There's an abundance of clinics in Singapore offering threadlifts. However, very little is known about the actual differences in threadlift materials used, or techniques applied.
In my practise, I commonly encounter patients with horrible memories of painful threadlifts which left them with severe bruising after. This issue seems to be the major bane to patients who've undergone threadlifts in Singapore, or those who've sent in an enquiry on DxD, and are still considering the procedure.
I'm not one who writes very much, but given how often this issue has popped up, I've decided to put pen to paper (figuratively) to share some insights gained over my 10 years of practise.
1. First things first, why do people face "lift"?
Let's go back to the basics. Your face has multiple layers, simply put:
- Skin, which consists of the famous "collagen", elastic and other matrix molecules
- Subcutaneous layer made up of a layer of fatty tissue with fibrous bands
- Different fasciae layers depending on the area involved
Your skin will inevitably sag with age, due to the forces of time and gravity. Pollution, sun damage, smoking and other undesirable lifestyle habits also play important contributory factors.
While popular machine-based treatments amongst Singaporeans like Thermage, Ultherapy and HIFU work well to some extent, they tend to be less effective than a threadlift or surgical facelift.
If full-on surgery puts you off, then the middle ground is held (no pun intended here) quite strongly by a good and skilfully performed threadlift.
2. How do you avoid a painful threadlift?
In my 10 years of practise, I've never had to subject any patient to general anaesthesia for a threadlift procedure.
My advice? Try not to attempt a full-on threadlift with just numbing cream. Neither is it really necessary for you to go down the general anaesthesia or deep sedation route, as these can have serious side effects.
A good, old fashioned local anaesthesia, if performed correctly, will ensure the entire threadlift procedure is comfortable and fuss-free.
It's just like going to a dentist who gives his or her local anaesthesia properly, compared to one who doesn't. Yes, I know the difference myself.
3. What types of threadlifts are available in Singapore?
This takes us to the confusion about the various types of threadlifts available in Singapore.
Disregarding the fancy names used for marketing (they usually have the ubiquitous alphabet "V" somewhere in the name), threads can be:
- Short or long
- Thin or thick
- Smooth or barbed/booked
- Made from various materials like Polydioxiane (PDO), Poly-L-Lactic Acid (PLLA), PCL to name a few
- Introduced by sharp needles, blunt cannulae or round tip cannulae
Just because you've seen a YouTube video of a doctor (sometimes, a spa therapist!) sticking 30 - 40 thin little needles with small thin PDO threads into a patient's face, doesn't mean that all PDO threads are small and tiny, and will require that many needles.
4. How do you avoid an ineffective threadlift?
This then begs the question, why do some doctors use tiny needle threads and not the longer, stronger and thicker threads for a stronger lift?
Inserting many tiny threads can indeed stimulate collagen in the skin. They are also much easier to insert, only requiring some numbing cream and very little aftercare. When it come to a heavy and sagging face however, smaller threads have their limitations for obvious reasons.
For the insertion of longer and larger threads, a good understanding and accumulated practical experience with the skin layers shows:
- Placing these threads too superficially can cause dimpling and tethering
- Placement too deep may damage certain skin structures
This is undoubtedly why some doctors tend to shy away from the thicker and longer threads. Good anchoring techniques are also important, as threads need to be properly anchored to exert the most ideal lifting effect.
Taking all these factors into consideration, I usually prefer using stronger, larger calibre threads with barbs and hooks.
How can you tell whether your doctor is using a small or large thread in Singapore? Here's a simple tip - to my knowledge, most long and thick threads come with some sort of hooks or barbs.
5. Which is my preferred choice for threadlift material?
Next comes the choice of threadlift material: PDO, PLLA or PCL.
Our experience with Polydioxane (aka PDO) is very well-established. It's the same material that's been used in all types of surgical stitches (sutures) for many years. Hence, human tissue-PDO interactions are well understood.
On the other hand, PLLA and PCL materials are newer. Even though the manufacturers of PLLA and PCL claim that they are able to induce more fibrosis for a greater facelift effect, I've not found any direct threadlift material comparison studies myself.
Consequently, I prefer PDO due to its longer history of use, and also because I'm more familiar with the feel and texture of the PDO material.
Maybe someday I'll try PLLA or PCL, but at the moment, when it comes to a skill-based procedure like threadlifting, I'd rather stick to the material I'm most familiar with in order to ensure the best outcome for my patients.
To sum up, when choosing a threadlift procedure, you should definitely be familiar with the basics I've explained above, while ignoring all the fancy names thrown at you in marketing advertisements.
Rest assured that there are many good doctors out there who are skilled in their particular technique of achieving an effective and painless threadlift!
Dr Lee Mun Heng is driven by a passion for helping his patients look their best. He does this by aiming to draw out their natural beauty through the application of safe, minimally invasive and holistic procedures. A graduate of University of Cambridge, Dr Lee read medicine and surgery on scholarship from the Cambridge Commonwealth Trust.