Thread Procedure Is Convenient Facelift Alternative

PARK CITY, UTAH — Contour threads offer a minimally invasive alternative to plastic surgery for patients who cannot opt for a full facelift, Dr. William H. Truswell said at a symposium sponsored by the American Society of Ophthalmic Plastic and Reconstructive Surgery.

Surgery is the standard "to rejuvenate the face, but there are people who, for money or time restraints, can't have a facelift. This is an alternative I can offer them," said Dr. Truswell, a facial plastic surgeon in Northampton, Mass.

The Food and Drug Administration approved the barbed sutures for midface, brow, and neck suspension in September 2004.

Dr. Truswell estimated the subjective improvement as 60%–70% of that provided by a facelift. He suggested that the threads are well suited for minimal repairs on the "early" aging face and for a postfacelift "tune-up."

"Virtually anybody with an aging face is a candidate," he said, adding that the widely publicized procedure has drawn patients to his practice. "I have gotten more facelifts out of advertising this," he said at the meeting, which also was sponsored by the American Society for Dermatologic Surgery and the American Academy of Facial Plastic and Reconstructive Surgery.

Dr. Truswell described his first 2 months' experience with the patented, trademarked product, which is made of polypropylene. He said that he found the thread lift procedure easy to learn, and that he could do an entire face in 40 minutes.

How long the improvements will last is an open question, he noted, as the procedure is too new for him to say with certainty. The process causes some patient discomfort and requires about a week of downtime.

Two weeks before the thread lift, Dr. Truswell advises patients to stop nonsteroidal anti-inflammatory drugs. For preoperative medications, he suggests prescribing diazepam (Valium) 5 mg, oxycodone/acetaminophen (Percocet), and dimenhydrinate (Dramamine) 25 mg.

"With oral medications they tolerate it very well," he said, noting that patients must be driven to and from the office.

For 2 weeks following the procedure, patients are told not to pull down on the skin, drink from straws, strain, talk a lot, or touch the face (splashing with water is okay, but the face should be patted dry). If patients cry, cough, or sneeze, they should hold the brow area up, added Dr. Truswell.

"Men should shave upward only," he said.

All patients are told to use cold compresses to reduce swelling and to keep the head elevated above the heart for the first 48 hours. Dr. Truswell also tells them to use two pillows when resting, and he recommends that they use a donut or travel pillow at night to keep the face straight up—a precaution against pressing on the threads.

Dr. Truswell warns patients that they will look "overcorrected" for 7–14 days, but advises that most of this will resolve in the first week. "There will be some "bunching" near the incision site that usually resolves in 1 week," he said, adding that he schedules follow-up appointments 2, 7, and 14 days post procedure.

As for possible complications, Dr. Truswell listed thread failure, migration, exposure, and palpable threads. Abrupt changes in suture depth will appear as lumps and depressions once the tissue has been telescoped during contouring, he said.

"The skin should progress from smooth and tight where the suture exits to corrugated and lax at the hairline," he said.

He warned against placing a suture too deep in the forehead; gathering of the skin will be inhibited. "Avoid 'V' placement of sutures, as 'U' placement distributes the tension more broadly," he said.

Dr. Truswell said that his talk was supported by Surgical Specialties Corp., the manufacturer of Contour Threads.

PARK CITY, UTAH — Contour threads offer a minimally invasive alternative to plastic surgery for patients who cannot opt for a full facelift, Dr. William H. Truswell said at a symposium sponsored by the American Society of Ophthalmic Plastic and Reconstructive Surgery.

Surgery is the standard "to rejuvenate the face, but there are people who, for money or time restraints, can't have a facelift. This is an alternative I can offer them," said Dr. Truswell, a facial plastic surgeon in Northampton, Mass.

The Food and Drug Administration approved the barbed sutures for midface, brow, and neck suspension in September 2004.

Dr. Truswell estimated the subjective improvement as 60%–70% of that provided by a facelift. He suggested that the threads are well suited for minimal repairs on the "early" aging face and for a postfacelift "tune-up."

"Virtually anybody with an aging face is a candidate," he said, adding that the widely publicized procedure has drawn patients to his practice. "I have gotten more facelifts out of advertising this," he said at the meeting, which also was sponsored by the American Society for Dermatologic Surgery and the American Academy of Facial Plastic and Reconstructive Surgery.

Dr. Truswell described his first 2 months' experience with the patented, trademarked product, which is made of polypropylene. He said that he found the thread lift procedure easy to learn, and that he could do an entire face in 40 minutes.

How long the improvements will last is an open question, he noted, as the procedure is too new for him to say with certainty. The process causes some patient discomfort and requires about a week of downtime.

Two weeks before the thread lift, Dr. Truswell advises patients to stop nonsteroidal anti-inflammatory drugs. For preoperative medications, he suggests prescribing diazepam (Valium) 5 mg, oxycodone/acetaminophen (Percocet), and dimenhydrinate (Dramamine) 25 mg.

