Dutch Plastic Surgery Society position on Threadlifts

Dutch Plastic Surgery Society position on Threadlifts

Backgroud : There is an ever increasing popularity and demand for soft tissue fillers for non-surgical facial rejuvenation. These fillers are broadly classified in absorbable fillers and semi-absorbable and permanent fillers. (Semi)-permanent fillers have been associated with detrimental complications such as ongoing infections and scarring. The Dutch Society of Plastic surgery is concerned about the recent growing popularity and reintroduction of permanent and semi permanent  threads sometimes made from filler materials . These “ threads” are most commonly used by aesthetic physicians with no specialist surgical training in operative aseptic techniques  and performed in beauty salons or unequipped "procedure rooms". Threadlifts are heavily marketed with catchy names like no Knife facelift, happylift, lunch time lift or softlift.

The members of The Dutch Society for Plastic Surgery ( NVPC) will abstain from using threadlifts with the following reasons including lack of safety and efficacy :

1 The so called Threadlift is a conceptually wrong and misleading principle of treatment :

Threadlifts are not a effective means for the treatment of facial soft tissue sagging due to ageing. Proponents and the industry attempt to lure the uninformed client into an illusion of an ideal Facelift result with no surgery, minimal discomfort, no complications and no downtime.  It is conceptually wrong to attempt a simultaneous lift of skin and subcuteneous tissue through the blind introduction & traction with a Thread with cones or barbs.  

A plastic surgical facelift is usually performed by separation of the skin with a layer of subcutaneous fat from the underlying SMAS tissue.  The SMAS is subsequently dealt with by excisional or plication techniques and fixed to firm fascia in a vertical vector after which skin excess is removed and inset in a more oblique vector. The Threadlift does not deal with skin excess or bi-directional lift vesctor and the perceived improvement in contour will be mitigated within a few weeks by the “ cheeswire” phenomenon. Initial improvement is also enhanced by trauma and swelling which also subsides wihin a few weeks .

2 The material of which threads are made is not always from a controlled  and safe source or origin.

Threads are often made from the same materials which have caused detrimental complications being used as (semi)permanent soft tissue fillers. Some threads have cones and or barbs in an attempt to  counteract the cheeswire phenomenon. These concentrated areas within the threads may cause severe scar formation within the delicate SMAS of the face and neck.

Many threads are manufactured  in Asia where the safety rules for medical devices may vary . Moreover these threads are sometimes used in combination with other types of thread and fillers which enhances the possibility of long term complications .

3 Threadlift treatments in The Netherlands

Threadlifts are almost exclusively used in The Netherlands by aesthetic physicians. The knowledge of facial anatomy, aseptic techniques, bacteriology and correct surgical tissue handling is vary variable amongst these doctors with often limited aesthetic traning and expertise. These threads are often used within beautysalons under compromising circumstances. The NVPC states that 'threadlifts' are ineffective and too invasive and therefore should not be included in the training modules which are intended to be developed for Dutch Aesthetic Physicians. 

4 Safe Filers, toxins and energy based devices adequate means of non surgical rejuvenation.

Threadlifts are expensive and their potential complications can be detrimental to facial tissue and very difficult to treat. They do not bring any value above the currently used safe soft tissue fillers, toxins and energy based devices for non-surgical  rejuvenation.

Hyaluronic Acid fillers ( with FDA approval) and calciumhydroxyapetite are considered safe if used properly by trained and experienced practioners. Their reported complications are low and can be managed . These modalities can effectively be used for patients who are suitable candidates for non-surgical procedures. 

Facelifting procedures and or lipofilling can be employed by core plastic surgeons in more advanced cases of sagging soft tissues, volume loss and skin excess.

 

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