For a basic understanding of what happens to people’s faces with age, we have aging skin with wrinkles, age spots, loss of elasticity, and loss of volume. The latter occurs from diminished fat and bone.

Regarding turning back the clock on aging faces: Since I began in plastic surgery, surgery first became more invasive for the never-ending pursuit of better results.

Times changed, and now the goal is equivalent results with less or no surgery and down-time. To achieve this, techniques and technology have mushroomed, from lasers, radiofrequency and plasma pens, to newer fat grafting techniques, to longer lasting “fillers,” and finally, improvement of thread-lifts.

Thread lifts are not new. The original lifts were performed using permanent threads with “barbs” to simply pull the sagging faces upward. As mentioned, the problem with aging faces is more than loss of elasticity.

The permanent threads did nothing for loss of volume or skin quality, and many became noticeable in appearance with time and especially as skin thinned with age. If the sutures were placed incorrectly, the patient was stuck with the results.

In addition, if an infection occurred, there was virtually no way to remove the threads, and the infections were difficult to treat.

Thread lifts have entered a new era. The new threads, called PDO threads or InstaLift threads, have small barbs or cones that allow the sutures to go in only one way. The small barbs or cones, when placed under slight tension, will pull the face in the proper direction, upward and backwards.

PDO threads also come smooth (not barbed) to be used as a volumizer with no lifting, as needed around the mouth or eyes and frown lines. The new threads are temporary, lasting about six months. However, they stimulate the small cells called “fibroblasts” to produce collagen and elastin.

This produces volume, diminishes wrinkles, increases elasticity, and improves the appearance of skin. The volume is thus the patient’s own collagen and will last 1½ to 2 years, according to the patient’s lifestyle.

The thread lift procedures must be individualized according to the problem to be addressed, and the procedures can often take less than an hour to perform under local anesthesia. The recovery involves some discomfort and usually some bruising that can last 7 to 10 days.

The areas that can be improved are limited by one’s imagination. The threads can be used in the neck, arms, wrinkles above the knees, and more. Consider PDO threads as needed for those who don’t want a facelift or are not quite ready for one.

Often they are used in combination with other procedures such as lasers, Renuvion for tightening the neck skin, or Botox/Dysport and fillers.

Continuing to look our best with aging is a process because, if lucky, we continue to age.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton.