While Dr. Pierone says he hasn’t often used PLLA threads, he thinks those newer technologies work as well as newer PDO threads to lift skin and stimulate collagen production.
A popular PLLA thread lift option in the U.S., Silhouette InstaLift (Sinclair Pharma) threads are 82% PLLA and 18% glycolide polymer (PLGA) with bidirectional cones. Researchers, who have consulting and other ties to Sinclair Pharma, report in a paper published July 2018 in the Journal of Drugs in Dermatology that the PLLA/PLGA suture and cone composition stimulates fibroblasts resulting in type 1 collagen synthesis.
“In addition to the ability to reposition soft tissue along a two-dimensional axis, the InstaLift suture provides three-dimensional correction due to its bio-stimulatory nature,” the authors write.
Absorbable suspension sutures are an adaptable, noninvasive option for lifting and repositioning descended facial tissues, but results depend on proper technique, they write.
The paper’s authors, who had used InstaLift sutures in more than 500 patients when they wrote the paper, recommend using the straight-line vector planning (SLVP) approach, which involves placing the sutures in the subcutaneous layer as straight lines. The authors reported no serious adverse events and noticeable bruising in less than 5% of their patients using SLVP.
Threads Gone Wrong
Dr. Pierone says when the technology first came out, he got really proficient in removing threads gone wrong. They weren’t robust; there were complications.
“You would put them in and get a little bit of a lift; then that person would cough or sneeze and the thread would dislodge. You’d have to go in and retrieve it and pull it out,” he says. “If you had a complication you would have to do a lot of hand holding and do filler to smooth it in. It was not that uncommon. And now with this latest generation, I rarely have a thread lift that goes wrong where I have to bring people in and deal with complications.”
Dr. Pierone attributes better thread lifting outcomes in his hands, in part, to using barbed threads that can be molded. Beware the barbed threads require making cuts into the thread to produce the barb.