Thread Insertion Research Articles

Reverse and antegrade vector thread lifting techniques: Correcting nasolabial and marionette lines.

This study evaluates the efficacy of reverse and antegrade thread lifting vectors in conjunction with thread selection for correcting nasolabial folds and marionette lines, aiming to enhance treatment precision and effectiveness. Three female patients aged 43, 48, and 53, presenting with primary concerns regarding nasolabial folds, underwent distinct treatment regimens utilizing various types of threads and vectors. Additionally, video demonstrations were recorded to showcase the procedural techniques employed in each case. The outcomes of the thread lifting procedures demonstrated significant improvements in the correction of the nasolabial fold and marionette line. Innovative thread insertion techniques involve entry points above the zygomatic arch and threading toward the temple hairline for lateral face lifting. These utilize barbs to pull skin and underlying tissues. The reversal technique involves inserting threads in a criss-cross pattern, forming a fibrous structure that may prolong the duration of results. Various thread combinations, considering factors such as composition, thickness, and barb size, provide customized procedures. This research introduces clinical applications, including temple area hairline lifting for nasolabial fold and marionette line correction, reverse vectors targeting nasolabial folds and marionette lines, and antegrade approaches from the lateral side.

Multicentric observational study of the possible side effects of the COVID-19 vaccine in relation to absorbable thread insertion.

Coronavirus disease 2019 (COVID-19) vaccination programs in Europe began in December 2020, and as the number of vaccinated people increased, more information emerged about the possible side effects of vaccines. Recently, some reports appeared around the association of adverse reactions following soft-tissue filler injections and the COVID-19 vaccines. This fact raised the concerns of esthetic practitioners regarding the possibility of the association of the COVID-19 vaccine and adverse effects in other esthetic treatments. Many of us wonder if botox injection, biostimulation, or other procedure could trigger the same or other adverse reactions after the COVID-19 vaccination. Many colleagues postpone esthetic treatments, canceling the appointments. The objective of our investigation was to understand if any adverse reactions have been observed in the patients who underwent threads implantation before and after the vaccination. Four medical centers have collected the data of the patients treated with absorbable threads before the vaccination and after vaccination for COVID-19. The dossiers of 190 patients with a mean age of 50.4 years were evaluated. Three questionnaires were administered 1 week, 1 month, and 3 months after thread implantation. There were no adverse reactions in the groups of patients under monitoring. Only one patient presented signs of inflammation and infection, but they are more probably attributable to the contamination during thread insertion. No patients treated with absorbable threads developed adverse events in relation to the COVID-19 vaccine. The only case of inflammation is attributable probably to the contamination of the thread during the procedure.

What Are the Factors That Enable Thread Lifting to Last Longer?

Thread-lifting traditionally addressed aging-related skin laxity by leveraging precise thread placement and traction. However, recent advancements, notably cog threads, expanded its application to younger patients seeking facial contour refinement. These newer threads effectively lift sagging areas and refine facial contours, broadening the procedure’s appeal. Challenges arise in selecting threads due to variable physician preferences and patient needs. Clear indications for thread efficacy are vital for credibility and tailored selection. Thread choice depends on tissue laxity, necessitating lighter threads for minimal laxity and stronger ones for significant sagging. However, no single thread universally suits all cases. Combining different threads is favored for optimal outcomes and minimizing side effects. Excessive traction post-procedure may lead to prolonged discomfort and skin irregularities. Post-procedural tension adjustments through massage remain debated, potentially conflicting with minimally invasive principles. Understanding thread characteristics guides tailored selection, considering patient conditions and procedural goals. This comprehensive understanding extends beyond specific products, aiming for optimal outcomes in thread-lifting procedures. Key factors influencing outcomes encompass thread materials, thickness, cog shapes, insertion depth, lifting vectors, and absorbable thread expiration dates.

SMAS repositioning technique utilizing cog thread: Anatomical perspectives.

