Avoiding complications with Aptos sutures

Abstract

Background: Over the past decade, several methods of minimally-invasive thread-mediated lifting have been widely adopted in aesthetic surgery. Early use of these methods met with great enthusiasm, and threadlifting was often performed without sufficient regard for proper indications, controls, or outcomes. Soon after, reports of early-relapse ptosis, complications, and other undesirable side effects began to appear in the literature.Objectives: The authors describe the current best practices associated with threadlifting to ensure proper use and improved results.Methods: The authors retrospectively reviewed their collective case data, analyzing the results of 12,788 face and neck threadlift procedures in 6098 patients over 12.5 years.Results: The data showed inconsistent results and early relapse of deformity with the Aptos Thread and Aptos Thread 2G methods. Complications included thread visibility, migration, and exposure; linear bleeding along the needle course; skin dimpling; hypocorrection and hypercorrection; transient paresthesias; and a small number of cases of injury to major vessels, nerve branches, and parotid capsule/duct. As new devices were developed and the indications for each technique refined, soft tissue suspension became more effective and durable, and the incidence of complications correspondingly decreased in the latter part of the series.Conclusions: Threadlifting is a relatively modern trend in aesthetic surgery that demands a similarly novel approach from surgeons. When performed properly, threadlifting is associated with minor and infrequent complications and is a helpful clinical alternative to traditional facial rejuvenation techniques. © 2011 American Society for Aesthetic Plastic Surgery, Inc.