A “PDQ thread lift” is a minimally invasive procedure using absorbable sutures to lift sagging tissues of the body, especially the face and neck. PDQ is an acronym for polydioxanone, the chemical name of the sugar like material used to create this suture material. PDQ has been utilized as a surgical suture material since the ?O’s. The difference between a PDQ suture used to close a wound in surgery and a PDQ thread used for a thread lift is the presence of cogs or barbs which are molded or carved into the suture to grab hold of the sagging tissue.
There have been many types of thread lifts in the history of nonsurgical procedures. The earliest versions used permanent suture material. Permanent suture material like nylon is specifically chosen for its lack of reactivity in the tissue so it is not broken down by the body. Absorbable suture material, on the other hand, is eventually broken down by the surrounding tissue, stimulating collagenases ie, leaving behind new collagen in its path. Permanent thread lifting material, albeit effective, was limited by the fact that it did not elicit a collagenases response. It also had the disadvantage that as the skin becomes thinner with age, the sutures (which are placed right below the skin) could become visible. This procedure, which was promoted in the US between 2004-2005 as a permanent nonsurgical facelift option, quickly developed a bad reputation, as the lift was not permanent as tissue continued to age but sutures remained in the thinning tissue and often became visible. Around 2010 an absorbable suture material called Polydioxanone, “PDQ” (used in cardiac and gynecological surgery since the 1970s) started to become popular in Korea. PDQ is basically a sugar-type molecule that breaks down into carbon dioxide and water via hydrolysis in the tissue over approximately 4 months. This material was pegged by cosmetic surgeons in Korea and Russia as an opportunity to advance the original thread lift procedure into one that could actually regenerate the tissue while it lifts. And although the threads aren’t permanent (they absorb within 5 months), the tissue collagenases that the sutures stimulate allow for a lifting effect that lasts far longer than the sutures themselves. Since PDQ stimulates collagen, simple non-barbed threads can be placed in tissue to simply smooth and tighten skin.
The basic concept of a PDQ thread lift is the lifting of sagging superficial fat pads with thin absorbable threads placed along carefully chosen vectors in and around the cosmetic unit of concern.
The current technology of PDQ threads involves the manufacture of tiny “barbs” along the length of the thread which is to be placed in the tissue. The barbs have a direction, and the most common type is “bi-directional free-floating”. This means that the lower portion of the thread can grab hold of the sagging tissue and the upper portion of the thread can attach into or “anchor” into the tissue up above to secure the lift.
Initially, the tissue will have a mild reaction to the threads which leaves fine deposits of collagen in its path. Eventually, the threads will completely dissolve into the tissue. However, although the threads are gone, there is collagen left behind to leave behind commonly associated with a significantly more cost and downtime, swelling, and bruising on the order of weeks to months.
Often a thread lift is only asked for when a patient feels there are no other options that they may feel are simpler or are the only procedures with which their clinician or surgeon is familiar. Cosmetic procedures are more accepted the longer a community is exposed to it. For example, when Botox was first FDA-approved, we all remember how many people misunderstood and even feared it. Now, 20 years later it is the number one most commonly performed cosmetic procedure. Non-invasive procedures are becoming far more accepted as the years prove safety and efficacy. The problem with the history of cosmetic procedures in the US is that once a procedure becomes widely accepted, it also becomes widely overutilized. This results in overfilled over Botoxed and unnatural-looking faces as patients and clinicians are struggling to achieve youthfulness with their current tools. The thread lift is a newer tool, only available in the US since 2014 and only over the past year developing popularity. Many clinicians are not yet familiar with the thread lift. This procedure has a steeper learning curve than simpler injectable procedures. A clinician must be dedicated to the highest quality results and spend many hours learning and training to confidently offer the procedure to their patients.
It is for this reason, that although a thread lift may be the best procedure for a patient, even before fillers and Botox, it is not offered or is not available. In my opinion, in many cases, a thread lift is one of the best first procedures a patient should undergo, before any fillers or neuromodulators. However, I believe that all cosmetic procedures work very well together and the most natural results come from a clever, thoughtful combination of many different types of cosmetic treatments, depending on the patient’s needs and desires. So the answer to the question of “who should ask for a thread lift” is “everyone”! You need to consider all of your options.
When you become a patient at The Med Spot, your most suitable cosmetic options will be presented to you during your consultation. Dr. Reyes has been performing cosmetic surgery since 2002 when Botox first became FDA approved for cosmetic use. She and her staff will present to you the best options for your needs and help you decide what is best for you. Once you decide to do a thread lift at The Med Spot, rest assured you are with an expert. Dr. Michelle Reyes has been performing PDQ thread lifts since 2015. She has worked extensively with many types of thread lift techniques and eventually came to training thread lift techniques to other professionals. She is one of the original US MINT certified trainers and key opinion leaders and has lectured internationally on the PDQ thread lift procedure. She is constantly modifying her different vector designs used in the thread lift procedure to improve patient comfort during and after the procedure, lift longevity, and overall patient satisfaction. She has patients return to her year after year for consistently satisfying results.