Short-term Treatment Outcomes of Facial Rejuvenation Using the Mint Lift Fine

What are filling (volumizing) threads?

Facial aging prompts a shift in the demands for lifting procedures, transitioning from targeted improvements in younger individuals to overall facial contour enhancements as skin elasticity declines in later years. This paper examines the evolution of PDO volumizing threads, delineating their development from initial limitations to contemporary innovations aimed at addressing tissue deformation and maintaining thread integrity post-insertion. Categorizing these threads based on elasticity, shape, and functionality underscores their versatility and application nuances, catering to specific wrinkle correction, contour sculpting, and facial volume restoration. The discussion emphasizes the pivotal role of thread characteristics in achieving optimal outcomes while minimizing potential complications. By delving into historical contexts, mechanisms, effectiveness, and thread classification, this paper equips practitioners with a comprehensive understanding to make informed decisions in selecting threads for volumizing thread procedures. Recommendations for future research directions, including long-term safety assessments and patient-specific outcomes, seek to enhance the clinical utility and applicability of this analysis.

Ultrasound-guided thread lifting for the prevention of parotid gland and diagnosing parotid duct complications

BACKGROUND

Thread lifting is a common minimally invasive plastic surgery procedure. Parotid gland injury caused by thread lifting is a known complication; however, visual evidence of this complication is lacking.

OBJECTIVES

This study aimed to present cases of parotid gland injury by thread lifting shown using ultrasound and to discuss the importance of ultrasound detection of the location of the parotid gland before thread insertion.

METHODS

This study included eight patients diagnosed with parotid gland perforation and one with parotid duct injury due to threads from November 2020 to October 2022.

RESULTS

Six patients showed tenderness and swelling, three were asymptomatic, and one with duct injury showed severe swelling and pain. Although the severity and duration of symptoms have differed, we confirmed the progress of improvement with conservative treatment and confirmed ultrasound findings progressed.

CONCLUSIONS

Using ultrasound to detect the parotid gland's location before thread lifting might reduce the chance of parotid duct injury. Identifying immediate parotid duct or gland injury with ultrasound can help to act quickly for delayed pain or swelling and reduce the likelihood of additional complications.

Evaluating Pull-Out Strength of Barbed Suture In Vitro by Using Porcine Tissue and Polydimethylsiloxane (PDMS)

Using barbed thread lifting for facial rejuvenation has become popular these days due to its minimally invasive procedures with reduced complications. However, only limited studies regarding its mechanical properties for face suspension were published. The aim of this study was to evaluate suture-holding ability regarding its facelift property, and different specimens were tested in order to establish an in vitro model. Fresh porcine tissue and the synthetic material polydimethylsiloxane (PDMS) were selected to simulate human skin for evaluating barbed suture pull-out strength by the universal material testing machine. The results showed that the pull-out strength of barbs between different porcine tissues varied without consistency. By contrast, PDMS (30:1) showed more consistent pull-out strength in each testing, and the average maximum load force was close to porcine tissue. Furthermore, after submerging barbed sutures in PBS for 0 days (T0), 7 days (T7) and 14 days (T14), a trend of decreased average maximum load force, displacement and force of 1.5 mm/2 mm/3 mm displacement could be detected by in vitro testing with PDMS (30:1). These results provide support for using PDMS (30:1) to evaluate suture pull-out strength and holding/lifting capacities in vitro to obtain consistent and objective information for evaluating substantial equivalence of devices. The established in vitro method could be used for the future development of barbed thread lifting technology.

An Accelerated Aging Test to Compare the Thermal Stability over Time between the Mint Lift® and the MEDI ROPE

It is allegedly known that the thermal stability of the Mint Lift® (the Mint Lift® 17 and the Mint Lift® Fine; HansBiomed Co., Ltd., Seoul, Korea) over time might be lower as compared with thread-lifts processed through ultrasonic molding technology, such as the MEDI ROPE (WSM 19-03; CNG Co., Ltd., Gyeonggi, Korea), because the Mint Lift® undergoes a thermal treatment during the manufacturing process. We conducted this accelerated aging test to compare the thermal stability over time between the Mint Lift® and the MEDI ROPE. Thus, we measured the degrees of strength of the MEDI ROPE, the Mint Lift® 17, and the Mint Lift® Fine at 0, 2, 3, 4, 5, 7, 8, 9, 10, 11, 14, and 17 weeks. Between 0 and 14 weeks, the Mint Lift® 17 and the Mint Lift® Fine had significantly higher degrees of strength as compared with the MEDI ROPE (p < 0.05). At 0, 5, and 10 weeks, the Mint Lift® 17 and the Mint Lift® Fine showed no notable differences in microscopic findings as compared with the MEDI ROPE. At 20 weeks, however, the integrities of the Mint Lift® 17 and the Mint Lift® Fine were better preserved as compared with the MEDI ROPE. In conclusion, our results indicate that the Mint Lift® 17 and the Mint Lift® Fine might be less vulnerable to degradation over time as compared with the MEDI ROPE under thermal conditions.

