Vertical Lifting: A New Optimal Thread Lifting Technique for Asians

Dermatol Surg. 2017 Oct;43(10):1263-1270. doi: 10.1097/DSS.0000000000001169.


Background: With the evolution of facial rejuvenation methods, thread lifts have gained popularity among patients who seek cosmetic improvement. Absorbable wedge-shaped polydioxanone (PDO) sutures are currently available, and they are extremely popular in the aesthetic clinics in Korea. In case of midface and mandibular jowl lift, threads are most often inserted in an oblique manner with vectors of rejuvenation directed toward the temple. However, specific characteristics of skeletal anatomy should be considered when deciding which technique to use in Asians. Herein, the authors introduce a vertical lifting technique most suitable for Asians, in which short (6 cm in length), wedge-shaped PDO sutures are inserted vertically downward in the anterior malar and submalar areas.

Objective: To describe a novel technique adopted to counteract the descent and laxity of the Asian face. The authors also aimed to assess the overall safety and efficacy of wedge-shaped PDO thread lift in facial rejuvenation.

Methods: A retrospective chart review was performed on cases of facial laxity treated with vertical thread lifting. A total of 39 Korean patients were included. All participants underwent a single treatment session. The results were assessed objectively using serial photography and subjectively based on the patients' satisfaction scores. Complications were also recorded.

Results: Most patients (89.7%) considered the results satisfactory. Consensus ratings by 2 independent dermatologists showed that the objective outcomes at the 6-month follow-up were largely categorized as very much improved (10.3%), much improved (43.6%), and improved (33.3%). The incidence of complications was low, and the complications were minor.

Conclusion: Thread lifting with short, wedge-shaped PDO sutures is safe and effective for facial rejuvenation. The authors' vertical lifting technique has several advantages over the current approaches. First, the vectors directly oppose the vertical sagging of the face, which makes the technique highly efficient. The technique also carries a lower risk of accentuating the cheekbones, a feature which most Asians do not prefer.

MeSH terms

  • Adult
  • Aged
  • Asian Continental Ancestry Group
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Rhytidoplasty / instrumentation*
  • Rhytidoplasty / methods*
  • Sutures*