Multi-diameter thread lift techniques

The re-positioning of tissues of the face is dependent on thread engagement in the superficial fatty tissue. The depth of this tissue varies in every face due to factors such as sex, age and sun exposure, etc.

Therefore, using one size of thread in the facial superficial muscular aponeurotic system (SMAS) and hoping to get optimum results cannot work. Surely the depth of the SMAS should determine the thread gauge (diameter)?

In clinical practice, this means that a smaller gauge thread should be used in areas of low fat depth, such as the pre-auricular and upper maxillary area. In the marionette area and the pre-jowl sulcus, a larger gauge (diameter) thread should be used.

To overcome this problem, in the past, the author pioneered the double twist technique. This technique can still be used with the new multi-diameter approach. It results in double vector force when used in either the direct or indirect route. It is not only capable of double vectorisation but, in certain circumstances, triple or even quadruple vectorisation has been used. The latter has mainly been used by the author in the male face.