Face-lifting surgeries were once common among individuals over 60 years old due to skin laxity, but recent trends favor thread lifting in this age group. Understanding dynamic changes in facial anatomy during postural shifts is essential. Fresh cadaver studies have demonstrated the passage of threads through the superficial musculoaponeurotic system (SMAS) layer, confirming the efficacy of the technique. Proper insertion depth targeting SMAS repositioning, rather than superficial skin layers, is crucial. The natural movement of tissues secured by thread (N-Cog and N-Fix, N-Finders Inc., Korea) insertion results in lifting effects. However, complications may arise if threads affect deeper facial muscles, leading to discomfort. Fibrous septa play a significant role in guiding thread placement, with different densities influencing thread maneuverability and tissue response during lifting. Procedures targeting SMAS repositioning using threads aim to maintain the new position of relocated tissues. Understanding structural variations in facial regions informs thread selection and placement. Aligning threads with tissue movement and the intended SMAS layer positioning is vital to prevent complications. Balancing thread insertion depth and tissue traction is critical for successful outcomes. Modern thread lifting techniques prioritize SMAS repositioning, enhancing lifting effects while ensuring procedure safety and efficacy.

Incomplete insertion of pedicle screws triggers a higher biomechanical risk of screw loosening: mechanical tests and corresponding numerical simulations.

Screw loosening is a widely reported issue after spinal screw fixation and triggers several complications. Biomechanical deterioration initially causes screw loosening. Studies have shown that incomplete insertion of pedicle screws increases the risk of screw breakage by deteriorating the local mechanical environment. However, whether this change has a biomechanical effect on the risk of screw loosening has not been determined. This study conducted comprehensive biomechanical research using polyurethane foam mechanical tests and corresponding numerical simulations to verify this topic. Pedicle screw-fixed polyurethane foam models with screws with four different insertion depths were constructed, and the screw anchoring ability of different models was verified by toggle tests with alternating and constant loads. Moreover, the stress distribution of screw and bone-screw interfaces in different models was computed in corresponding numerical mechanical models. Mechanical tests presented better screw anchoring ability with deeper screw insertion, but parameters presented no significant difference between groups with complete thread insertion. Correspondingly, higher stress values can be recorded in the model without complete thread insertion; the difference in stress values between models with complete thread insertion was relatively slight. Therefore, incomplete thread insertion triggers local stress concentration and the corresponding risk of screw loosening; completely inserting threads could effectively alleviate local stress concentration and result in the prevention of screw loosening.

Automatic Thread Insertion Kit Sewing (ATIKs) Device for Vocational Fashion Design Student: Practical Sewing Application

The incorporation of technology is a consistent aspect of education, which is widely advanced through teaching and learning (T&L) in the industrial revolution 4.0 (IR 4.0) education technology. In this study, an automatic thread insertion set for sewing (ATIKs) was developed. The ATIKs device improves students' understanding and facilitates the process of sewing in fashion design subjects for high school curriculum. The device was programmed using an Arduino microcontroller board and open source Arduino software (IDE). The CDIO model is used as the basis for product development, which includes the steps from conception to design, implementation, and operation. The development for this product consists of the main components standard needle size, automatic thread, Arduino UNO R3, stepper motor, coil, and Arduino coding to control the movement. In addition, this product is relatively portable with its dimensions of 7 x 7 x 10 cm. A qualitative research method was applied using a list of interview protocols validated by five professional experts in the field. Based on the open-ended questions, the experts indicated that this product facilitates the criteria of the T&L process, improves understanding of the use of the thread needle, and increases student confidence in the sewing process. In the future, this kit could be integrated into an automated control system. This research development can help develop teaching tools that further increase student safety and improve student skills and cleanliness in handling sewing tools during hands-on work.

Infraorbital Rejuvenation Combined with Thread-Lifting and Non-cross-linked Hyaluronic Acid Injection: A Retrospective, Case-Series Study

