Gerald Pierone, Jr., M.D., has performed more than 30,000 dermal filler procedures, including liquid face lifting. But he says there is a law of diminishing return with using dermal fillers alone to lift the skin.
“At a certain point, you can’t go any further. People start looking ridiculous if you keep putting filler in the zygomatic area to get the jowls lifted up. At a certain point their cheeks enter the room before they do,” says Dr. Pierone, an internist physician who has focused on cosmetic treatments for about 13 years.
Thanks to advances in thread technology, Dr. Pierone says thread lifting has become an effective and safe minimally invasive option for lifting the skin.
“Thread lifting is something you can do both for people that need filler and for people that don’t need filler and don’t want surgery, but just need some slimming, along with upward and backward traction,” he says. “It’s a middle ground between fillers and surgery and represents a dramatic advancement in nonsurgical facial rejuvenation.”
For example, thread lifting with polydioxanone (PDO) sutures can build on liquid facelift techniques. One scenario, Dr. Pierone says, is the patient who comes in with prominent nasolabial folds, a depleted lower face and jowls. He might use fillers for a liquid facelift combined with PDO threads. The threads would be inserted in the upper face superior to zygoma with the thread directed toward the oral commissure and the middle jowl area. The goal is to obtain upper and backward traction beyond what he can achieve with fillers alone. He trademarked such a procedure: The Symmetry Lyft combines fillers and threads for full minimally invasive facial rejuvenation.
Threads in the U.S. tend to be made of PDO, which is the polymer that absorbable sutures are made of, or poly-L-lactic acid (PLLA), the same polymer in Sculptra (Galderma).
Dr. Pierone recommends barbed PDO threads for most lifting procedures. After trying several brands, he uses the Mint brand (HansBiomed). Dr. Pierone says Mint’s thread technology has uni-directional barbs and offers quality and affordability. Mint threads cost about $35 a thread, compared to other brands that charge up to $150 a thread, according to Dr. Pierone, who has presented on Mint threads in Korea and was reimbursed for his lecture and travel.
“When you insert the Mint threads in the upper face and thread them down to the lower face and pull back, you get 1 cm or 2 cm of upward, backward traction,” he says.