Thread lift requires patient selectivity

Successful Aptos thread lift facial rejuvenation requires knowing where to use this technique and where not to, according to a Florida-based plastic surgeon.

"It's really very simple," says Jeffrey M. Hartog, M.D., a plastic surgeon in private practice in Winter Park, Fla. "I find Aptos threads helpful in producing some three-dimensional fullness in the cheek and midface area. But I haven't found them to be very effective in the jowl and not at all effective the neck."

Based on his experience in treating 29 patients over a little more than a year, Dr. Hartog says the Aptos thread lift can provide subtle improvement in the cheek and midface.

Accordingly, he advises physicians to counsel patients regarding realistic expectations.

"It's important not to oversell the procedure," Dr. Hartog says. "If patients are expecting a true facial lift, my opinion is they're not really going to get it from the Aptos threads. Many patients will walk into the office and pull back on their cheeks and jowls, essentially mimicking what they are trying to achieve from a facelift procedure. Whenever my patients who are asking for the Feather Lift (Kolster Methods Inc./KMI) or Aptos threads do that, I'm very clear in explaining to them that they're not going to get that type of effect from these threads."

Good results

When used properly, however, the Aptos lift provides good results with minimal complications.

"It is done under local anesthetic," Dr. Hartog says. "The only kind of problems I've had is that sometimes the tips of the threads can be seen immediately below the skin."

When this occurs, says Dr. Hartog, "One must uncover the tip with a tiny incision, grab the tip and cut it a little shorter."

Technique recommendations

To perform the Aptos lift procedure, he recommends using an epidural needle, passing it immediately beneath the skin in a snakelike fashion.

"Then the thread is passed into the needle, and the needle is pulled out," he says. "Then one must simply clip the ends of the thread."

When it comes to patient selection, says Dr. Hartog, "The best patients are those who have fairly early and subtle flattening of the cheek and infraorbital area - those who are either not ready or not really candidates for a facelift or midface lift procedure. It can buy them some time by improving the three-dimensional fullness of the cheek, particularly when one combines it with procedures such as fat injections in the nasolabial folds."

Another advantage the Aptos lift can provide is durable results. In patients he's treated thus far, Dr. Hartog says, "I don't see any sign of sagging at this point. There are some people who claim that the threads may have some preventative aspect by maintaining some support within the tissues, and due to the scar tissue that forms around the thread."

Dr. Hartog reports no experience that would support or refute such a claim. However, he does have limited experience treating the neck area.

"If one thinks about what these threads do, the little barbs within the thread engage the tissues and create a bunching together rather than a true lift. For many patients, where the neck sags they really need to have the muscle, particularly the muscle layer underneath, tightened and lifted. These threads don't do that because they're not attached to anything. They're just placed within the tissues," he explains.

Conversely, he's had some success in treating small aesthetic concerns on the forehead with Aptos threads.