A Meta-Analysis and Systematic Review of the Incidences of Complications Following Facial Thread-Lifting

BACKGROUND

Facial thread-lifting (FTL) has gained more popularity, but the incidences of complications following FTL remain controversial. We aimed to perform a meta-analysis and systematic review to estimate the incidences of complications and to compare the short- and long-term satisfaction rates following FTL.

METHODS

We searched PubMed, Web of Science, Embase and Cochrane library for eligible studies. The primary outcome was the incidences of complications following FTL. The secondary outcome was the satisfaction rate immediately and 6-month after FTL. The pooled incidences of complications and 95% confidence intervals were estimated using random-effects models.

RESULTS

A total of 26 studies were included in this meta-analysis. Swelling was the most commonly reported complication with a pooled incidence of 35%, followed by skin dimpling (10%), paresthesia (6%), thread visibility/palpability (4%), infection (2%), and thread extrusion (2%). Absorbable threads were associated with a significantly lower risk of paresthesia (3.1% vs. 11.7%) and thread extrusion (1.6% vs. 7.6%) than non-absorbable threads. Patients older than 50 years had a significantly higher risk of dimpling (16% vs. 5.6%) and infection (5.9% vs. 0.7%) than their younger counterparts. In addition, the pooled long-term satisfaction rate was significantly decreased compared to it immediately after FTL (88% vs. 98%).

CONCLUSION

Non-absorbable threads and older age of patients are associated with higher risks of complications. Therefore, we recommend a judicious use of non-absorbable threads and FLT in older patients. Furthermore, it should be discussed with patients preoperatively that the rejuvenation effect of FTL may not maintain in the long-term.

LEVEL OF EVIDENCE III

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 .

Expert consensus on the facial rejuvenation using the Mint Lift® in Koreans: Perspectives of plastic surgeons

BACKGROUND

It would be mandatory for plastic surgeons to consider anthropometric and anatomical differences between Asians and Caucasians in performing facial rejuvenation procedures using absorbable threadlifts in Asians.

METHODS

A consensus meeting was convened to discuss indications, treatment procedures, possible combination treatments, clinical outcomes, and safety of an absorbable polydioxanone (PDO) monofilament threadlift (Mint Lift® ; HansBiomed Co. Ltd., Seoul, Korea), for which the "Mint Aesthetics Expert Group" was organized with four Korean board-certified specialists in plastic and reconstructive surgery.

RESULTS

Our recommendations are as follows: First, the entry and exit points should be determined considering anatomical characteristics of the face (Level of evidence III). Second, treatment procedures may vary depending on indications (Level of evidence III). Third, short-term efficacy and safety of facial rejuvenation using the Mint Lift® have been well documented (Level of evidence I and III). Third, facial rejuvenation using the Mint Lift® may be combined with a liposuction (Level of evidence III).

CONCLUSIONS

Here, we propose expert consensus on facial rejuvenation using a novel absorbable PDO monofilament threadlift in Koreans. Of note, this is the only expert consensus prepared by board-certified specialists in plastic surgery in Korea. But more evidence-based efforts should be made to update and to expand the current recommendations.

Proposed Treatment Protocols for Facial Rejuvenation Using a Novel Absorbable Polydioxanone Monofilament Threadlift in Koreans: Empirical Perspectives of Aesthetic Physicians and Surgeons

Background

Aesthetic physicians and surgeons should consider differences in anthropometric and anatomical characteristics between Asians and Caucasians in performing facial rejuvenation procedures using absorbable threadlifts in Koreans.

Objectives

This paper was prepared to propose empirical treatment protocols for Korean aesthetic physicians and surgeons.

Methods

A panel of 5 Korean experts on the aesthetic uses of an absorbable polydioxanone (PDO) monofilament threadlift (Mint Lift; HansBiomed Co. Ltd., Seoul, Korea), thus termed as “the Mint Consensus Group,” was convened to recommend practical guidelines for empirical treatment with the Mint Lift.

Results

To summarize, our recommendations are as follows: First, the entry and exit points should be determined considering the anatomical characteristics of the face (level of evidence III). Second, treatment procedures may vary depending on indications (level of evidence III).

Conclusions

Here, the authors propose empirical treatment protocols for facial rejuvenation using a novel absorbable PDO monofilament threadlift in Koreans. But more evidence-based efforts should be made to update the current treatment protocols.

Level of Evidence: 4