Combining Liposuction and Thread-Lifting for Middle-Lower Facial Rejuvenation.

BACKGROUND: Thread-lifting (TL) is a minimally-invasive technique for facial rejuvenation, whereas liposuction is commonly used for facial contouring. This retrospective cohort study aims to introduce and evaluate a novel technique that combines liposuction and thread-lifting for mid-lower facial rejuvenation. METHODS: Consecutive patients who underwent TL for mid-lower facial rejuvenation from May 2016 to May 2021 were divided into thread-lifting group (TL group) or thread-lifting plus liposuction group (TLL group) according to whether liposuction was performed adjunctively. The co-primary outcomes were the changes between the preoperative and 6-month postoperative Wrinkle Severity Rating Scale (WSRS) and Facial Aging Evaluation Scale (FAES). RESULTS: A total of 185 patients (184 females) with an average age of 34.5±5.5 years were included. There were no significant differences in patients' age, number of threads, and preoperative WSRS and FAES between the two groups. The TLL group (n = 128) had significantly lower postoperative WSRS (1.5±0.6 vs. 1.8±0.8, p<0.001) and FAES (2.5±1.4 vs. 3.8±2.1, p<0.001) than the TL group (n = 57). The decrease in WSRS (0.8±0.6 vs. 0.2±0.7, p<0.001) and FAES (2.7±1.3 vs. 1.6±1.6, p<0.001) were greater in the TLL group. Only 3.8% patients experienced slight side effects and totally recovered. CONCLUSIONS: The combination of TL and liposuction is an effective and safe technique for simultaneous contour improvement and facial rejuvenation in middle-aged East Asian females. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .

A Meta-Analysis and Systematic Review of the Incidences of Complications Following Facial Thread-Lifting.

BACKGROUND: Facial thread-lifting (FTL) has gained more popularity, but the incidences of complications following FTL remain controversial. We aimed to perform a meta-analysis and systematic review to estimate the incidences of complications and to compare the short- and long-term satisfaction rates following FTL. METHODS: We searched PubMed, Web of Science, Embase and Cochrane library for eligible studies. The primary outcome was the incidences of complications following FTL. The secondary outcome was the satisfaction rate immediately and 6-month after FTL. The pooled incidences of complications and 95% confidence intervals were estimated using random-effects models. RESULTS: A total of 26 studies were included in this meta-analysis. Swelling was the most commonly reported complication with a pooled incidence of 35%, followed by skin dimpling (10%), paresthesia (6%), thread visibility/palpability (4%), infection (2%), and thread extrusion (2%). Absorbable threads were associated with a significantly lower risk of paresthesia (3.1% vs. 11.7%) and thread extrusion (1.6% vs. 7.6%) than non-absorbable threads. Patients older than 50 years had a significantly higher risk of dimpling (16% vs. 5.6%) and infection (5.9% vs. 0.7%) than their younger counterparts. In addition, the pooled long-term satisfaction rate was significantly decreased compared to it immediately after FTL (88% vs. 98%). CONCLUSION: Non-absorbable threads and older age of patients are associated with higher risks of complications. Therefore, we recommend a judicious use of non-absorbable threads and FLT in older patients. Furthermore, it should be discussed with patients preoperatively that the rejuvenation effect of FTL may not maintain in the long-term. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Real-World Study of Definisse Threads for Facial Reshaping in Indian Patients: REDEFINE FACE Study.

INTRODUCTION: In recent years, thread lifting has gained popularity as a less invasive cosmetic surgery. It helps raise and realign sagging tissue. The newest thread type for thread lifting procedure is poly-lactic acid-polycaprolactone (PLCL) Definisse threads (RELIFE S.r.l., Florence, Italy). These are fourth-generation absorbable suspended barbed threads. Their double action involves an immediate elevating impact through mechanical action and, over time, the promotion of histological rejuvenating activity through inducing fibroblasts and the synthesis of elastin, hyaluronic acid, and collagen. OBJECTIVES: The REDEFINE FACE study assessed the effectiveness and tolerance of Definisse threads in a real-world setting for facial reshaping in patients in India. METHODS: This multicenter, retrospective observational research included patients treated with Definisse threads for face contouring. RESULTS: Three hundred seventeen patients with a mean follow-up of 4.9 months and an average age of 48.6 years participated in the study. All patients underwent thread lifts using either a single or a combination of Definisse thread reshaping techniques. The Global Aesthetic Improvement Scale for Physicians and Subjects (PGAIS and SGAIS) reported improvement instantly following the treatment (mean score- 3.23 and 3.18, respectively). Improvements continued to enhance during the follow-up visits (mean score- 4.09 and 4.03, respectively). Following the procedure, 96% of patients on the PGAIS and SGAIS exhibited enhancement. Most procedure-related side effects were minor and went away on their own in a few days without the need for proactive care. CONCLUSION: The results of this real-world analysis showed that the latest Definisse threads effectively achieve facial reshaping on patients in India and have both immediate and long-term effects. Treatment was generally well tolerated, and no patient experienced serious adverse events.