The use of tension threads in aesthetic medicine, both facially and corporally, is a practice dating back to 1956, with the publication by Buttkewitz, which described a correction of the nasolabial fold using a nylon thread. Today, the emergence of different types of tension threads, their self-supporting and resorbable nature has translated into increased demand and use of this treatment modality.

The use of tension threads as an aesthetic-medical approach seeks to reposition tissues that, with the passage of years, suffer sagging secondary to chrono-aging and photoaging. In the case of the face, these changes are perceived as a sad-looking face. With the application of tension threads, we seek to reverse this sad appearance by producing a more youthful and harmonious face.

Moreover, with current technological developments, not only the mechanical effect of tension threads achieves tissue repositioning, but the thread materials tend to promote the formation of new collagen fibers and controlled fibrosis, which provides greater tissue firmness in the medium and long term, further improving the external appearance of the skin.

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Will I Get Good Results with Tension Threads?

Achieving aesthetically pleasing results after repositioning with tension threads depends largely on the technique and experience of the professional, the correct selection of the material to use — i.e., the type of thread — and no less importantly, the correct selection of each case. Regarding this last point, your aesthetic professional will assess whether tension threads are appropriate for your specific concern.

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Classification of Tension Threads (Silhouette Instalift)

The classification of tension threads is quite varied, based on characteristics related to the thread design and the material used for its manufacture.

According to their design, threads are classified as smooth, barbed/spiculated, and with cones. Threads with spicules or cones can be subclassified based on the orientation of these spicules or cones into unidirectional or bidirectional. In turn, bidirectional threads are classified based on the presence or absence of convergence of their cones or spicules.

Regarding the material used for thread manufacture and its duration in the body, we find non-resorbable and permanent threads and resorbable and temporary threads. There are also other ways to classify tension threads, either by their mechanism of action or their implantation technique.

Taking into account the different classification schemes for tension threads, we can infer that each type of thread will have its specific indications, and it is your aesthetic medicine professional who will select the most appropriate one for each case.

How Do Tension Threads Work in the Body?

Tension threads achieve this repositioning effect through 3 main mechanisms. The presence of one or more mechanisms depends on the type of thread used, though some thread types exhibit all 3 effects.

The first mechanism is based on an immediate tensing, lifting, or suspension action. This is produced by anchoring the thread’s spicules in the tissue, which generates lifting of the treated area during the traction performed at the end of thread implantation. Additionally, when thread anchoring is performed at a specific point, tissue suspension from this anchor point is also achieved. Based on the above, another way to classify tension threads is by their implantation technique into floating threads and anchored threads.

Another effect is late revitalization. The tissue trauma inherent to tension thread implantation generates a cascading inflammatory reaction that culminates in fibrosis along the implantation path. Most resorbable threads base their main mechanism of action on this fibrosis process. This is what produces the evident clinical results in the months following implantation of this type of thread.

In addition to late revitalization, there is a third effect linked to collagen formation and elastin stimulated by the tension thread’s manufacturing material, especially polydioxanone. The final result of these effects — repositioning of lax tissue, formation of fibrous tissue, and collagen production — will impact the texture, tone, and elasticity of the treated skin, with the consequent aesthetic improvement.

Let’s Talk About Tension Thread Implantation

In the authors’ practice, a very common patient concern relates to the degree of pain during implantation. While pain perception is subjective and individual to each patient, we could place the pain of this procedure at 3-5/10 on the analog pain scale, making it a completely tolerable procedure for most patients. After implantation and depending on the type of thread used, there may be discomfort (pricking sensation) in the following two to three days.

Moreover, as with any aesthetic procedure, tension thread implantation is not free from possible adverse effects, although the most common are mild, such as the presence of bruising or externalization of part of the thread, both being easily resolved complications.

Once the implantation is performed, during the next 2 or 3 days, certain recommendations should be followed to minimize adverse effects and improve results. These actions include sleeping on your back, avoiding excessive facial gesturing, and not massaging the treated area. Additionally, the use of certain cosmetic products can also accelerate recovery while enhancing the aesthetic results of the implantation.

Below, we share one of these cosmetic products used after tension thread implantation in the routine practice of professionals at Clínica Skin Esthetic.

“Natural Botox” Facial Cream by Herbal Skin

Reduces wrinkle depth while firming the skin and providing greater elasticity. Acmella Oleracea extract provides a completely natural Botox effect.

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Skin Esthetic Pearls on Tension Threads

We’ve shared an overview of the use of tension threads in aesthetic medicine, both for facial and body treatments. Tension threads are used to reposition tissues that have sagged due to aging, seeking to reverse aspects such as a sad-looking face and improve the external appearance of the skin.

Threads not only reposition tissues mechanically but also promote the formation of new collagen fibers and controlled fibrosis, resulting in greater tissue firmness and vitality, with the consequent aesthetic improvement.

The efficacy of aesthetic results obtained with tension threads depends largely on the technique and experience of the professional, as well as the correct selection of material and the specific case. Tension threads are classified by their design (smooth, barbed/spiculated, and cones) and by the material used for manufacture (resorbable and temporary, non-resorbable and permanent).

Tension threads work through three main mechanisms: tensing action, late revitalization, and collagen and elastin formation. Pain perception during implantation is subjective and generally tolerable, with mild discomfort in the following days. The most common adverse effects are mild and easily resolved, such as bruising or thread externalization.

Clínica Skin Esthetic

Aesthetic medicine performed in unauthorized centers by personnel lacking proper training and qualification poses a serious risk to patient health. At Skin Esthetic, we are an Advanced Aesthetic Medicine Clinic. We perform aesthetic-medical procedures with high scientific rigor, by a duly qualified team, always focused on preserving the natural look that only you can have. Remember, at Skin Esthetic we work so that your only concern is thinking:

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