Nova Threads: Facial Lifting – Without the Knife!

History of Thread Lifting

We’ve all heard the saying; “necessity is the mother of invention” and this aphorism certainly holds true in the case of using suture material to lift sagging tissues of the face (aka thread lifting). This idea was formulated by Dr. Gregory Ruff, a plastic surgeon in Chapel Hill, N.C. In 1992, while searching for a way to raise the crushed cheek of a car-accident victim, he cut little notches into a few of his surgical sutures, threaded these sutures under her skin and created a sling to move her cheek back into position.  After using hand-notched sutures in several more reconstructive surgeries, Dr. Ruff decided they’d also make a useful cosmetic tool. In 2004, he introduced these modified sutures and christened them Contour Threads.  These transparent sutures with one-directional barbs were designed to tighten sagging skin on the face and neck.

Meanwhile, half-way across the globe, another surgeon in Moscow, Dr. Marlen Sulamanidze, was actively searching for a method of face-lifting that would not require large incisions. His search proved fruitful and in 1999, he developed the Aptos threads.  The name Aptos was a derivation of the two words: against ptosis (sagging).  These were blue sutures with two-directional barbs.

These thread lifts quickly became popular. Patients liked the idea of a procedure that was less costly, did not require large incisions and did not demand a long recovery period.  Unfortunately, this technique was a little ahead of its time.  These threads were non-absorbable and their use  fraught with difficulties: Placement was complicated, skin ‘bunching’ occasionally occurred and the sutures sometimes extruded through the skin.  So in 2007, Contour Threads were taken off the market. Although great in theory, the mechanics of this procedure clearly needed more refinement.

A Better Solution

Subsequently, around 2010, a simpler, less invasive, lower risk thread procedure was developed by surgeons in Korea. They employed PDO (polydioxanone) sutures taking advantage of the outstanding safety profile of this material. PDO sutures has been used extensively in Cardiothoracic, Plastic, OB-Gyn and Trauma surgeries for over 30 years and excels in being highly flexible, strong and elastic.  Best of all, this suture is entirely absorbable – in four to six months the suture is degraded by the body’s immune system. However, the PDO material is a powerful collagen stimulant. It is this new collagen which provides long-lasting lift or skin thickening which can remain in effect 12 – 15 months.

The Four Nova Thread Types:

1. Smooth threads: These are utilized for collagen stimulation and cause firming and thickening of the skin.  They are often placed in a ‘net-like’ or mesh pattern and are beneficial in treating crepey skin of the face, neck or décolleté. They are also used for superficial wrinkles of the forehead, glabella, cheeks, smoker’s lines, marionette lines or lines in the neck. Additionally, they work well to define lip borders.

I had the [smooth] threads put in my lips and laugh lines. They are absolutely amazing & I love how they have made my face look flawless with no fine lines. Thank you Dr. Cohen for once again making me feel fabulous.” ~ Amber Nolte

2. Twisted threads: These are smooth threads which have been coiled. This feature results in more collagen production. These threads are used in the nasolabial folds and marionette areas but also in lips for subtle volumization.