Aptos thread lift

HISTORY

The Aptos thread lift technique developed in 1996 by Russian father and son cosmetic surgeons Drs. Marlen and Georgi Sulamanidze, involves the use of suture like threads made from a special bio-compatible material. These APTOS®-Threads, with tiny spikes their entire length, are inserted under the skin at different angles to fill out and lift the cheeks and sagging skin. Instead of the invasive, traditional facelift that involves the removal of skin, fat and tissue, the Aptos thread lift system uses barbed threads to pull the skin tighter without cutting.

WHAT IS FEATHER LIFT (APTOS THREAD LIFT)?

As we begin to age the tissue becomes weakened, we lose facial fat and the underlying support structure becomes lax and ptotic (sagging). The areas that suffer this sagging are the cheeks, around the eyes, the brows, the jowls, and the neck, creating a longer, older looking face. Younger patients suffer from cheek and brow ptosis, as well, often prompting them to seek procedures which may be designed for individuals in need of more invasive means. There is now a less invasive procedure available which can lift, contour and suspend the sagging tissues of the face and neck. The Feather Lift Procedure can provide quick and relatively bloodless lifting for patients who may need only little to moderate rejuvenation. The Feather Lift has also been called the APTOS Lift, the APTOS Thread Lift and Suture Suspension Face Lift. Feather Lift is Kolster Methods, Inc.'s (K.M.I.) name for using monofilament, polypropylene threads with cogs or barbs, also called APTOS® threads to lift the underlying tissue and contour the face. Other thread manufacturers have coined the technique as the Silk Lift™, BPS® (Barbed Polypropylene Sutures) threads, and even the Russian Lift or Russian Threads.

The APTOS threads have cogs or barbs which lie in one direction and open up, so to speak, when implanted into the subcutaneous fat and tugged into place. The tissue is caught slightly in these cogs and the tissue is then suspended and lifted. The threads are placed in carefully predetermined areas of the face to support the tissue and lift it. Even better, the results are improved over time as your collagen encapsulates and "bunches" around the threads causing an even further lifting effect. This procedure is considered much less invasive than traditional mid-face, face and brow lifts, requiring less operating room time and less downtime. The Feather Lift is also becoming popular with younger persons wishing for subtle changes or to possibly delay the signs of aging such as facial drooping.

WHICH AREA CAN BE TREATED?

The areas which may be treated thus far with APTOS threads are the outer brow for zygomatic arch ptosis (1), the cheeks for buccal and infraorbital ptosis (2); the jaw line for mental ptosis such as jowls (3) and the neck for sub mental ptosis (4). Diagramfive (5) is an alternate suture suspension technique for the cheeks. Most younger patients will not need all these areas corrected. Common areas for younger patients are the cheeks and brows since they are the first in line to begin their descent. As you age, the lower half of the face begins to sag as well.

WHO IS A CANDIDATE FOR APTOS THREAD LIFT?

If you are in good physical and emotional/mental health, have realistic expectations, no serious health defects, have reasonably normal skin thickness and have the desire to rid yourself of loose sagging tissue of the face and neck, you may be a good candidate for a Feather Lift.

Those with considerable laxity may opt for a face, brow and neck lift instead. Please discuss this with your surgeon at your consultation. Only a qualified medical professional will be able to determine your needs as an individual. It is also smart to have several opinions to help you decide which options may be best for you. However, please know that the Feather Lift is a newer procedure and many doctors will not agree with or be familiar with this procedure.

Also, if you are considering losing weight, you may want to wait until after your desired weight is met. You may need additional lifting or skin removal surgery to alleviate excess skin after you have lost the desired weight, which would mean that the money spent on the procedure may be wasted.

BEFORE THE OPERATIVE PROCEDURE

You may or may not have a pre-operative appointment for the Feather Lift. Often you will book the same day as your consultation, should you decide on that particular doctor and then be given a date after partial or full payment. You may either receive your info packet, medications and/or instructions at your pre-operative appointment or at your consultation once you pay. All offices are different, so please discuss this at your consultation should you decide to book.

