Hanging by a Thread: Choosing the Right Thread for the Right Patient

Abstract

Submit Manuscript | http://medcraveonline.com There are three main types of threads currently available; polydioxanone (PDO), polylactic acid (PLA) and polycaprolactone (PCA). PDO threads have been around the longest and are made of a synthetic biodegradable polymer that has been used in surgery for many years. PDO threads are absorbed into the body over 6 months by hydrolysis and work by triggering fibroblasts to produce more collagen in a targeted area. There are three main types of PDO threads used; mono, cog and screw threads. Mono threads are smooth without barbs and are anchored to a point on the face or the scalp. They mainly tighten the skin and provide a small amount of lift [2]. Cog threads have barbs which hook onto the skin to provide support and lift the sagging tissue. Screw threads have one or two intertwined threads around the needle and provide good volume restoration to sunken areas of the skin. The production of collagen around the threads and their barbs helps to restore volume and improves the skin texture and elasticity resulting in a natural aesthetics outcome. After PDO threads, PLA threads were developed. They are made from a biocompatible polymer derived from lactic acid that has been used in many applications such as orthopaedic pins and sutures. PLA threads are resorbable and regenerate collagen over a longer time than PDO threads. PLA threads use cones to hook to the tissue and increase the volume of saggy areas therefore helping to restore shape to the facial area as well as providing a lift. PCA threads are the newest threads and are bio-absorbable, monofilament suspension threads of synthetic origin (caprolactone) [3]. They work by regenerating collagen over a longer time than PDO and PLA threads. They leave behind a collagen structure that provides support for the skin, tightens the skin and prevents it from sagging. Due to the fibrotic reaction caused by the threads, the lifting and stretching action will