BackgroundInfraorbital aging develops during the natural aging process. Various treatment options offer unique benefits, accompanied by diverse side effect profiles, and can be synergistically combined to optimize results. This study aimed to evaluate the efficacy of a comprehensive approach involving non-cross-linked hyaluronic acid injection and smooth absorbable PPDO (poly p-dioxanone) thread insertion for infraorbital rejuvenation.MethodsThis retrospective case series study enrolled ten female patients with infraorbital aging from March 2022 to April 2023. Clinical outcomes, patient satisfaction, and adverse events were assessed at 1, 3, and 6 months posttreatment.ResultsThe median Global Aesthetic Improvement Scale scores evaluated by the operator and blinded evaluator were 1.70 ± 0.42 and 1.80 ± 0.35, respectively, at six months posttreatment. The median Allergan Infraorbital Hollows Scale determined by the operator was 1.15 ± 0.34 at six months posttreatment, whereas the scores evaluated by the blinded evaluator were 1.15 ± 0.53. At six months after treatment, 50% of patients were satisfied, and an additional 40% reported strong satisfaction with the clinical improvement following treatment. No serious adverse events, such as infections, lumps, irregularities, Tyndall effect, hematoma, or skin necrosis, occurred during the treatment period.ConclusionsThe combination of PPDO thread insertion and non-cross-linked hyaluronic acid injection yielded satisfactory and effective clinical outcomes with no occurrence of serious adverse events for infraorbital rejuvenation. We anticipate that this study will contribute to the advancement of novel treatment options for infraorbital aging.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Efficacy and mechanism of Xuefu Zhuyu Decoction on model rats of coronary heart disease with heart blood stasis syndrome based on metabolomics

This study investigated the effects of Xuefu Zhuyu Decoction on myocardial metabolites in a rat model of coronary heart disease with heart blood stasis syndrome and explored the therapeutic mechanism of blood circulation-promoting and blood stasis-removing therapy. SD rats were randomly divided into a sham operation group, a model group, a Xuefu Zhuyu Decoction group(14.04 g·kg~(-1)), and a trimetazidine group(5.4 mg·kg~(-1)). The sham operation group underwent thread insertion without ligation, while the other groups underwent coronary artery left anterior descending branch ligation to induce a model of coronary heart disease with heart blood stasis syndrome. Three days after modeling, drug intervention was performed, and samples were taken after 14 days of intervention. General conditions were observed, and electrocardiogram and cardiac ultrasound indices were measured. Hematoxylin-eosin(HE) staining and Masson staining were used to observe tissue pathological morphology. The enzyme linked immunosorbent assay(ELISA) was used to measure the levels of triglyceride(TG) and total cholesterol(TC) in the serum. Ultra high performance liquid chromatography-quantitative exactive-mass spectrometry(UHPLC-QE-MS) technology was used to screen differential metabolites in myocardial tissue and conduct metabolic pathway enrichment analysis. The results showed that Xuefu Zhuyu Decoction significantly improved the general condition of the model rats, reduced heart rate and ST segment elevation in the electrocardiogram, increased left ventricular ejection fraction(LVEF) and left ventricular fractional shortening(LVFS), and decreased left ventricular internal diameter in diastole(LVIDd) and left ventricular internal diameter in systole(LVIDs). HE staining and Masson staining showed that Xuefu Zhuyu Decoction effectively alleviated myocardial tissue structural disorders, inflammatory cell infiltration, and collagen fiber deposition in the model rats. ELISA results showed that Xuefu Zhuyu Decoction effectively regulated serum TG and TC levels in the model rats. There were significant differences in the metabolic phenotypes of myocardial samples in each group. Fourteen differential metabolites were identified in the Xuefu Zhuyu Decoction group, involving five metabolic pathways, including arginine and proline metabolism, glycerophospholipid metabolism, aminoacyl-tRNA biosynthesis, ether lipid metabolism, and alanine, aspartate, and glutamate metabolism. Xuefu Zhuyu Decoction improved cardiac function and myocardial structural damage in the rat model of coronary heart disease with heart blood stasis syndrome, and its biological mechanism involved the regulation of lipid metabolism, choline metabolism, amino acid metabolism, energy metabolism, and protein synthesis pathways.

Experimental investigation of biostimulatory effects after polydioxanone thread insertion in a pig model.

Polydioxanone (PDO) threads have been widely used to tighten and lift the facial soft tissue. This research aims to determine the collagenation and inflammation changes that occur in the adipose tissue over time when different types of threads are implanted. Three threads types, PDO, poly glycolic-co-lactic acid (PGLA), and nylon, were inserted in the subcutaneous fat of 12-month-old Bama miniature pigs. Collagen production and inflammatory response were evaluated by hematoxylin and eosin and Masson trichrome staining at 1, 4, 12, 24, and 48 weeks. The integrity of the PDO thread lasted up to 24 weeks with mild inflammation and collagen production. The PGLA thread integrity lasted until 12 weeks and had a strong inflammatory response. The nylon thread's integrity was maintained for 48 weeks and showed minor inflammation and collagen production. Our data suggest that PDO thread is the best choice for clinicians, as it has a mild action process with minimal irritation, moderate collagen production, a reasonable explanation time, with obvious bridging fibrous tissue, and thickening action for the superficial fascia.

