The PDO Thread Lift

Ah, the “glory” days. ​For the sports fan struggling to maintain an upbeat, optimistic outlook, I’m talking about us, Philadelphia Eagles fans, in the face of, as of this writing fifty seven years, in the sports championship wilderness, it’s common to recall, real or not, the “perfect time.” Norm Van Brocklin to Tommy McDonald for a touchdown. “Concrete” Chuck Bednarik tackling Jim Taylor on the one yard line to secure our last (to date) NFL championship.

Good times. The year? 1960. Since then? As they say in the Bronx, ”Fugetaboutit.”

In the mid-forties, Army, the football team, cruised to a 27-0-1 over three seasons. (On the battlefield, they did pretty well to after a slow start.) Featuring the two greatest players of the era, “Mr. Outside,” Glenn Davis, and Mr. Inside, “Doc” Blanchard, the West Point Academy achieved three team national championships and a Heisman Trophy for each.

Like the fabled duo of yesteryear, we,at the Clearfield Medical Group, pride ourselves being the anti-aging equivalent of “Mr. Inside” and “Mr. Outside.

“Mr. Inside” is our customized hormone replacement programs for both men and women. “Mr. Outside” is our ever expanding array of cosmetic rejuvenation procedure. From Botox, to dermal fillers, to the Y Lift, to the Vampire Techniques including the Vampire Facelift and Vampire Facial, and now, we introduce the Polydioxanone (PDO) Thread Lift.

Volume loss, then gravity causes our facial features to regress and drop. The subsequent loss of fat and bone results in a squaring of our jaw and an inversion of the eye pupil to mouth ratio, distorting our so called “triangle of beauty.

The ​Golden Ratio ​of Symmetry and Facial Proportion

Based on the “Golden Ratio,” a symmetrical face is an attractive face.

Understanding the triangle of beauty allows us to recommend remedial measures in an analytical way.

Leonardo Da Vinci’s Golden Ratio​ is a mathematical progression derived by dividing a line into two parts. The longer part is divided by the smaller part equaling the whole length divided by the longer part. a/b = (a+b)/a = 1.6180

We sculpt a symmetrical face based on the “Golden Ratio.” ​With dermal fillers, we restore volume loss. But how do we defy gravity? Lifting fallen tissues, non-surgically, remained a want rather than a reality. Until now.

Introducing the “scaffold” specifically designed combat effects of gravitational pull on the mid cheek, lower jaw and neck.

The PDO Thread Lift

“Polydioxanone” or PDO threads, literally surgical sutures used in the cardiac and pediatric operating theatre for more than thirty five years, are specifically designed to slide through the dermal layers, anchor to the underlying skin, and lift engaged tissues in various vector plains.

Unlike older permanent sutures, PDO fibers absorb after four to six months, require, at most, only a minute pin size, less than 1/10 of 1 milliliter, of anesthetic, are advanced with a blunt edged cannula, rather than a needle, to safely navigate around underlying nerve and vascular tissues.

The previous generation of threads were permanent, inserted via an incision, behind the ear, were tied in a knot, and left lumps and scars. To add to the misery, the ties, frequently slipped or broke.

Our newer, PDO threads, dissolve over time, are advanced over your skin like a shower curtain rod over a curtain rod, lie flat, and when extruding through the skin, are cut in a downward motion burying the thread. There are no ties. At most a minute opening for the cannula insertion is closed with a polysporin ointment dressing and a tiny dot bandaid.

Why use Polydioxanone Threads?

PDO threads create an “instant” gratification as one can see an immediate effect from treatment. But what you see isn’t what you get as, over time, the treads induce a micro-irritation in the dermal layer, inducing angiogenesis, fibroblast stimulation, collagen induction, skin tone rejuvenation, rejuvenated skin elasticity, and a shrinking and closing of pores.

The procedure requires minimal to no downtime and is described as minimally painful. We apply a laser grade anesthetic cream for patient comfort, if needed, and inject a minimal dose of lidocaine with epinephrine, < ¼ cc in the thread insertion site, for pain control and to stem any bleeding. (The face is highly vascular and even a minimal nick can cause significant bleeding.)

Collagen Production, Promotion of Local Blood Microcirculation and Activation of the Reparative Processes

PDO threads create micro-traumas under the skin, agitates dermal tissue inducing a regenerative processes. Fibroblasts, reparative cells that produce new structural components, collagen, elastin and hyaluronic acid, in the “damaged” area.(1)

Looking through a 200x magnification, we see collagen fibers arrayed circumferentially around the PDO threads along with neovascularization aligned along the longitudinal axis of the dissolving PDO threads.

As for safety, PDO threads sport a thirty five year history in pediatric cardiac surgery, are minimally invasive, take 30-45 minutes per procedure, leaves no scars, requires only a minute < ¼ cm opening to introduce the cannulas, are 100% biodegradable and are naturally excreted in the urine in six months.

PDO Thread Indications:

  • Wrinkle reduction-​Face, neck, hand, marionette lines, nasolabial fold, crows feet.
  • Lift-​Full face, breast, hip, upper arm, buttocks, thighs.
  • Firming and Shaping​-Breast, calf muscle.
  • Skin​ Tightening-​Skin pores.
  • Brightening-​Skin Tone.
  • Volume Reduction-​Double chin, zygoma, arms, abdomen, buttocks, thigh

​ Thread Types ​(2)

Mesh: Collagen Stimulation and Tightening

Lift: Anchor, Gripping

Lift: Blunt Tipped Cannula

Treatment Patterns

The Seder (Order of Treatment)

  1. Photograph patient before procedure
  2. Disinfect treatment area
  3. Map Area to be treated while patient is in upright seated
  4. Photograph of treatment map
  5. Treat area – Introduce PDO Threads
  6. Disinfect Treatment area post insertion
  7. Remove loose threads exiting the skin
  8. Apply occlusive scar patch to large insertion site
  9. Apply Arnica or Vitamin K if needed
  10. Apply cold compresses if needed
  11. Obtain photographs post procedure

Complications ​(3)

  1. Extrusion of PDO Thread (6%)
  2. Iatrogenic Asymmetry (14%)
  3. Temporary Pain, Edema, Hyperemia (34%)
  4. Paroxysmal Dysesthesia (up to 50%?)
  5. Bruising and Hematomas (34%)


  1. Pregnancy
  2. Coagulation Defects
  3. Cutaneous Neurofibromatosis
  4. Acute infectious diseases
    • i. Influenza
    • ii. Inflammation of the skin in areas to be treated
  5. Non-absorbable implant (Silicone) in the zone of thread insertion
  6. Ongoing cancer treatment (chemotherapy)
  7. Tendency toward keloid scarring
  8. Neurotic psychological disorders resulting in unrealistic expectations.

Although we use threads universally in the face and body, we see the best results with combination therapy. Here is a rule of thumb” of what to treat where:

Call us at 775 359 1222 for more information or to schedule your facial aesthetic consult.

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  3. Della Torre, F., Della Torre, E. & Di Berardino, F. Side effects from polydioxanone. Eur. Ann. Allergy Clin. Immunol. 37, 47–8 (2005).