PDO--the thread that bolsters!

You may have heard about PDO (polydioxanone)threads; but if you’re here reading, clearly you want to know more!


PDO is a biodegradable material that is commonly used for suturing—but for the purpose of this blog, we’re going to discuss it as a tool in our fight against aging. While threads have been around for decades as a non-surgical option to “lift” the face, those in play today are different from those utilized even 15 years ago.


Threads are made from many materials (PDO, Polylactic acid (PLA), and polycaprolactone (PCA)) but the most commonly seen in the United States is good ol’ polydioxanone. These threads come for insertion in a variety of ways: mounted on a needle, or a cannula. And their presentation also vary: some are smooth, some twisted similar to a screw, and others have molded hooks designed to attach themselves to the tissue they contact to and give a little lift in whichever direction they are placed. And while these are biodegradable (how long it takes them to dissolve depends on the thickness of the thread to begin with, and your body’s own response to them) it isn’t just about the thread being present that makes them useful.


If you’ve read any of my other blog posts you’ll know I’m a big fan of collagen induction. Collagen in our skin gives it it’s bounce and fluffiness. The natural aging process and exposure to UV and free radicals over the years causes a breakdown of collagen and a thinning appearance to our skin—none of us have the same fluff at age 60 that we did at 16! Treatments like medical microneedling, radiofrequency microneedling, poly-l-lactic acid injection (sculptra) and calcium hydroxylapatite injections (radiesse) can all trigger the body to think there is an “injury” and prompt the response for repair—aka collagen production! Generally speaking, the more collagen we have the less translucent we appear. Of course, collagen isn’t the only thing we lose over the years—loss of elastin also occurs giving us more slack and less snap. But we need to tend to what we can.


So, despite that these PDO threads degrade over time, their simple presence in the tissue provokes controlled inflammation which is the trickery we are looking for to promote collagen strand growth right around that space! This collagen then lasts much longer than the thread did initially. Yahoo!


In my professional opinion, PDO threads are a compliment to other facial treatments; but rarely are stand alone when it comes to lifting. In someone with lax, not-too-thin skin it can provide a very nice scaffolding and the start of “lift”. Filler can then still serve to provide contour to specific areas and be more efficient once the tissue is closer to where it belongs. Other non lifting uses for PDO? Well, in one who has heavy “angry 11” creases, placing threads within those valleys along with their usual neurotoxin dose can help change the Grand Canyon into a rolling meadow (much less harsh!). And if there is laxity or crepey-ness around the mouth, fine threads (smooth, not lifting) can help reduce the “swag” of that tissue without increasing the fullness so you don’t move toward a Homer Simpson look. And how about that turkey gobble just under your chin skin? Yes, threads can be place there to help create less drape in that region too. But remember, this is a process, not a one-stop-shop.


Threads are sometimes referred to as “solid” filler, but I’m not super keen on that description. Still, in areas that I feel are too risky for actual filler, threads can contribute to that end, over time. They are prickly going in, and some are aware of their presence for a week or so. If skin is super thin to begin with, they may be visible at first—but the thread starts as blue/purple, and quickly changes to transparent when it interacts with your body fluid. Bruising, inflammation, and discomfort is manageable. If you’re inclined to consider a face lift, go get your consult. But if you’re scalpel averse, we can certainly discuss threads as an alternative. Book a consultation or bring it up at your next regularly scheduled visit with Teri (not everyone is a great candidate for threads so consultation and managing expectations is key). Package pricing—check out the website service menu for current costs!


A stitch against time….PDO just might play a role for you!