Serdev Lift / Suture Suspension Background Information
, 22 December 2008, 22:07
Gravity may keep us “grounded” but it also leads to facial sags and droops, which begin by the fourth decade of life. Previously round and full cheeks take on a flat appearance, and nasal-labial and marionette folds are accentuated by this cheek descent. Jowls slowly appear and become increasingly apparent. Sub-mental and sub-mandibular skin and muscle also move downward under the continuous pull of gravity. These prolepses, or drooping, have been addressed by brow, face or neck lifts. However, there is a technique, new to the United States, which offers a minimally invasive alternative while still delivering tangible results for many patients. The recent introduction of the principle of the suture suspension lifts such as the Feather lift R and the Contour Threads R, has fueled the creation of many other modalities with better results. This new cosmetic procedure, known as the Curl Lift / Suture Suspension Lift addresses the areas needing uplifting.
This in office procedure is performed under local anesthesia, using a permanently implanted suture thread, inserted with a long needle, the physician then pulling the thread, and bunching together the subcutaneous fat evenly into the desired uplift direction, there by lifting sagging skin. Upon removal of the implantation needle, the thread is secured to the scalp and a stitch or two is used to close the only small incision in the scalp.
Stability for this lifting effect depends on fibrosis formation occurring around the threads over six weeks postoperatively. This technique is applied to lift sagging lateral brows, malar cheeks, jowls and submental/submandibular neck areas. Experience has proven good, for mild to moderate correction. Physicians may also be able to add threads through the years to previously treated patients to maintain or improve results.
The Curl Lift / Suture Suspension Lift procedure is quite straightforward and looks deceivingly simple.
There are definite nuances to planning for suture placement and techniques for implantation, which significantly influence the quality of the result. In other words, it is not as simple as it looks!
The procedure starts with complete patient education and preparation. Areas that may benefit from treatment are identified. Informed consent is obtained. Alcohol and other foods or drugs affecting platelet function or blood clotting are stopped two weeks preoperatively unless there are medical contra-indications.
On the procedure day the treatment areas are marked. One to one and one-half cc’s of Xylocaine 2% with epinephrine is infiltrated along each planned implantation needle/thread path. A sterile field is created. A special Curl Lift needle is inserted along the marked path. The needle enters laterally and exits medially. The thread is inserted into the bore of the needle and held in place as the needle is turned, and reinserted into the subcutaneous fat, therefore creating a sling. After needle removal the thread, and subcutaneous fat are gently pulled up by the surgeon in a direction parallel to the needle path, allowing the physician to anchor the suture thread to the scalp and finishing with a closing stitch. The suture ends are trimmed.
Recovery is relatively simple. Patients gently apply cold packs over the treated areas. They are instructed to avoid rubbing or sleeping on treated areas for three weeks. Hygiene must be carried out carefully to avoid loosening of the threads. Vigorous exercise should also be postponed for three to six weeks. Bruising may occur but is usually rare. Excess skin created by the pulling up of skin and tissue may be hidden with a band-aid or the covering of the area with the patient’s hair. The excess skin will normally re-distribute itself in a 360-degree fashion, anywhere from 3 weeks to a couple of months. Symmetry issues may arise but can be addressed by adding new threads or neutralizing existing threads.
This approach yields significant results but was never intended as a substitute for classic lifting. It is intended for the younger individual with early drooping wanting improved appearance but not ready for more aggressive surgical approaches.
People who are older and have a greater degree of skin and muscle prolepses should not look to the Curl Lift / Suture Suspension Lift as an equivalent substitute for surgical lifting. However, these older patients unwilling or unable to undergo a larger lifting procedure can benefit from the Curl Lift while recognizing that it is not an “apples to apples” comparison. The Curl Lift / Suture Suspension Lift procedure is intended for the individual with early drooping wanting improved appearance but not ready for more aggressive surgical approaches.
Several other procedures are complementary to the Curl Lift / Suture Suspension Lift. Including Botox, injectable fillers, and superficial peels are among the most popular.
Curl Lift / Suture Suspension Lift is an ingenious, minimally invasive approach to the early drooping of facial and neck tissue. For the right patient with the appropriate expectations it is a relatively easy and non-invasive solution. It can be augmented over time as more sagging occurs. It lends itself to complementary procedures, which address related cosmetic concerns of the patient population.
