Reshaping and Contouring
Dr. Sukhbir Singh, Plastic and Cosmetic Surgeon, New Delhi, discusses benefits of using fourth generation threads in reshaping and contouring the facial shapes of his patients, and ease of using Double Needle PCLA threads.
There are two categories of patients that are ideal for thread lift treatments. Firstly, there are patients with obesity issues, and, secondly, there are patients in the age group of 26-35 years who are planning to get married. Both categories feel the need to get facelifts and/or contouring done, as they have lost weight or are planning to lose some weight and want a natural contoured look. They are facing issues such as sagging skin and double chin. Threads not only offer support to the sagged skin but also help to relocate the fat pads and hence influence the desired facial shape change and a contoured look. Patients in the age group of 40-60 years aspire to have a slimmer face shape with correction of sagging skin.
While specifically working with non-surgical and minimally invasive techniques for facial contouring, a plan with a combination of treatments is often required to achieve mild to moderate lifting. For example, threads can be combined with Energy Based Devices, Botulinum toxin and Hyaluronic Acid Fillers. Patients are given options and they can choose a suitable treatment plan for a natural and subtle 360-degree transformation, after looking at pre and post treatment images for all the techniques and discussing it carefully with their treating doctor. In my experience, for a middle-aged person, it is best to do thread lift first with PCLA threads, followed by Hyaluronic Acid Fillers for volume replacement and further refinement after two to four weeks.
Procedural protocol
In terms of techniques, the JR technique (Jawline Reshaping) consists of three main reshaping lines, the first from 1 cm above the mandibular angle to a point lateral to the marionette line. The second line comes from the starting point to pre-tragus, while the third is from the pre-tragus to a point 2 cm away along a line between the pre-tragus and previous point of exit, hence producing the ‘J stitch’. In this J stitch area, the thread has greater holding strength.
The second technique –the MR technique (Malar Reshaping) is also a special technique used for malar area (cheek bone area) reshaping and helps in reducing the NLF (Naso-Labial fold).
Apart from these two techniques, double needle threads can be used for double chin, eyebrow lift and neck lift.
A double needle thread definitely provides an advantage, as it is smooth to use. Threads of the earlier generation were thicker and the patients experienced a lot of pain but with fourth generation threads they do not feel the presence of thread and the recovery is faster. Moreover, the results are longer lasting, up to 18 months as compared to 12-14 months with the older generation of threads.
The techniques remain the same for both men and women for the thread lift procedure. We have been using Definisse Double Needle Threads ever since they were launched in India, and impressive results are seen three weeks after the procedure. Apart from contouring, these PCLA threads (Poly-L-Lactic Acid and Caprolactone) also help in skin rejuvenation. As collagen forms due to insertion of threads, the microcirculation in the skin improves, leaving it with an improved texture and glow.
For practitioners who are new to threads, it is advisable to take adequate training. Start slowly and take the jawline as the first indication because it is easier to adopt and execute. Then proceed to malar reshaping. The neck area should be the last area of treatment which you may consider to do. Be it double needle threads or conventional threads, tissue should be handled very gently.