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

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

2004: FDA approval given to Contour Threads

2005: Reports of adverse events: breaking and extruding

2007: Contour Threads were removed from market

2009: FDA withdraws approval

2014: FDA approves RESORBABLE sutures

New Generation of SuturesABSORBABLE

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

Good skin quality

Malleable tissue

Midface sagging

Nasal labial fold/marionette/ buccal region

Not Ideal Client

Excessive skin

Thick skin

Thin skin with no fat

Non-mobile skin tissue

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