Facial ageing in our population has three distinct components :
1. Gravitational Descent
2. Deflation
3. Skin Changes
Skin changes can be attributed to depletion in collagen layer which leads to wrinkle formation, which is more profound in Caucasian population.
Deflation which is typically due to loss of fat mainly and partly because of loss of bony skeleton is a feature of both Caucasian as well as asian ageing.
Gravitational descent however makes the major portion of ageing in asians. Gravitational descent is ptosis of facial structures because of effect of gravity on the supporting ligaments. Over a period of time these supporting elements become lax and lead to ptosis of structures. Malar pad of fat which in younger individual sits on malar prominence comes down so do other structures leading to jowl formation.
This component of facial ageing in asians makes them more suitable for lifting techniques like thread lift unlike their western counterparts who have profound loss of skin elasticity and are candidates for traditional facelift.
If we look at the history of development of these threads used for lifting we have come quite far since first threads APTOS were used by Russians and judicious use of modern threads can give a significant lift to the ptosed facial structures. They are welcome addition to our armamentarium.
APTOS threads which were designed and used by Russian surgeons lacked strength in the cogs and have been largely replaced with modern coned threads which are much more stable and provide long duration of lift. Some of the companies are also manufacturing absorbable threads.
The surgical technique for insertion of these threads has also evolved over a period of time. Initial free placement of APTOS like threads has largely given way to techniques in which thread is typically fixed at superior end to the deeper tissue by making small cut onto the skin. This even though partially invasive technique gives better results which are long lasting.
The procedure is conducted under local anesthesia as a day care and there is very little downtime as compared to the traditional facelift.
