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1 OREON Lifescience Co.,Ltd. Safe Long lasting Effective
2 Skin Aging INSTRINSIC Intrinsic aging obviously occurs to anyone with the passing of time. It occurs as damage in components in our body is accumulated by reactive oxygen free radical produced during the metabolic process. However, skin damage is caused by a series of inflammation when oxygen free radical in body is not well removed with some protective device after oxygen free radical is produced. EXTRINSIC Photoaging refers to changes on face, neck and hands when exposed to environmental factors like sunlight for a long time. It has become a main cause of most of cosmetic and medical skin problems. Action spectrum which leads to photoaging is under ultraviolet region, and not onaly ultraviolet B but also ultraviolet A (UVA, 320~400nm) causes skin aging and cancer
3 History of skin lifting CONVENTIONAL SKIN LIFTING EXPOLIATING SKIN & SUBCUTANEOUS TISSUE LIFTING SMAS LAYER, UNDER PERIOSTEUM, COMPOSIT LIFTING INVASIVE LIFTING BY FRACTIONAL LASER BARRED SURTURE APTOS_NON-SOLUBAL NON-INVASIVE PRESENT SKIN LIFTING BARRED SURTURE PDO THREAD_SOLUBAL
4 What is PDO thread? Thread lift treatments are a minimally invasive procedure using dissolvable PDO threads (Polydioxanone threads a medical grade thread used for suturing for over 20 years) which are broken down naturally by the body over time. PDO Thread Lifts are designed to rejuvenate, regenerate and improve facial structure, giving the same benefits as a facelift, but without the need for surgery.
5 Mechanism of PDO thread The concept of skin rejuvenation is that the Barbed PDO Thread, an absorable suture, has special design for hooking up our tissue under the sagging skin so the lifting result can be seen immediately after procedure. Later on, threads will gradually stimulate collagen production until it is completely absorbed inside of body within 6 months. Then our own collagen will lift up skin instead after that time and the results will lasts for 1-2 years. Cog thread The aging face loses the tensile strength of structural integrity. Cog threads have been used recently to tighten lax skin and soft tissue. The cog thread placed under the skin immediately pulled the skin and subcutaneous tissue. The myofibroblasts around the thread played a role in fibrous tissue contracture 4 weeks post-insertion of the thread.
6 Types of PDO thread Unabsorbable thread (Polypropylene) 1. Aptos Lift Absorbable thread (Polydioxanone) 1. Mono 2. E-Z Lift 2. Screw Screw / Twin 3. Contour Lift 4. Gold Lift 3. Cog Bi-directional / 3D / Heart Bi 3D Heart
7 Treatment Conunselling Preperation Anesthesia - Prediction of patients expectation and recovery process - Objectify - Plan for treatment - Explanation of recovery process - Explanation of after treatment care and adverse event - Avoide these patients; Obese, thick skin, high cheek bone - Take a patient photo - Prepare all equipments - Design for inserting thread - Disinfection - Anasthetic cream - Lidocain Supraorbital Nerve Block Supratrochlear Nerve Block Infraorbital Nerve Block Mental Nerve Block - Tumescent - Sedation Anesthesia
8 Treatment procedure Type 1. Design by face shape and type of skin Type 2. Cog thread procedure for Lifting effect Type 3. Mono thread design for skin elasticity Type 4. Mono thread procedure for skin elasticity
9 1. Design by face shape and type of skin 1. 40~ 70s thin skin Bi cog(8~10) +Twin(4~5) 2. 40~70s thick and sagging skin Bi Cog/ Twin 23G 3.0, 90mm Bi cog(5) + Bi cog(3) 23G 3.0, 40mm Bi cog(2) +Twin (3) 3. 40~70s thin and not too much sagging skin 23G 3.0, 90mm Bi cog(5) + Bi cog(3) 23G 3.0, 90mm Bi cog(5) + Bi cog(3)
10 1. Design by face shape and type of skin 4. 20~ 30s for wanting V-line : Jaw line 23G 3.0, 90mm Bi cog(5) +Twin (3) 23G 3.0, 40mm Twin (8) 5. Serious Nasolabial fold Bi Cog/ Twin 23G 3.0, 90mm Bi cog(5) + Bi cog(4) Inserting from nasolabial fold 23G 3.0, Twin (40mm x 10~20) + Twin (90mm x 5) 6. 70~80s Wringkles 23G 3.0, 90mm Bi cog(4) + Bi cog(4~5)+twin (4~5)+Twin (4~5) 23G 3.0, 90mm Twin (15~20)
11 1. Design by face shpe and type of skin Neck lines 7. Twin 23G 3.0, 60mm Twin (4)
