An Assessment and Comparison of Adverse Effect Rates in Differing Absorbable Thread Lift Suture Materials.

Abstract

Background: Thread lifting, a minimally invasive alternative to facial rhytidectomy, has shifted from using nonabsorbable to absorbable sutures. Although many thread lift options exist, the impact of these different properties on complication rates remains unclear.

Objective: To systematically compare thread lift complication rates across different suture materials, textures, fixation methods, and lift locations.

Materials/methods: A systematic review was conducted through February 2024, following PRISMA guidelines, using multiple databases. The study focused on absorbable sutures, excluding nonabsorbable materials. Statistical analysis used Chi-Square tests with Bonferroni correction.

Results: Nineteen studies, encompassing 1,406 patients, met inclusion criteria. A total of 876 complications were reported. Ecchymosis (19.49%), swelling (16.79%), and tenderness (9.96%) were the most frequent complications, while hematoma (0.64%), paresthesia (1.14%), and infection (2.49%) were least frequent. Complications varied significantly among the studied factors. Swelling and ecchymosis were more associated with polycaprolactone sutures, barbed threads, and midface lifts. Barbed threads were associated with more complications than smooth or coned threads, as were floating threads compared with fixed threads.

Conclusion: Variations in thread lift suture materials and fixation technique were associated with different complication rates. Thread lifts using absorbable sutures exhibited complication rates under 5%, suggesting a generally favorable safety profile.