Use Aesthetic Sutures To Provide Uplifting Results Rebecca Suess, RN, CPSN, CANS
Objectives For Today: Identify the different types of aesthetic sutures Explain how aesthetic sutures will compliment existing, non-invasive treatments provided in your office
Aging: What Happens To The Face? Skin Changes: texture, pigmentation, laxity Fat Loss: superficial and deep fat compartments Ligaments: loosen, separate Muscles: contraction, hypertrophy Skeletal: resorption, rotation
How Do We Treat These Issues? Resurface: skin changes (laser, peels, microneedling) Refill: volume/fat loss (dermal fillers) Relax: hypertrophy, contraction But what about laxity? How do we actually REPOSITION the skin?
Repositioning The Skin Laxity needs to be repositioned The only option available was facelift surgery Re-evolution of sutures makes this available to your clients
History of Aesthetic Sutures: 1961: First sutures arrived: used for tendon repair and they were permanent 2005: Reports of adverse events: breaking and extruding 1964: Pioneer of barbed sutures 1990: Began use in the aesthetic market for cosmetic use. Unidirectional and permanent 2002: Introduced bi-directional threads still permanent 2007: Contour Threads were removed from market 2009: FDA withdraws approval 2014: FDA approves RESORBABLE sutures 2004: FDA approval given to Contour Threads
New Generation of Sutures ABSORBABLE Polydioxanone (PDO) Nova Thread, Aqulift, Elionce Used in cardiothorasic surgeries Uni and Bi directional barbed threads Fully absorbed in 4-6 months No scar tissue Creates an inflammatory response similar to other modalities such as lasers/microneedling Results 4-12 months Repeat treatment at 4-6 weeks for best result Can add volume to the face as well Poly-L-lactic Acid (PLLA) Silhouette Instalift only type 82% PLLA (Sculptra) and 18% Vicryl suture Only bi-directional Uses 360 degree smooth cones Fully absorbed in 9-12 months Neocollagenesis with biostimulator effect producing collagen type I and type III Results peak at 6 months Lasts 18-24 months Will not add volume
Who Is An Ideal Client? Ideal Client Strong, bony projection Not Ideal Client Excessive skin Good skin quality Thick skin Malleable tissue Thin skin with no fat Midface sagging Non-mobile skin tissue Nasal labial fold/marionette/ buccal region Sensitivity to suture materials
No Treatment Is Perfect Or Without Risk Adverse Reactions: they are rare, minor, not long lasting, and self-limiting. Asymmetry Misplacement Bruising Dimpling or puckering of the skin *Downtime approximately 1 week
Not A Solo Treatment Sutures should be used in addition to all other modalities in your practice: Neurotoxins: relax fine lines, muscle hypertrophy Dermal Fillers: restore volume Lasers/Microneedling: repair texture, pigmentation Skin Care/peels/facials: restore glow and hydration Sutures: reposition the skin, lower face laxity
Before And After
Before and After Photos
Longevity Of Results
Treatment Progression
Thank You rebeccasuessrn@gmail.com
References: Bishara S Atiyeh, MD, FACS, Saad A Dibo, MD, Michel Costagliola, MD, & Shady N Hayek, MD (2010). Barbed sutures lunch time lifting: evidence-based efficacy. Journal of Cosmetic Dermatology 9,132 141. Helmy Ali, Yasser, MD. (2017). Two years outcome of thread lifting with absorbable barbed PDO threads: Innovative score for objective and subjective assessment. Journal of Cosmetic and Laser Therapy. 20 (1), 41-49. DOI: 10.1080/14764172.2017.1368562 Kalra, R. (2008). Use of barbed threads in facial rejuvenation. Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India, 41(Suppl), S93 S100. Kaminer, Michael S, MD; Bogart, Megan MD; Choi, Christine MD; Wee, Sue Ann, MD. (2008). Long-Term Efficacy of Anchored Barbed Sutures in the Face and Neck. Dermatologic Surgery,34(8), 1041-1047. doi: 10.1111/j.1524-4725.2008.34203.x Villa, Mark T. M.D.; White, Lucile E. M.D.; Alam, Murad M.D.; Yoo, Simon S. M.D.; Walton, Robert L. M.D. (2008). Barbed Sutures: A Review of the Literature. Plastic and Reconstructive Surgery, 121(3), 102e-108e. doi: 10.1097/01.prs.0000299452.24743.65