You will be told how to take care of yourself and what to expect after your procedure. Your doctor should tell you to avoid certain medications which may increase your chances of bleeding, bruising, or even a negative reaction with certain anesthetics and medications. If you are not told well inadvance of any of the above before your procedure, please ask your doctor for specifics.

PREPARING FOR PROCEDURE

Be sure to follow your doctor's guidelines regarding medication alerts and avoidances. Caffeine and Nicotine may be on this no-no list as they are vasoconstrictors. Vasoconstriction is when the bore of your blood vessels are narrowed, decreasing the amount of blood to the treatment area. Obviously hemoglobin and oxygen are vital for proper healing -- so not smoking is especially helpful. Vitamin E, alcohol, and aspirin increase the chances of bleeding and bruising. Inquire about the cessation of these two as well. Vitamin C is considered helpful in collagen synthesis and health by some doctors, please ask your doctor if you can take this vitamin and what dosage. Some doctors suggest that their patients take Arnica Montana or Bromelain to help with bruising and swelling. However, it is very important to ask your own doctor's approval before consuming any of the above.

Make arrangements for someone to drive you to and from your procedure. The medications and experience will make you drowsy and dizzy, thereby being very dangerous for you to drive. You more than likely may not be able to drive yourself home after your procedure.

As far as directly before your treatment, you may be given an oral sedative an hour in advance or be asked to take it before you arrive.

HOW APTOS THREAD LIFT IS PERFORMED?

The face is swabbed and scrubbed usually with a Betadine solution to reduce the amount of surface bacteria to help avoid infection. After you are dried your face is carefully felt and measured and will be marked for the placement of the threads. If the marker used is single use there is usually no need for a re-washing of your face. If not or just to be doubly careful, the face may be wiped again, leaving a faint but definitive lines on your face as a guide for your doctor.

Your doctor then begins to infiltrate the area using a hypodermic needle with a local anesthetic mixture usually consisting of lidocaine, epinephrine, normal saline and a sodium carbonate buffer. This ensures that you will not feel any pain and also the epinephrine decreases the amount of blood loss and anesthetic absorbed during the procedure. The epinephrine does this by temporarily narrowing the bore (vasoconstriction) of the blood vessel.

After you are adequately anesthetized, your surgeon inserts a hollow trocar (a stainless tube with a needle-sharp end) at the specified entry points and through the subcutaneous fat along a specified plane. The tissue is dissected along this plane as needed based on the individual patient. The exit point is then made and the APTOS thread is then inserted into the trocar. The thread is pulled through the other side of the trocar and the trocar removed, with the thread staying in place. The thread is positioned, tugging and testing its placement and finally anchored when the needed placement is achieved, the threads are cut just at the skin and inserted under the surface of the skin.

Each area is treated and the treatment areas are normally taped to prevent movement in the first few days. Excessive movement can dislodge the intended placement of the threads, altering the desired result.

DOWNTIME & RECOVERY

Although not as invasive as other lifting procedures, this procedure will cause swelling and possibly bruising. The area will be sore, and puffy and possibly discolored from the minor intraoperative bleeding (aka a bruise). You are told not to make exaggerated facial expressions, massage the face, rub the face in anyway, not to sleep on the face or disturb the face if at all possible. Any of the above can, again, disrupt the placement of the threads.

You can resume normal activities (light walking, sitting up, watching television, computer, etc.) within the hour and are told to take it easy during the first few days. This means no exercise, no sexual activities, no excessive talking or exaggerated facial movements, again no facial massage, no shaving of your face, scrubbing, rubbing, chemical peels, harsh cleansers, or facial sleeping for 5 days.

RISKS & COMPLICATIONS AFTERAPTOS THREAD LIFT

Risks include an allergic reaction to the anesthetics, hematoma, seroma, infection, palpability of the APTOS threads resulting in a telltale line. Sometimes a thread ends my poke through the skin, if this should happen contact your doctor immediately for an in-office visit. Do not attempt to re-insert the thread yourself, at any time. This may possibly result in an infection.

Dislodging of the thread may occur resulting in a lopsided or crooked result (asymmetry). Please contact your surgeon as soon as possible for an in-office visit. Please discuss your options beforehand with your doctor in the event this may occur (or not occur for that matter).