use aesthetic sutures to provide uplifting resultshistory of aesthetic sutures: 1961: first sutures...
TRANSCRIPT
Use Aesthetic Sutures To Provide Uplifting Results
Rebecca Suess, RN, CPSN, CANS
Objectives For Today:
Identify the different types of aesthetic sutures
Explain how aesthetic sutures will compliment existing, non-invasive treatments provided in your office
Aging: What Happens To The Face?
Skin Changes: texture, pigmentation, laxity
Fat Loss: superficial and deep fat compartments
Ligaments: loosen, separate
Muscles: contraction, hypertrophy
Skeletal: resorption, rotation
How Do We Treat These Issues?
Resurface: skin changes (laser, peels, microneedling)
Refill: volume/fat loss (dermal fillers)
Relax: hypertrophy, contraction
But what about laxity? How do we actually REPOSITION the skin?
Repositioning The Skin
Laxity needs to be repositioned
The only option available was facelift surgery
Re-evolution of sutures makes this available to your clients
History of Aesthetic Sutures:
1961: First sutures arrived: used for tendon repair and they were permanent
1964: Pioneer of barbed sutures
1990: Began use in the aesthetic market for cosmetic use. Unidirectional and permanent
2002: Introduced bi-directional threads still permanent
2004: FDA approval given to Contour Threads
2005: Reports of adverse events: breaking and extruding
2007: Contour Threads were removed from market
2009: FDA withdraws approval
2014: FDA approves RESORBABLE sutures
New Generation of SuturesABSORBABLE
Polydioxanone (PDO)
Nova Thread, Aqulift, Elionce
Used in cardiothorasic surgeries
Uni and Bi directional barbed threads
Fully absorbed in 4-6 months
No scar tissue
Creates an inflammatory response similar to other modalities such as lasers/microneedling
Results 4-12 months
Repeat treatment at 4-6 weeks for best result
Can add volume to the face as well
Poly-L-lactic Acid (PLLA)
Silhouette Instalift only type
82% PLLA (Sculptra) and 18% Vicryl suture
Only bi-directional
Uses 360 degree smooth cones
Fully absorbed in 9-12 months
Neocollagenesis with biostimulator effect producing collagen type I and type III
Results peak at 6 months
Lasts 18-24 months
Will not add volume
Who Is An Ideal Client?
Ideal Client
Strong, bony projection
Good skin quality
Malleable tissue
Midface sagging
Nasal labial fold/marionette/ buccal region
Not Ideal Client
Excessive skin
Thick skin
Thin skin with no fat
Non-mobile skin tissue
Sensitivity to suture materials
No Treatment Is Perfect Or Without Risk
Adverse Reactions: they are rare, minor, not long lasting, and self-limiting.
Asymmetry
Misplacement
Bruising
Dimpling or puckering of the skin
*Downtime approximately 1 week
Not A Solo Treatment
Sutures should be used in addition to all other modalities in your practice:
Neurotoxins: relax fine lines, muscle hypertrophy
Dermal Fillers: restore volume
Lasers/Microneedling: repair texture, pigmentation
Skin Care/peels/facials: restore glow and hydration
Sutures: reposition the skin, lower face laxity
Before And After
Before and After Photos
Longevity Of Results
Treatment Progression
Thank You
References:
Bishara S Atiyeh, MD, FACS, Saad A Dibo, MD, Michel Costagliola, MD, & Shady N Hayek, MD (2010). Barbed sutures
‘‘lunch time’’ lifting: evidence-based efficacy. Journal of Cosmetic Dermatology 9,132–141.
Helmy Ali, Yasser, MD. (2017). Two years’ outcome of thread lifting with absorbable barbed PDO threads: Innovative score
for objective and subjective assessment. Journal of Cosmetic and Laser Therapy. 20 (1), 41-49. DOI: 10.1080/14764172.2017.1368562
Kalra, R. (2008). Use of barbed threads in facial rejuvenation. Indian Journal of Plastic Surgery : Official Publication of the
Association of Plastic Surgeons of India, 41(Suppl), S93–S100.
Kaminer, Michael S, MD; Bogart, Megan MD; Choi, Christine MD; Wee, Sue Ann, MD. (2008). Long-Term Efficacy of
Anchored Barbed Sutures in the Face and Neck. Dermatologic Surgery,34(8), 1041-1047. doi: 10.1111/j.1524-4725.2008.34203.x
Villa, Mark T. M.D.; White, Lucile E. M.D.; Alam, Murad M.D.; Yoo, Simon S. M.D.; Walton, Robert L. M.D. (2008).
Barbed Sutures: A Review of the Literature. Plastic and Reconstructive Surgery, 121(3), 102e-108e. doi:
10.1097/01.prs.0000299452.24743.65