"With oral medications they tolerate it very well," he said, noting that patients must be driven to and from the office.

For 2 weeks following the procedure, patients are told not to pull down on the skin, drink from straws, strain, talk a lot, or touch the face (splashing with water is okay, but the face should be patted dry). If patients cry, cough, or sneeze, they should hold the brow area up, added Dr. Truswell.

"Men should shave upward only," he said.

All patients are told to use cold compresses to reduce swelling and to keep the head elevated above the heart for the first 48 hours. Dr. Truswell also tells them to use two pillows when resting, and he recommends that they use a donut or travel pillow at night to keep the face straight up—a precaution against pressing on the threads.

Dr. Truswell warns patients that they will look "overcorrected" for 7–14 days, but advises that most of this will resolve in the first week. "There will be some "bunching" near the incision site that usually resolves in 1 week," he said, adding that he schedules follow-up appointments 2, 7, and 14 days post procedure.

As for possible complications, Dr. Truswell listed thread failure, migration, exposure, and palpable threads. Abrupt changes in suture depth will appear as lumps and depressions once the tissue has been telescoped during contouring, he said.

"The skin should progress from smooth and tight where the suture exits to corrugated and lax at the hairline," he said.

He warned against placing a suture too deep in the forehead; gathering of the skin will be inhibited. "Avoid 'V' placement of sutures, as 'U' placement distributes the tension more broadly," he said.

Dr. Truswell said that his talk was supported by Surgical Specialties Corp., the manufacturer of Contour Threads.

PARK CITY, UTAH — Contour threads offer a minimally invasive alternative to plastic surgery for patients who cannot opt for a full facelift, Dr. William H. Truswell said at a symposium sponsored by the American Society of Ophthalmic Plastic and Reconstructive Surgery.

Surgery is the standard "to rejuvenate the face, but there are people who, for money or time restraints, can't have a facelift. This is an alternative I can offer them," said Dr. Truswell, a facial plastic surgeon in Northampton, Mass.

The Food and Drug Administration approved the barbed sutures for midface, brow, and neck suspension in September 2004.

Dr. Truswell estimated the subjective improvement as 60%–70% of that provided by a facelift. He suggested that the threads are well suited for minimal repairs on the "early" aging face and for a postfacelift "tune-up."

"Virtually anybody with an aging face is a candidate," he said, adding that the widely publicized procedure has drawn patients to his practice. "I have gotten more facelifts out of advertising this," he said at the meeting, which also was sponsored by the American Society for Dermatologic Surgery and the American Academy of Facial Plastic and Reconstructive Surgery.

Dr. Truswell described his first 2 months' experience with the patented, trademarked product, which is made of polypropylene. He said that he found the thread lift procedure easy to learn, and that he could do an entire face in 40 minutes.

How long the improvements will last is an open question, he noted, as the procedure is too new for him to say with certainty. The process causes some patient discomfort and requires about a week of downtime.

Two weeks before the thread lift, Dr. Truswell advises patients to stop nonsteroidal anti-inflammatory drugs. For preoperative medications, he suggests prescribing diazepam (Valium) 5 mg, oxycodone/acetaminophen (Percocet), and dimenhydrinate (Dramamine) 25 mg.

"With oral medications they tolerate it very well," he said, noting that patients must be driven to and from the office.

For 2 weeks following the procedure, patients are told not to pull down on the skin, drink from straws, strain, talk a lot, or touch the face (splashing with water is okay, but the face should be patted dry). If patients cry, cough, or sneeze, they should hold the brow area up, added Dr. Truswell.

"Men should shave upward only," he said.

All patients are told to use cold compresses to reduce swelling and to keep the head elevated above the heart for the first 48 hours. Dr. Truswell also tells them to use two pillows when resting, and he recommends that they use a donut or travel pillow at night to keep the face straight up—a precaution against pressing on the threads.

Dr. Truswell warns patients that they will look "overcorrected" for 7–14 days, but advises that most of this will resolve in the first week. "There will be some "bunching" near the incision site that usually resolves in 1 week," he said, adding that he schedules follow-up appointments 2, 7, and 14 days post procedure.

As for possible complications, Dr. Truswell listed thread failure, migration, exposure, and palpable threads. Abrupt changes in suture depth will appear as lumps and depressions once the tissue has been telescoped during contouring, he said.

"The skin should progress from smooth and tight where the suture exits to corrugated and lax at the hairline," he said.

He warned against placing a suture too deep in the forehead; gathering of the skin will be inhibited. "Avoid 'V' placement of sutures, as 'U' placement distributes the tension more broadly," he said.

Dr. Truswell said that his talk was supported by Surgical Specialties Corp., the manufacturer of Contour Threads.