Evaluation of the Efficacy of Polydioxanone Threads versus Autologous Plasma Gel for Infraorbital Rejuvenation

Abstract Introduction Infraorbital dark circles refers to presence of darkness of the infraorbital region. Infraorbital dark circles possess no medical harm but signifies cosmetic and psychological burden. Various therapeutic modalities are prescribed for management of infraorbital dark circles without conclusive results. Aim of the Work compare between the efficacy and safety of PDO monothreads versus autologous plasma gel injections for infraorbital rejuvenation. Patients and Methods 40 patients with infraorbital dark circles were included. Patients under went plasma gel injections on the left eye, PDO threads treatment on right eye. All patients were assessed using 3D Antera camera before and after 1 month and 6 months of treatment. Results Both treatment modalities revealed marked cosmetic improvement. Both treatments showed marked response yet results on left eye were superior as regards wrinkle's size, indentation index, texture roughness and average melanin concentration. PDO thread insertion possessed marked significant improvement to wrinkle's size followed by indentation index then texture roughness and average melanin concentration. Plasma gel injection possessed marked significant improvement to wrinkle's depth followed by wrinkle's size then indentation index and finally texture roughness and average melanin concentration. Conclusion Both PDO thread insertion and plasma gel injection exerts beneficial effects in improving periorbital wrinkles and hyperpigmentation. However, plasma gel revealed more potent effects compared to PDO threads.

Open Pilot Study on the Rejuvenation Effect of Absorbable Threads in the Genital Area.

We propose a new method of genital rejuvenation based on absorbable thread insertion. In this study, we aimed to assess the safety and efficacy of particular absorbable threads made of P (LA/CL), the so-called Nano Spring 7, for vulvar rejuvenation. The study was conducted in two parts: the first by anatomical dissection and the second by clinical study. The first part of the study clarified safety and efficacy of thread insertion in this anatomical area. During the second part, 19 patients underwent Nano Spring 7 absorbable thread insertion in the subcutaneous layer of the labia majora to improve esthetic parameters and were followed up after 7, 30, 90, and 180 days. We evaluated outcomes using four different patients' questionnaires and one investigator's questionnaire. The anatomical dissection defined the correct anatomical layer of threads implantation and the subcutaneous structures allowing for the thread anchoring. All the patients completed the study. The patients' and investigators' subjective evaluations during follow-up and at the end of the study were very positive. All the patients showed a decrease in discomfort sensations related to the labia majora conditions and aesthetic improvement in the vulvar area and recommended the treatment to their friends. The use of absorbable threads is an innovative, safe minimally invasive approach to genital rejuvenation.

Fiber-Reinforced Clay: An Exploratory Study on Automated Thread Insertion for Enhanced Structural Integrity in LDM

This exploratory study examines the potential of combining clay and natural fiber material in liquid deposition modeling (LDM) to enhance the structural integrity of the soft-bodied print during the additive manufacturing (AM) process. For this purpose, a custom extruder module and a support structure have been developed as novel additions to the delta 3D printer that allows for automated fiber thread insertion into the deposit clay body and stabilize the 3D print during drying. This study explores material compatibility and durability in the liquid state and the material strength of the sintered ceramic body after pyrolysis of the natural fibers. The findings demonstrate the feasibility of an automated process for thread insertion and tensioning control to stabilize and control the 3D print until drying and showcase the versatile design possibilities of this method. The study may serve as a baseline for future research on fiber-reinforced clay printing in the construction industry and related disciplines.

