Investigation on the Cutaneous Change Induced by Face-Lifting Monodirectional Barbed Polydioxanone Thread

Dermatol Surg. 2017 Jan;43(1):74-80. doi: 10.1097/DSS.0000000000000925.


Background: Owing to its potentially greater mechanical force on the implanted tissue, barbed thread is frequently used in face-lifting procedures. However, the long-term durability thereof remains controversial. Moreover, reports on underlying histologic and molecular changes resulting from face-lifting procedures are scarce.

Objective: To evaluate histologic and molecular changes induced by absorbable, barbed face-lifting thread in an animal model.

Materials and methods: Fragments of monofilament, monodirectionally barbed polydioxanone thread were implanted in dorsal skin from 12 guinea pigs. Tissue samples were harvested at 1, 3, and 7 months thereafter. Histopathologic analysis and quantification of Type 1 collagen and transforming growth factor beta 1 (TGF-β1) levels were performed.

Results: Implantation of a single fragment induced fibrous capsule around the thread. Tissue reactions were strongest at 1 month after implantation, showing marked infiltration of inflammatory cells and fibroblasts, which gradually decreased. On molecular analysis, Type 1 collagen and TGF-β1 levels were significantly increased, compared to normal skin, throughout the 7-month study period.

Conclusion: Our results suggest that implantation of barbed thread induces strong anchorage to skin tissue. Quantitative analysis of collagen and its downstream signaling molecule TGF-β supports the long-term durability of the thread. Therefore, the authors expect potential beneficial effect for rejuvenation on its clinical application.

MeSH terms

  • Absorbable Implants
  • Animals
  • Collagen Type I / genetics
  • Collagen Type I / metabolism*
  • Equipment Design
  • Foreign-Body Reaction / etiology
  • Foreign-Body Reaction / pathology*
  • Guinea Pigs
  • Polydioxanone* / adverse effects
  • RNA, Messenger / metabolism
  • Rhytidoplasty / instrumentation
  • Skin / metabolism*
  • Skin / pathology*
  • Sutures* / adverse effects
  • Time Factors
  • Transforming Growth Factor beta1 / genetics
  • Transforming Growth Factor beta1 / metabolism*


  • Collagen Type I
  • RNA, Messenger
  • Transforming Growth Factor beta1
  • Polydioxanone