laxity benefit from initial procedure of high intensity focussed ultrasound to generate newer collagen and then add threads to refine the results. I recommend threads predominantly in the lower face as we have limited effective treatments in this area. Lower face thread procedure assists in creating a more defined jawline and reduce the jowl fat compartment sagging. I also use standalone threads in few cases at a younger age wherein I require contouring or improving the asymmetry of face.”

“The effects of thread lift can be enhanced with dermal fillers.”

Dr Jasleen Kaur, Dermatologist and Cosmetologist, Dr Jasleen’s Skin and Laser Clinic

“Fine thread contour therapy (FITC) is one the latest techniques that helps in skin rejuvenation from natural wound healing process through tissue contraction. It is a quick, minimally invasive treatment for people who are not ready for a surgical facelift. After threading, skin appears lifted and tighter however, for the maintenance and enhancement of results thread lifts are combined with other rejuvenation options. Thread lifts are most effective when used in combination with fillers, neurotoxins and energy-based devices.

The effects of thread lift can be enhanced with dermal fillers. This combination can lead to a facelift comparable to surgical treatment or liquid facelift. Once the skin has been lifted with thread lift therapy, a new subcutaneous structure is created for collagen to develop around. Ideally threads should be done prior to fillers. This reduces the amount of filler required for tissue augmentation. There should be a minimum gap of 20 to 30 days between fillers and threads.

Botulinum toxin can be used in conjunction with thread-lift to slow down the visible ageing by helping in the management of dynamic facial lines and wrinkles, as threads alone are often not suitable for these facial features. Botulinum toxin can be done with threads in the same session in a different area but after thread insertion as after botulinum toxin, a patient cannot lie down. If the treatment is to be done on same area, than it should be done a week prior to threads.

The most effective results can be achieved by a combination of Silhouette Soft Thread Lifting and High Intensity Focused Ultrasound (HIFU). Ideally, HIFU treatment is done prior to Silhouette Soft because the collagen stimulation will lead to better anchorage for the sutures. Also, the effects of a Silhouette treatment will be enhanced by a HIFU treatment three to four months afterwards for further collagen stimulation around the sutures.

Radiofrequency facial skin tightening can be combined with thread lift. It tightens the skin and improves tone without any pain or downtime. It works by using heat to trigger collagen and elastin production in deeper layers of skin. RF treatments should be done at least two weeks prior to the thread lift.

Laser skin resurfacing can often be combined with a thread lift in a damaged skin like sun or age spots, acne scars, an uneven texture and other issues. Thus, thread lift facilitates the effects of other skin rejuvenation procedures when used in combination. The approach should be right procedure for the right patient and to provide correction in a most natural looking manner and not over do the procedures just to satisfy the patient’s unrealistic expectations.”