Facial Vector Alignment

Dr. Madhuri Agarwal, MD Dermatology, Founder and CEO of Yavana Aesthetics Clinic, Mumbai, discusses thread lift for older patients and aligning the right facial vectors for the right patient needs.

Earlier the premise for threads was limited. When a foreign body is inserted into the skin, it reacts by producing new collagen, which has a positive effect on the skin’s texture. Today, with the advent of advanced threads, we are able to achieve facial lift, tightening and toning in areas like the malar area and jawline. Fourth generation threads help in giving a subtle non-surgical lift because of the strength of the material of the thread being used. PCLA threads (Poly-L-Lactic Acid and Caprolactone) are also long lasting. Now the procedures are well defined, too, with the help of protocols and techniques, which are designed to give better results.

When older patients walk-in with skin concerns, they are primarily worried about a drooping face and ill-defined jawline. It is important to analyse their skin’s texture, facial lines, jaw area and double chin before considering threads as an option. Earlier, a thread lift was never my go-to procedure for ageing concerns, but now, thanks to fourth generation threads, it has become my first choice in the line of treatments.

To use threads for face lift, we need patients of a moderate age, and so, I recommend the age group of 30s to 60s as ideal. The skin of patients in this age group is not very loose.

They just have mild skin texture problems. For threads, the skin should not be very thick or very thin either.

Right alignment

For aligning the right facial vectors, in the younger patients, contouring can be done. In the older patients, skin laxity and ageing can be evaluated. For older patients, hence, I prefer a lateral lift. Due to ageing, the skin crowds in the mid face area, so the face can be pushed back with the help of a thread lift. Further, lateral repositioning can be done with PCLA threads.

For facial reshaping, a vertical shift can be done to achieve a V-shape for the jawline. The vector alignment largely depends on the needs of the patient. In the oval reshaping horizontal (ORH) lift technique, we go up to the temples and lift the face. The ORV technique focuses on the lower face and the chin. Lateral vectors for lifting jowls help achieve oval reshaping of the face while repositioning tissues from the mid-face area and pulling back the deep folds visible on the face. For the mento-labial fold (MLF), we have the jawline reshaping technique, which helps to lift the MLF and gives definition to the jawline. It is ideal for younger patients who have recently started experiencing sagging of the skin.

The best part of using fourth generation threads is that they have an algorithm of techniques, suitable for different age groups. The technique can be determined, depending on the desired results. Thus, the technique is patient-centric, the method remains the same and results become more predictable, both for aesthetic medicine practitioners and patients. The effects on skin are including but not limited to a long lasting smoother texture and lessening of hyperpigmentation.