Medical nose reshaping: current evidence behind techniques

The nose, centrally located on the face, plays a crucial role in facial aesthetics. Any imbalance in its length, width, tip position, or a gross deformity, such as dorsal hump and deviation, can significantly affect the overall facial harmony, which is thus a major concern for patients. When it comes to minor deformities, they have been treated with hyaluronic acid, toxin injection, and thread insertion since 2005. This study has originally been carried out to review the published medical literature on the non-surgical techniques for Medical Nose Reshaping (MNR): a PubMed search was carried out in December 2020 using the search terms: “Nose [and] filler”, “Nose [and] botulinum toxin” and “Nose [and] thread”. A large number of studies were identified and reviewed, and it was found that rhinoplasty remains the gold standard to correct nose defects; nevertheless, MNR is gaining popularity due to its minimal invasiveness, short downtime, and the market availability of different injectables, toxins, and threads. This study aims to provide an evidence-based approach to guide the use of non-surgical techniques for MNR by reviewing published medical literature and drawing on the authors’ experience.

Relationship between thread depth and fixation strength in cancellous bone screw

BackgroundClarifying the effect of each parameter of screw design on its fixation strength is critical in the development of any type of screw. The purpose of this study was to clarify the relationship between the thread depth and fixation strength of metal screws for cancellous bone. MethodsNine types of custom-made screws with the only changed variable being the thread depth were manufactured. Other elements were fixed at a major diameter of 4.5 mm, a thread region length of 15 mm, a pitch of 1.6 mm, and a thread width of 0.20 mm. The pull-out strength and insertion torque of each screw were measured for each of two foam-block densities (10 or 20 pcf). The correlation between the thread depth of the screw and the mechanical findings were investigated with single regression analysis. ResultsRegardless of the foam-block density, the pull-out strength significantly increased as the thread depth increased from 0.1 mm to 0.4 mm; after that, the increase was more gradual (p < 0.01, respectively). The relationship between the thread depth and insertion torque was similar. In addition, the insertion torque tended to be more strongly affected by screw depth than the pull-out strength (2.6 times at 20 pcf and 1.4 times at 10 pcf). ConclusionsThe pull-out strength of 4.5-mm-diameter metal screws in a cancellous bone model was found to be biphasic, although linearly correlated with the change in screw depth in both phases. The boundary of the correlation was 0.4 mm regardless of the density of the bone model, with the effect of screw depth on pull-out strength beyond that being small in comparison.

Polydioxanone thread insertion in combination with radio frequency treatment does not exhibit synergistic efficacy: Animal study with pigs.

Polydioxanone (PDO) thread insertion and monopolar radio frequency (RF) treatment are two common antiaging modalities. The efficacy and safety profile of PDO in combination with RF treatment is unknown. To investigate pathological changes in skin in response to PDO+RF treatment in an animal model. PDO threads were implanted into the skin of young white domestic pigs. RF treatment was performed on the PDO insertion sites 2weeks after the PDO procedure. Skin biopsies were taken at 6 and 12weeks after PDO for histological examination. Both PDO and PDO+RF treatments induced the fibrous granular formation surrounding the PDO threads. There were more exaggerated inflammatory responses such as development of nodular panniculitis and adipocyte necrosis in the skin at 6weeks after PDO+RF as compared with PDO alone, which was largely resolved at 12weeks. All treatments led to thickened and replicated interlobular septa, many of which were connected to the collagenous network in dermis. In all treatment groups, the cross-sectional areas of the dermal collagenous bundles were significantly increased at both endpoint times as compared with the baseline level. PDO+RF treatment did not lead to increases in neocollagenesis as compared with PDO or RF treatment alone. Our data showed that RF and PDO induced comparable levels of collagen remodeling in the skin. PDO+RF treatment did not exhibit evident synergistic effects of derma collagen remodeling but rather amplified the inflammatory responses in the skin. Therefore, combined treatment is not recommended.

Thread Lifting of the Jawline: A Pilot Study for Quantitative Evaluation.

Introduction:The facial aging process produces changes that are characteristic of the superficial and deep fat framework and skin layers. Subdermal suspension with threads enables the sagging tissues to be lifted by means of a minimally invasive, closed procedure without surgical dissection. This observational study has been carried out on the basis of standardized tridimensional photographic analysis and measurement, aimed at determining objective, repetitive, and reliable evaluation of the soft tissue suspension technique.Materials and Methods:Eight participants were enrolled in this pilot study presenting with mild to moderate ptosis of the jawline tissues. Patient photographs were taken before (t0), immediately after threads implantation (t1), and at the following visit (t2). Each image captured before thread insertion was registered by the software and surface linear lengths in between the mentioned points were calculated.Results:The result showed an overall average improvement in the “tragus-to-marionette distance” (C-A) and the “tragus-to-jowl distance” after a mean follow-up time of 8.16 months (t0-t2). All analyzed parameters improved significantly (P < 0.05) at t1 and at t2 with respect to t0.Conclusions:This pilot study suggest that facial tissue suspension by means of poli-lactic/poli-caprolactone threads is safe and effective in treating skin flaws that affect mild-to-moderate ptosis of the jawline up to 8 months.

