A New Approach to Thread Facelifting.

Background Facial rejuvenation has traditionally been achieved by repositioning soft tissue via invasive surgery. Objectives The present work describes a thread-based, face-lifting (TBFL) technique (BussoLyftt that has provided reproducible and predictable results for 200 to 300 patients. Methods To reposition the orbital, nasolabial, and jowl fat pads, three primary vectors (one vertical, two oblique) are established on the side(s) of the face that requires lifting. The vertical vector for the orbital fat pad is volumetric and the oblique vectors for the nasolabial and jowl fat pads lift by thread-tissue engagement and repositioning. Results Repositioning the superficial fat pads of the orbital, nasolabial, and jowls areas results in a pleasant cosmetic outcome. In the treated nasolabial and jowl fat pads, the primary repositioning vector results from engaging cogs with fat septa, which places fat in a cosmetically optimal position. The primary mobilization of the superficial fat pad through the septal attachments to the dermis and superficial fascia creates a secondary movement and repositions the overlying skin and underlying superficial muscular aponeurotic system (SMAS). Very few threads are needed to reposition full-face superficial fat. Conclusions By optimizing every step of thread placement, the TBFL technique provides an efficient and effective method to reposition facial fat pads. J Drugs Dermatol. 2021;20(10):1085-1090. doi:10.36849/JDD.6139.