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Quill Thread Lift

Feather thread lift is a suspension lift surgery first published by a Soviet Union physician. Because the initial material of threads are unable to easily integrate with the skin and soft tissue, thread puckering and inflammation, as well as other complications, are frequently reported; this surgery has not been acknowledged or adopted by majority of specialty plastic surgeons over the past years. Nevertheless, the evolution and improvement of the surgery and the approval of one double-stranded (direction) absorbable Quill SRS thread by the Food and Drug Administration (FDA) offer scientific evidence and confirm the safety of such surgeries. Although unable to provide the long-term results similar to real facelifts, if using the aforementioned thread as the supplementary sutures for facelifts or as revision intended to mend the shortcomings of a previous facelift, Quill thread lift is still able to show certain effects.

A minimally invasive embedding lift, this procedure is different from ordinary facelifts. It merely relies on the particular traction and binding force of the Quill thread and the tension of thread materials to lift and suspend the loose facial skin upward by embedding the threads at multiple points and directions. It is done by first making an incision of approximately 1 cm in the scalp above the temple and then passing the Quill thread via a specific long needle subcutaneously from the scalp directly to the nasolabial or marionette wrinkles. Next, the direction of the Quill thread is reversed to return to the original scalp starting point, which is stretched and fixed to the deep fascia. This way, the distal skin and soft tissues may be elevated in the posterior–superior direction. The number of threads embedded is determined by the range and degree of skin laxity. Commonly, an average of 4–5 Quill lines is necessary for each cheek to provide sufficient support and tightening. Meanwhile, the distal skin will only be left with a few needle holes or dimples that do not need to be sutured and will return to a natural state within a week. The Quill threads embedded below the skin will be automatically absorbed by the body within approximately 6 months. Nevertheless, this does not actually amount to a facelift because there is no removal of any loose skin. Because the Quill thread will be absorbed in approximately a year, the duration and stability of the result is relatively short-lived (averaging approximately 6 months to a year). Therefore, it is primarily used as a secondary procedure to supplement other facelifts and is seldom offered as a primary surgery option now.

Surgical conditions

Duration

0hr
  • Type of anesthesia: IV sedation + local anesthesia
  • Type of incision: An incision of approximately 1 cm in the scalp within the hairline. Approximately 4–5 needle holes on the cheek
  • Recovery: 3–5 days
  • Removal of sutures: 7–10 days

General instructions

No food and water on the day of surgery

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  • Rubbing or pressing of the face should be avoided for 1 month postoperatively.
  • Smoking, alcohol consumption, or irritating food should be avoided for 2 months postoperatively.
  • Facial massage or irritation should be avoided for 3 months postoperatively.
  • Filler or fat injection in the facial area where the thread is embedded should be avoided for 6 months postoperatively.

Ideal candidates

  • Patients with mild to moderate cheek or nasolabial fold sagging.
  • Patients who have previously undergone a facelift without an obvious result.
  • Young patients with premature skin laxity due to facial bone reduction.
  • Patients unable to accept a traditional facelift such as SMAS or MACS lift.
  • Patients unsatisfied with non-surgical Ulthera or Thermage therapy and willing to boost the effects by a micro-invasive procedure.
  • Supplementary lift threads for any facelift.

Potential complications

  • Temporary facial stiffness or numbness
  • Incomplete correction
  • Foreign body reaction, thread knot exposure
  • Poor healing of the scalp wound

Surgical advantages

  1. Extremely minimally invasive with rapid recovery.

  2. No need for major surgery to obtain a better tightening result than what an Ulthera or a Thermage can offer.

  3. No risk of nerve injury.

  4. Able to conduct thread lifting from different directions and parts depending on patients’ requirements and not subject to incisions.

  5. Able to be repetitively performed.

  6. Only needle holes rather than scars are left by the procedure.

Surgical drawbacks

  1. Because there is no skin removal, the surgical effects are short (1–2 years on average).

  2. There may be foreign body reaction of the thread or thread extrusion.

  3. Distal Quill thread needle hole may incur temporary cheek dimples or shadows.

  4. It can only improve the area of skin sagging but is unable to provide comprehensive results such as those of traditional facelift surgery.

Possible procedures in conjunction