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What are PDO Threads?

PDO Threads are surgical threads made from Polydioxanone and is the material commonly used in surgical application treatments in Orthopedic and Cardiovascular uses for over 32 years. The PDO thread sutures used in aesthetic application are specifically designed to lift, tighten, and rejuvenate different aesthetic indications across the face and body. Once inserted below the skin, the PDO threads provide outstanding dermal retention with predictable and accurate results for skin volume deficits, scars, rhytids, and skin tightening as a result of increased collagen production in the area. The use of barbed sutures attach and lift the skin while improving the overall appearance of the skin.

PDO (Polydioxanone) thread sutures are a very safe and non-invasive procedure and are biodegradable that correct the outward appearance of aging skin, asymmetry, and moderate skin laxity.


What are the benefits of PDO Thread Treatments?

PDO Thread Lift Treatments allow for correction of skin laxity, tissue integrity, and improving the appearance of wrinkles, creping of skin, and folds across the face and body. There are (2) types of PDO Threads that are used; smooth threads and barbed threads.  Smooth PDO threads add volume to the tissues and creates collagen synthesis (increased collagen) in the inserted area.  Barbed PDO threads also create collagen synthesis in the treatment area but also attaches to the skin and creates a lifting effect to tissues upon activation of the threads. The benefits associated with the procedure are numerous due to the effects of increased collagen and include:

    • Improved skin tone, firmness of tissue, and complexion by increased collagen production.
    • PDO Threads help provide essential Amino Acids that is used to promote healthy skin:
      • Collagen is primarily made up of 3 nonessential amino acids: proline, glycine, and hydroxyproline.
      • Skin is primarily made up of the protein keratin: Proline is also the main component of keratin. Therefore, consuming proline-rich collagen will provide your body with the building blocks it needs to create new skin and greater cell turnover.
    • PDO Threads helps fight damage to Superficial & Dermal Tissue Layers.
      • Collagen acts as an antioxidant and endogenous enzymatic damage caused by free radicals while replenishing elastic fiber network and collagen depletion.
      • Collagen makes up 70% of your dermis, the middle layer of your skin which is responsible for elasticity and integrity of the skin.

Additional benefits associated with the procedures include:

    • No incision, no tieback of sutures, and no fixation points with no downtime
    • Typical procedure is only 30 minutes and only local anesthesia is needed.
    • Non-Allergenic: PDO threads do not lead to antigenic or pyrogenic reactions
    • Very little chance of edema, no bruising or scarring with quick recovery.
    • PDO threads have a semi-permanent effect, New PDO sutures are absorbable in 6-9 mos. and restrains the skin and facial wrinkles from the aging process that can last up to 1-2 years.
    • Immediate Improvement of facial wrinkles, neck lines, knee skin laxity, abdomen, arms or other body areas. Threads are not visible or felt by patient.
    • Certain PDO threads can be reversed (RF & IPL Light Energies).


How do PDO Threads work?

PDO threads are placed within tissue where the patient is experiencing indications where loss of collagen or tissue integrity is needed. PDO thread sutures are absorbable, nonallergenic and will be resorbed naturally within (6) months of implantation. When PDO threads are implanted the body sees the material as foreign matter and produces collagen in the implanted area as well as reinforcing tissues. The collagen effect (increased collagen) occurs during the (6) months it takes for the threads to slowly resorb and the effects of which will result in new collagen, elastin (form of collagen), and increase in Hyaluronic Acid (natural to the skin – increased hydration) that will last up to 12 months or more. For even longer lasting results from the procedure Empire recommends to have additional threads injected at different time intervals after the initial procedure.

Depending upon the type of PDO Thread used in the treatment there are additional benefits to patients.  Barbed (COG) PDO threads attach to the deeper dermis of the skin and when activated will lift, suspend, and give support to sagging skin in addition to the collagen benefits. As the Barbed Threads resorb the effect of lifting the skin remains the same as new collagen keeps supporting the lifting of the tissues. Smooth PDO Threads are used to support present tissue without the lift effect, they can be used to fill contrasting features of the face and body as well as supporting the barbed PDO Threads. As the smooth PDO Threads resorb the filling effect remains the same as new collagen replaces the surgical PDO suture.


How long do PDO Threads Last?

The effects of PDO Threads when placed properly in the mid to deep dermis will last 12-24 months in most individuals. Results vary based upon age, body metabolism, and damage to the tissue where the corrective threads are placed. PDO threads will slowly resorb for 3-4 months while creating collagen synthesis within the skin that replaces the immediate volume effect of the threads whether it be the lifting effect or rejuvenation. Because the collagen synthesis is continual while the thread slowly reabsorbs, the newly created collagen will last approximately 9-13 months in addition to the first 3-4 months of the thread first being placed.

For even longer lasting results from the procedure Empire recommends to have additional threads injected at different time intervals after the initial procedure. Many patients will use a maintenance time interval to keep enjoying the results achieved.


