Patient selection and counselling

Dr Malavika Kohli, Dermatology and Aesthetics Director, Skin Secrets, shares insights on how dermatologists can identify the right patients for thread lift, and what does the counselling procedure involve.

Reshaping and recontouring the face with the fourth-generation barbed threads requires high precision, sound knowledge of anatomy and a well aligned suitability criteria to attain gratifying results.

The ones who will show best results with these threads, both male and female, are those with reasonably good tissue quality, not too thin or thick (not more than a one inch pinch up of skin). Those with mild to moderate skin laxity, minimal fat in the lower face, jowl, and submental area (not more than an inch of pinchable fat) show excellent results. Those who are already following a good skincare regimen and lifestyle, non-smokers and with few or no comorbidities see visible results sooner and enjoy them for a longer period.

Poor candidates are those whose faces show hypertrophic ageing, extreme loss of jawline definition with excess laxity and fat in the area. Severe ptotic changes due to extreme mid-face volume loss and naturally lean, gaunt faces with depleted fat pads are not suitable or will have to be done guardedly or in combination with injectables and aesthetic treatment devices.

Counselling a patient for the thread-lift procedure would involve the following:

• An explanation of the insertion procedure itself, which is followed by inflammation, fibroblast stimulation, synthesis of collagen, elastin fibres, and vascular neogenesis.

• It is imperative to help differentiate that these threads are for redraping and repositioning of tissue.

• It should be made clear at the beginning itself that the effects are immediate, followed by gradual progressive improvements over time.

• Also, the preventive benefits and longlasting results over a year are important to emphasise upon.

• A crucial point in discussion should be a natural post procedure appearance and fast recovery time.

• Bruising, dimpling at the site of entry and minimal discomfort as possibilities should be pre-informed.

• The patient should be reassured that there is no incision or telltale scar.

• Do’s and Dont’s post procedure need to be pre-explained. These include avoiding any strong facial movement workouts, swimming, and lifting bending for a week.

Also, no steam, sauna, and facials should be considered for two weeks. Any other aesthetic procedure in the same area of thread insertion should be avoided for two months.

One satisfying aspect in a patients’ journey, particularly with these threads, is that further positioning of a new set of threads can be customised and revised as the face evolves. This is because of the numerous techniques that have been designed for different areas and desired shaping such as Jawline Reshaping (JR), Malar Reshaping (MR), Lateral Reshaping (LR), Oval Reshaping Vertical (ORV), and Oval Reshaping Horizontal (ORH).High patient satisfaction can be achieved if we as aesthetic physicians master the science and art of thread lifting and can articulate this to our patients for best outcomes.