12 2. Cog thread procedure for Lifting effect Step 1. Step 2. Step 3. Step 4. Diagnose Select thered type Design Anesthesia - Diagnose patient status - Design facing patient eye level - Lifting purpose 40mm/60mm/90mm - Tensile strength 1-0 / 4-0 USP - Type of thread cog, twin, mono Ex. - Sagging nasolabial fold and jaw line Cog thread - Marionette line Twin
13 2. Cog thread procedure for lifting effect Draw lines on nasolabial and marionett line Mark dots on temple spot and hair line & mark 5 dots each along the 2 lines evenly Draw lines for inserting thread Insert threads (Bi cog: 5~10 one side) inside subcutaneous layer Mark 3dots evenly below the ear & center of neck Draw lines with 45º (Twin) Local anasthesia Insert 23G, 3.0, 90mm Bi thread Once inserted, never pull back and insert deeply into the subcutaneous layer Pull the thread and cut with scissors
14 2. Cog thread procedure for lifting effect Insert 3~5 3.0 Twin threads along the marionett line Insert 3~5 additional twin threads on the jaw line vertically Insert twin thread on the neck 45º diagonally against neck wringkle Sit infront of patient and check both sides & perform on the other side
15 3. Mono thread design for skin elasticity Step 1. Step 2. Step 3. Step 4. Diagnose Select thered type Design Anesthesia - Diagnose patient status - Design - Elasticity purpose 29G, 40mm mono threads in cross strips way - Insert thread thinly - Insert across the wrinkle and upward - Insert tightly - Insert thread considering patient s age, skin elasticity and sagging degree
16 3. Mono thread design for skin elasticity Nasolabial fold Insert 27G, 40mm Mono(10~30) in cross strips way + Twist tread(1~2) + 40mm x 10~15 in cross strips way for pore tightening Insert Twin(5~8) + Twin(3~5) Marionette line Insert 27G, 90mm Twin(5) + Twin(3~5) Insert 27G, 40mm Mono(10) horizontally
17 3. Mono thread design for skin elasticity Jaw line Insert 27G, 60mm Twin (3~5) - Some for Jaw line and some for Neck line Insert Mono (40mm x 10) & possible to add 10 more Double chin Insert Mono (40mm x 10~20) Crow s feet Forehead Insert Mono (40mm x 10~20) in in cross strips way Insert Mono (40mm x 5~10) around crow s feet Insert Mono (40mm x 10~20) in cross strips way More effective to add 10~30 according to the number of wrinkles
18 3. Mono thread design for skin elasticity Glabella Insert Mono (40mm x 10~20) in cross strips way More effective to add 10~15 according to the wrinkles
19 4. Mono thread procedure for skin elasticity Nasolabial fold Insert 40mm Mono(10~15) in vector direction Insert 3~5more threads above the 1st line Insert 5~10 threads vertically Pull out approx. 5 thread at the same time and press gently with other hand Marionette line Insert 5 Mono threads + 5more threads vertically
20 4. Mono thread procedure for skin elasticity Jaw line Case1. Insert 5~20 Mono threads along the jaw line Case2. Insert approx. 3~ 7 60mm Twist thread Double chin Insert 10~20 40mm Mono threads in the edge of double chin Insert 5~10 Mono threads vertically from the jaw line Insert 5 more threads below the 1 st layer Remove all thread at once while pressing gently with other hand
21 4. Mono thread procedure for skin elasticity Crow s feet Insert 3~8 mono thread around crow s feet Forehead Insert 3~5 additional thread above the 1 st layer Measure the length 5mm below the eye, Insert 3~4 threads vertically Insert 3~5 additional threads according to the sagging degree Check the wrinkles and insert 40mm 1~2 threads layer on the middle of hairline Insert 40mm 10~20 mono threads horizontally Add another layer of 5 threads Add another layer of 5 threads Pull skin gently considering bone flexure Insert 5~15 threads vertically
22 4. Mono thread procedure for skin elasticity Glabella Summary of Mono thread design Insert 10~15 threads around glabella Insert 5~8 threads vertically Twist threads Rest of them are all Mono threads
23 Management & Cautions after treatment Frequent Adverse Event Rare Adverse Event Frequent Adverse Event Rare Adverse Event Facial asymmetry Ecchymosis hematoma Erythema, swelling Infection Skin dimpling Skin irregularities Thread migration Thread protrusion Palpable thread ends with pain Parotid gland duct rupture Nerve damage Scar formation in the entrance sites Granulomas Chronic foreign body sensation
24 Thank you
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