Facial aging causes loss of fat within the fat pads of the face, and they also change position – descending and sagging towards the lower face. This loss of support for the overlying skin manifests as wrinkles and sagging that is particularly prominent in the jowl area, marionette lines, mid-face, temples, and eye area.
In addition, degradation of our own collagen and elastin as part of the aging process, hastened along by UV exposure, contributes to the loss of skin firmness and elasticity, and simply compounds the issue. These dermal proteins (along with other substances) for a scaffold, or network, underneath our skin that acts as a support structure, and once this starts to degrade the skin loses this support, and wrinkles form.
The technique of ‘thread lifting’ has been around since the 1990s and uses biodegradable sutures that are placed underneath the skin to stimulate our own response to building collagen. This acts to replace the scaffold structure and support the overlying skin. When threads are placed under the skin, they can have the effect of tightening and lifting the looser or sagging areas to rejuvenate the appearance and combat the aging process.
There are 3 main types of threads available currently, with the PDO (polydioxanone) thread being around the longest. This material has been used in surgical procedures for many years and is biodegradable (as are the other forms of threads too). The other threads available are PLA (polylactic acid) and PCA (polycaprolactone). These threads have a longer-lasting effect than PDO threads, being broken down over a longer period (PLA – breakdown in 12 months, PCA – breakdown in 12-15 months). PLA threads also utilize a cone structure to add some additional lifting effect.
PDO threads are naturally broken down in the body over a period of 6 months, but while they remain under the skin they stimulate fibroblast cells to produce more collagen – the effect of which can last 12-18 months. They can achieve a regenerative and firming effect within the skin, but as they are smooth (without barbs or cones) they cannot provide a significant lifting effect.
PDO threads are able to firm and tighten loose or wrinkled skin and can be used in a variety of areas:
Jawline and submental area (double chin)
Smokers lines (around the mouth)
Placing the threads in a specific configuration, or network, under the skin, stimulates a collagen network that gives support and structure to the dermis and, in turn, smoothes and tightens the skin. They are also great for thinning skin as this process increases the quality and integrity of the skin too.
Mono threads vs Cog threads
Cog threads are so-called because they have cogs, barbs, or cones as part of their structure. They can be made from PDO, PLA, or PCA materials, but it is the addition of the cog that makes it different from the smooth mono threads. These barbs can be either mono-directional or bi-directional, with bi-directional threads offering an immediate anchoring to the tissue and lifting effect.
The cog allows this type of thread to hook, or catch, the overlying tissue and generate a lifting effect. This is more suitable for those with more significant skin laxity or sagging, or in the more mature patient. These threads also stimulate collagen production in the area of treatment, so you benefit from the skin tightening and rejuvenating effects from these threads as well.
When comparing these treatments, it’s important to note a difference with the procedure itself. Mono threads are a relatively straightforward procedure, requiring topical anesthetic only and an experienced practitioner to expertly place the threads under the skin. Downtime is minimal and you may experience slight bruising, redness and swelling afterward, that settles within a few days. Cog threads require injected local anesthetic and (depending on the number of threads being placed) multiple long threads being inserted into the face. These threads are then pulled tight. There can be a significant amount of bruising and swelling with cog threads, and they require downtime of approximately 2-3 weeks.
The type of thread used depends on the patient, the quality of their skin, and skin elasticity. In some cases, threads are not an option, and another treatment will yield better results. In the case of significant sagging or aging, then threads will not give a good result, and consideration of surgery would give a better outcome.
At Dr. Tranter Aesthetics I use MINT Mono PDO Threads for skin tightening and collagen stimulation. I personally love these threads because you can really improve the quality of the skin with their use, and you can build on the results by adding more threads. The addition of more threads simply amplifies the collagen-building response and increases the integrity of the dermal scaffold structure.
This has been a short summary of the main differences between mono threads and cog threads…are there other threads-based topics you’d like me to cover? If so, let me know!
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Any questions, let me know!