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A “Nonsurgical” Facelift? Be Wary

Comparing Facelift Techniques in Chicago

In my more than 30 years in practice, I have seen a number of less-invasive “facelift alternatives” come and go. One that appears to be trending now is the thread lift–sometimes marketed as the Silhouette Instalift™–which uses either absorbable or non-absorbable sutures and cones to lift tissue without surgery. Patients considering a facelift at my Chicago practice occasionally ask about this technique, and I have seen several patients who were disappointed by the lack of durability  of the results, and in some cases more down time than expected.

Since I have quite a bit of experience with thread lifts, I’d like to explain them in a little more detail and describe my reasoning for steering patients away from this procedure.

What is a thread lift and how does it work?

During a thread lift, the surgeon inserts sutures through the skin and into tissue with attached bi-directional cones. These cones grab the tissue just below the skin’s surface and pull it into an elevated, more youthful position. Theoretically, the cones hold the tissue in place even as the sutures and cones dissolve.

How does a thread lift compare to a surgical facelift?

What attracts patients to the thread lift is the promise of a facelift alternative that doesn’t require incisions and involves minimal downtime. Because it’s minimally invasive, a thread lift is an in-office procedure performed using only a local anesthetic. However, in my experience, the recovery time from a thread lift is not necessarily shorter than that  from a lower facelift or necklift, in terms of feeling ready to go back to work or to socialize.

How long do the results last?

This is probably the most important question. Unfortunately, my experience has proven that results aren’t durable. We previously  conducted a study using sophisticated 3-dimensional imaging that showed the results lasted only 3months.   Although the type of threads being used has changed, I am personally skeptical that the results will be more durable, because fundamentally in order for results to last the facial tissues, particularly the deeper layers need to be actually released and repositioned, with redundant tissue excised.

Why is a surgical facelift more effective?

Cosmetic surgery involves making choices and considering tradeoffs. A surgical  lower facelift, necklift or a modification ( minilift)  performed by an experienced, board-certified plastic surgeon, can produce results that  typically last for ten or more years. Because it involves incisions and manipulating deep tissue, the recovery does involve more initial swelling but downtime typically is 10-14 days depending on the procedure, although if the relaxation is marked it can take longer.

I recommend that patients do their homework before making a decision about any cosmetic procedure, including consulting with more than 1 surgeon and looking for reviews about specific techniques. One good resource is RealSelf, where you can read what actual patients say. Only 57% of patients on RealSelf say the thread lift is worth it, compared to 95% for a surgical facelift. Also, look at a surgeon’s before-and-after photo gallery showing the types of results that can be expected.

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