Since the dawn of modern cosmetic surgery over a century ago the game has been about getting the best results possible with minimum risk and minimum downtime.
For much of this time the gold standard approach has been the facelift, but with the advent of dermatologic lasers, fat transfers, fillers and “anti-wrinkle injections” in the 1980s cosmetic surgeons have turned their minds to broader strategies.
One such idea that emerged in the late 1990s was the barbed thread. Originally marketed as APTOS threads (for anti-ptosis: “against falling“), these threads were meant to provide mild-to-moderate elevation to dropped skin without excising any skin and without attaching the threads to any anchoring struture.
The concept was patented by the Russian Dr Sulamanidze, and for a time were alternately called Russian Threads.
But, like Marxism, the Russian thread is a beautiful concept in every respect except one - it doesn’t work.
APTOS threads were, overall, disappointing. I did some in 2004.
Thereafter we saw the emergence of the Contour Thread. This was in some respects similar to the APTOS thread system, but with the added strength of an anchor point against which the threads could lift skin.
Another great idea that worked worked modestly in some patients but overall not enough to justify the procedure. I did some in 2005 and 2006.
The problem with both the APTOS and the Contour systems was that they relied on little notches in nylon threads that were simply not strong enough to suspend skin and facial tissue.
It really should have been predictable. Plastic surgeons had understood for decades that quite extensive facelifting procedures had proven necessary to achieve lifts of any duration, so the flimsy barbs of an APTOS or Contour thread were never really going to be up to the task.
So why the attraction for such an approach? Aside from (relative) ease of application and reversibility, one major attraction was the avoidance of any scar.
Lifting with threads was popular because no-one had figured out how to lift with a loop without creating a scar.
When any doctor stitches up a wound, 9 times out of 10 the doctor is creating loops. Like tying a parcel, like tying up a bunch of sticks, we can tie the edges of a wound together using a loop. Loops work.
But, technically and practically, can a surgeon use loops to achieve a face lift, without creating a scar??
South African plastic surgeon Des Fernandes devised such a system: the Fernandes Loop. It involves a clever technique of using a spinal needle to bring a thread down from, say, the hairline, to the brow and then back up to the hairline witout creating a scar at the brow. This allows a surgeon to lift that point of the brow.
Yet this is the weakness of Fernandes’ system. I have used this system a number of times and have been frustrated that these loops lift a single point rather than a region. Hence, the lift looks uneven unless many such loops are applied thus distributing the force amongst the many loops.
A Peach breakthrough??
In early 2011 I conceived of a method that would allow me to create a loop under the skin without creating a scar.
The Peach Loop Lift
This unique approach has meant that at Peach we can offer a brow lift without a scar and without the puckering of the Fernandes lift. We can do it under local anaesthetic, and the effect is stronger than the Contour and the APTOS methods.
Talk to us in consultation, or email.
