Foothill Cities - November-December 2021

Gregory J. Vipond, M.D., F.R.C.S.C. VIP Facial Artistry (909) 608-7770 info@drvipond.com www.drvipond.com 1601 Monte Vista Avenue Suite 200, Claremont, CA 91711 New patients mention ‘ YOUR VILLA ’ and receive $50 OFF your first treatment! *Cannot be combined with others offers. Expires 12/31/2021 I had originally planned to write about a different topic for this editorial. However, I have had a number of patients come into the office over the past two months with concerns about having threadlifts placed after having read my last article. Because of this, I thought I should review what I have seen in the office and operating room. As I mentioned in the last article, threadlifting involves the placement of sutures with cones or barbs to help lift sagging muscle and skin. These sutures then dissolve over several months and are supposed to cause the creation of collagen underneath the skin to help restore volume. The advertised benefits of this procedure are minimal downtime, minimal pain, immediate results, and long-lasting collagen production. I mentioned that I have never used threadlifting in my practice because I believe it is a gimmick and don’t want to offer any treatment to patients that I don’t believe in. The technology never sounded legitimate, even with the original threadlifts that used permanent sutures. The modern version uses dissolvable sutures to help elevate the fallen tissue of the face. However, the sutures quickly lose strength, even though they dissolve over several months. The companies advertise that the dissolving process stimulates collagen to help maintain the effect, but I feel this effect is not significant. A study was performed a few years ago that looked at patient satisfaction after threadlifts and found that only a small minority was happy at 6 months while nobody was happy at one year. Last month, I had a patient come in for consultation after having a threadlift procedure that left her with ear and facial pain. She told me that she had dimpling right after the procedure and could feel the threads breaking over the first month after they were placed. She was also very unhappy with the result and felt there was no improvement in her face. Another patient that came into the office had spent approximately $5000 on threadlifts several years ago without any improvement. She more recently had Kybella placed underneath her chin to dissolve fat and improve her profile. She felt that this treatment actually created more skin excess. I ended up doing a deep plane face and neck lift on her. During her surgery, I could see the streaks of collagen that were left when the threads dissolved. They were located at the level of the facial musculature and were less than 2mm thick and did add any significant volume to her face. Additionally, the collagen that was produced made the surgery more difficult as it got in the way of the dissection to free up the face and neck muscles so they could be lifted. This week, I had a third patient with a history of threadlifting come in for a deep plane face and neck lift. She mentioned that she had many threadlifts in the past because she was hoping to delay any surgery for as long as possible. When I evaluated her in the office, she had noticeable muscle looseness in her neck as well as her jowls –areas that had been treated with multiple threadlifts. Her surgery was extremely difficult due to the scarring and fibrosis that was caused by the threads as they dissolved. Collagen is the principal ingredient in scar tissue and is thick and stiff and doesn’t look or behave like normal tissue. It also acts like glue and sticks the different tissue layers together and feels like the gristle in steak. All of that collagen didn’t help volumize her face and neck or help lift up the falling face and neck muscles. Fortunately, her surgery was successful and I was able to re-suspend the muscles in a much more youthful position. Threadlifting is a very popular procedure that is fueled by marketing by the companies that make the threads. Healthcare providers are attracted by the potential to make a lot of money and are convinced by the sales representatives and paid medical experts, called Key Opinion Leaders (KOLs) that there is some legitimate scientific benefit to these treatments. Additionally, these procedures are mostly performed by non-surgeons who don’t really understand facial anatomy or see the consequences of their procedures. It is my opinion that if more surgeons operated on people that had threadlifts, then they would also speak out against the procedure. There were very good reasons that the FDA revoked its approval of the original threadlifts, and this newest version doesn’t provide a much better option. As I said last time, I believe that the only reason to get a threadlift would be to look rejuvenated for a special event that was a few weeks away and there would not be enough time to recover from a more effective, longer- lasting technique. Nonetheless, at the end of the day, physicians and other healthcare providers have an ethical duty to their patients to provide treatments that are safe and effective and to ensure that patients understand what they are consenting to. We should not be in the business or practice of selling things to patients for mere financial gain or to keep them from going somewhere else. Facial Artistry Gregory J. Vipond MD, Inc. 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