Comparative study between the efficacy of subcision versus subcision with poly-L-lactic acid threads in facial atrophic scar treatment

Background Subcision is defined as an office surgical technique that has been considered for treatment of atrophic scars. Thread insertion is a well-known effective therapy for face lifting. Recently, some studies proved their efficacy in atrophic facial scar treatment. Aim To evaluate the safety and efficacy of subcision versus subcision with poly-L-lactic acid (PLLA) threads in treatment of facial atrophic scars. Patients and methods Thirty patients with facial atrophic scars were included. They were divided into two groups, group I treated with subcision and group II treated with subcision and PLLA threads. All patients were evaluated clinically after 3 months. Results After 3 months, in group I, the mean clinical improvement was 58.40±20.52. In group II, the mean clinical improvement was 68.40±13.88. The degree of improvement of group II was better than group I but did not show a statistically significant difference (P=0.796). The side effects were very minimal in both groups. Conclusion For atrophic facial scar treatment, combined subcision with PLLA thread insertion seems to be more effective than subcision alone.

Following a new technique for thread insertion

Thread lifts are an increasingly prevalent non-surgical procedure. Dr Irfan Mian details a new technique that has promising indications for longer results and improved patient satisfaction, as well as the dangers that needles may bear

Novel technique for infraorbital groove correction using multiple twisted polydioxanone thread.

The infraorbital groove can be corrected by lower blepharoplasty, microfat grafting, and soft tissue filler injection. Recently, multiple twisted polydioxanone threads were developed for facial rejuvenation. This study aimed to examine the efficacy and associated risks of the use of new synthetic threads for infraorbital groove correction. From March 2018 to June 2019, 40 patients (mean age: 43.4years; range: 25-56years) underwent transcutaneous multiple twisted thread insertion to correct the infraorbital groove. Three threads were inserted along the infraorbital groove on each side. The outcomes were assessed based on a comparison between preprocedure and postprocedure findings. Barton's grading and Global Aesthetic Improvement Scale scores were assessed by two physicians. Patient satisfaction with the aesthetic outcome of the procedure was evaluated at the end of the procedure and after 3months. Ultrasonographic evaluation was performed to confirm that the threads had been properly placed. The anatomical layer in which the threads were placed was evaluated in a cadaveric study. The mean Barton grade improved significantly (P<.001) without decline throughout the 12-week period. Improvement was found in all patients who were designated with a score >2 ("improved"). More than 77.5% of the patients were satisfied with the outcomes, and the rest of the patients reported some extent of correction with little satisfaction. The findings indicate the benefits of the multiple twisted polydioxanone thread insertion in the treatment of patients with infraorbital groove without septal protrusion. This evaluation raised no major safety concerns.

Doppler ultrasound-guided thread lifting.

Although there are various techniques of thread lifting, most of these techniques require anchoring of the threads at the temple area. However, the frontal branch of the superficial temporal artery (FBrSTA) is located in the temple area and a detour pathway should be created for thread insertion to avoid vascular complications. We aimed to determine the relationship between the FBrSTA and the hairline using real-time Doppler ultrasound. Doppler ultrasound was used to detect the FBrSTA pathway, and the relationship between the hairline and the FBrSTA was analyzed. After confirming the arterial pathway, thread lifting was performed in patients, and complications related to the entry point and insertion of the threads were evaluated. Patient satisfaction was evaluated immediately after the procedure and 3months later. This study included 50 patients (45 women and 5 men; age: 51 [range 26-71] years) who underwent thread lifting in a single institution from January to May 2019 after Doppler ultrasound-guided detection of the FBrSTA. No vascular complications were noted in all patients. Our findings suggest that Doppler ultrasound can be used to detect the FBrSTA at the temple area to avoid vascular complications during thread lifting.