THREAD FOR

SKIN LIFTING

Fine Thread
Contour
dr. Dian Andriani, SpKK,M.Biomed,MARS
History of ThreadLifting
1st Generation – Catgut (Plain and Chromic) 10th century
The first known absorbable sutures : made of sheep intestines.
Manufacture: twisting together strands of purified collagen from serosal or
submucosal layer small intestine (cattle, sheep, goat)
Use for: natural musical strings  violins and guitar, tennis racquets.
Galen: first to use gut strings for medical suture
2nd Generation – PGA (Polyglycolide acid) 1954
prepared starting from glycolic acid by means of polycondensation or ring
opening polymerization.
3rd Generation – PDO (Polydioxanone) : Emil Borysco, 1982
Polymer multiple repeating ether-ester units
• Very high tensile strength
• Excellent pliability
• Smooth tissue passage
 Products Mass absorption
Plain catgut ± 70 days
Chromic catgut ± 90 days
PGA ± 60-90 days
PGLA ± 60-80 days
PGCL ± 80-120 days
PDO ± 180-240 days

Penelitian menunjukkan: derajat inflamasi dan reaksi benda

asing pada penggunaan PDO sangat minimal dibandingkan
catgut dan PGA
Type of Thread

Catgut
Risk of tissue reaction.
10-20 days

PGA (polyglycolic acid)

Risk of infection. PDO (Polydioxanone)
60-90 days Safe
Last 6 months
Polyglactic acid
Most Common use.
Risk of infection.
60-90 days
PDO THREAD LIFT
• PDO thread lift is one of the most commonly
performed skin lifting procedures that rejuvenates
& regenerates your face without the need of
surgery.
• The treatment using threads made of
Polydioxanone lifts & tightens up the sagging skin
tissue. These threads are introduced into the
deeper layer of skin that further leads to:
 Immediate lifting of skin by contracting fat
tissue tightens up skin
 Improves skin elasticity & fine lines
Available Sizes of F.T.C Needles

90 mm
60 mm
50 mm
38 mm
25.4 mm
Effectiveness & Safety
(Mechanism of Action)
Mechanism Of Action
Insert Thread

Inflammation

Produce Fibroblast

Synthesis Collagen, Skin Rejuvenation:

elastin fiber, increase Lifting, tightening,
blood supply and brightening
metabolism
•Noticeable after 1 or 2 months
•Optimal results achieved in 6 months
Collagenogenesis
Key Advantages
• Minimal invasiveness, fast and easy procedure
• Leave No scars
• Extremely small incisions to the entry points
• Safe – minimal risk of bleeding (except of some
areas)
• Instant and long lasting results – consecutive 2 times
procedure results in lasting effect for up to 18 Months
• Applicable to face and various body areas
• Ideal to combine with Micro needling, PRP, Laser,
• Chemical peel to enhance more powerful skin
rejuvenation
• 100% bio-compatible like absorbable sutures
• What areas can be treated via PDO
thread lift?
 PDO thread lift can lift, rejuvenate, add
volume & reduce fat in nearly all the area
of body, few of them include:
Is the procedure safe?
The PDO face lift procedure is quite safe
with no to minimal bruising.
The threads are inserted via needle & not
by surgical procedure.
The threads are resorbable & get resorbed
in 6-8 months.
One can still expect mild swelling &
soreness after 3-5 days of the procedure,
mild dimpling of the skin & sensation of
tightness that resolves within few days of
the procedure.
• The procedure is minimally invasive. The
procedure begins with local anesthesia
infusion followed by insertion of PDO
threads via canulas into different layers of
the skin.
• Once the threads are inserted they anchor
the skin & lift it upwards.
• The procedure usually takes 15-30 minutes
depending upon the areas to be treated
Suitable candidate for PDO thread lift
• It’s a non surgical face lifting treatment
that is appropriate or suitable for anyone
looking to improve the appearance of their
sagging skin.
• This procedure helps one to attain an
immediate face lift without undergoing any
surgical procedure.
Post-operative care
 Candidates are advised to say no to alcohol,
avoid supplements like vitamin E, omega fish
oils for 2-3 days after the procedure.
 Avoid excessive heat & do not engage in
strenuous exercises for few days.
 In order to reduce swelling of face, sleep on
your back & do not apply any pressure on your
face that might cause misalignment of threads.
 Do not undergo for any treatment for at least 2
weeks after the procedure that demands
excessive mouth opening for prolonged period
of time.
Indications
Effects
• Wrinkle: face, neck. Hand,

marionette fold, indian groove

• Lifting Effect: full face, breast,

hip, upper arm

• Brightening

• Improvement in skin texture,

tightening pores

• Volume Reduction: Double chin,

zygoma
Vector Reinforcement Factors
 Vertical insertion to vector(B→A)
 Αnchoring point : More Wound
 Sewing between Deep Dermis
& Hypodermal Layers
 Thread thickness
 Threads number
 Distance between threads
 Multiple depth sewing
Insertion Directions &
Depth:
 From Downwards
to Upwards
 From Face’s
Centre to
Outwards
 Between Lower
dermis & Sub
dermal
Recommended Lifting
Threads:
• PDO(50MMX29G)USP 6-0
• PDO(50MMX27G)USP 5-0
• PDO(60MMX29G)USP 6-0
• PDO(60MMX27G)USP 6-0
• What is Platelet Rich Plasma?
• It is an effective concentration of
multiple fundamental growth factors
• (GF’s) by virtue of platelets alone
(stored as α-granules in platelets) and
plasma proteins
• “REGENERATIVE”
• COCKTAIL of growth factors
• Degranulation of the prepacked
• GF’s in platelet occurs upon
“activation”
• Aim : to sequestrate platelets in high
concentrations, enough for achieving
therapeutic benefit and in a viable
state at the same time, so that they
can actively secrete their GF’s
• Precautions :
 aseptic condition
 optimum temp regulation
 anticoagulant
Indications for use

• Androgenic alopecia
• Alopecia areata
• Acne scars
• Skin rejuvenation
• Wound healing
 A special dermaroller is
used to stimulate dermis.
• The microneedling causes
microtrauma to dermis that
induces growth repair cells
into action.
• PRP is then applied
topically
EXOSOME/SECRETOME
CONDITIONED MEDIA /EXOSOME
 Biological functions of the
exosomes
Depending on the cell/tissue of origin, many different roles and functions
have been attributed to exosomes.
To name a few:
• eradication of obsolete molecules
• facilitators of the immune response
• antigen presentation
• programmed cell death
• angiogenesis
• inflammation
• coagulation
• dissemination of oncogenes from tumor cells
• spread of pathogens such as prions and viruses from one cell to
another
• exosomes are delivering macromolecular messages (RNA and
protein)- enabling cell-to-cell communication and signaling
Exosome analysis is very challenging due to their sophisticated
composition and small size; and it’s a heterogenous population
Human umbilical cord blood-derived mesenchymal stem cells (UCB-
MSCs) play an important role in cutaneous wound healing, and recent
studies suggested that MSC-derived exosomes activate several
signaling pathways, which are conducive in wound healing and cell
growth. In this study, we investigated the roles of exosomes that are
derived from USC-CM (USC-CM Exos) in cutaneous collagen synthesis
and permeation. We found that USC-CM has various growth factors
associated with skin rejuvenation. Our in vitro results showed that USC-
CM Exos integrate in Human Dermal Fibroblasts (HDFs) and
consequently promote cell migration and collagen synthesis of HDFs.
Moreover, we evaluated skin permeation of USC-CM Exos by using
human skin tissues. Results showed that Exo-Green labeled USC-CM
Exos approached the outermost layer of the epidermis after 3 h and
gradually approached the epidermis after 18 h. Moreover, increased
expressions of Collagen I and Elastin were found after 3 days of
treatment on human skin. The results showed that USC-CM Exos is
absorbed into human skin, it promotes Collagen I and Elastin synthesis
in the skin, which are essential to skin rejuvenation and shows the
potential of USC-CM integration with the cosmetics or therapeutics.
Take home message
1. Before the procedure it is necessary to
evaluate the condition of the skin to
predict the outcome and assess the
need for other procedures.
2. Morphological changes around the
implant depend on: fibroblast activity ,
collagen production, and capillary
enhancement.
3. This procedure will improve
microcirculation 44-53%, which will
improve skin nutrition in the target area.
4. Skin tightening can be used as
prevention of wrinkles.
5. Mild case give good result