PDO Thread Training near me

There are not many educational institutions providing training on PDO Threads, however Empire Medical Training does provide this training nationwide throughout the year at major destination cities by board-certified physicians who have incorporated these procedures within their own practices.

Manufacturers may also offer training but most likely the trainers are mid-level healthcare providers who may be good at the placement of threads but may be lacking in the protocols and standard of care concerns associated with the procedure. It is our opinion that physicians are best suited to provide the initial training in PDO Thread procedures.


Who is a good candidate for a PDO Thread Treatment?

  • The best candidates are men and women between 30-65 who prefer not to have plastic surgery of the area indicated for treatment. Candidates should have some or all of the following to be considered as a patient:
    • Mild to Moderate flat & ptotic cheek tissue (cheeks have fallen creating nasolabial folds)
    • Mild to moderate jowling / descent of tissue in the lower third of the face
    • Mild to moderate brow ptosis (lowering of eyebrows due to aging)
    • Mild neck cutaneous bands – hypertrophic platysma bands or excess skin are not good candidates for the procedure
    • Crepey skin of the area of the face or body indications being treated
    • Mild to moderate ptosis of the body area being treated (breasts, thighs, buttocks)
    • Currently not taking any blood thinning medications; Omega 3's, Vitamin E, Ginko, Ginseng, Garlic, anti-inflammatories, steroids, or neuromuscular blockers.
    • Not allergic to lidocaine (methylparaben) or epinephrine
    • No active infections including colds, sinus infections, upper respiratory infections, cold sores, or skin rashes
    • No “medical at risk” conditions.


When will patients see results from a PDO Thread Treatment?

Every patient is different due to their age, lifestyle, biological processes, and the extent of their indication (skin quality, scarring, excessive laxity etc.).  Patients will observe some immediate benefits at the time of treatment but the true indication for treatment will occur 3-6 weeks post treatment.  Collagen synthesis takes approximately 3-6 weeks to occur from the increase of fibroblasts to the formation of collagen within the tissue area.  The barbed PDO Threads have more of an immediate effect as patients will see the lifting effect almost immediately when the threads are engaged and will see further improvement of the area 3-6 weeks post treatment.


How much do PDO Thread Treatments cost?

  • The price to patients is usually determined by the procedure being performed and not on a thread-by-thread basis.  The cost to patients for PDO Thread Treatments vary by patient and the extent of correction desired for the various facial and body indications.  Smooth PDO Threads are less expensive than barbed PDO Threads so many of the collagen and facial treatments are considerably less than HA dermal fillers and can range from $400.00 to $1,500.00 for a full face.  The most common smooth PDO Thread treatments include:
    • Full Face
    • Nasolabial Folds (NLF)
    • Lips (Vermillion Border and Perioral Area)
    • Marionette Lines
    • Undereye Indications
    • Perioral Indications (Corner Commissure, Smoker Lines)
    • Décolleté, Arms, Abdomen, and Hands
  • Barbed PDO Threads are used when a lifting effect is desired and are more expensive due to the cost of the threads and include smooth PDO Threads for the treatment areas.  Again, the cost is usually determined by body part area being treated and not by the number of threads and can range from $800 - $1500.  The most common barbed and smooth combination PDO Thread treatments are:
    • Mid/Lower Face Lift
    • Eyebrow (Lateral and Medial) Lift
    • Cheeks
    • Chin / Jawline
    • Neck Lift
    • Sagging Knees
    • Arms
    • Breasts


What are possible adverse events, risks and complications of a PDO thread treatment?

  • PDO Thread Lifting aesthetically is a minimally invasive procedure with a very high safety profile.  Newer PDO thread lifting techniques, types of threads, and the use of threads for aesthetic rejuvenation of the face and body areas make it very attractive to aesthetic practitioners. However, there are possible adverse events and complications that may occur with less trained physicians or inexperienced injectors:
    • Asymmetry: Corrected with additional threads
    • Bunching and Dimpling of the skin:  Easily corrected with pushing the thread forward to remove the dimpling and reactivating the thread.
    • Migration and Threads visible under the skin: If migration is observed before thread has been cut, remove the thread by simply pulling it out.  If thread migrates after the thread is cut, thread must be removed by creating a new pilot hole and pulling the thread out.
    • Sensitivity and/or numbness in the treated area: In rare occasions the cannula injection may come in contact with nerve endings that cause sensitivity or numbness, this condition usually subsides within a week or two after the procedure
    • Infection of the treatment area: very rare complication due to non-sterile technique or improper cleansing of the area.
    • Thread is Exposed at Insertion Point: Thread was not cut properly and not flush to the skin.  Excess thread is pushing against the skin causing inflammation, discomfort, and/or possible infection.  Easily corrected by reintroducing a new pilot hole and recut the thread.


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