The Thread Lift - Contour Thread Lift -
APTOS Threads - Feather Lift Procedure
About Feather Lift (APTOS Thread Lift) On Our Message Board
Is Feather Lift (APTOS Thread Lift)?
As we begin to age
the tissue becomes weakened, we lose facial fat and the underlying support
structure becomes lax and ptotic (sagging). The areas to suffer this
sagging is the cheeks, around the eyes, the brows, the jowls, and neck
creating a longer, older looking face. Younger patients suffer from
cheek and brow ptosis, as well, often prompting them to seek procedure
which may be designed for individuals in need of more invasive means.
There is now a
less invasive procedure available which can lift, contour and suspend the
sagging tissues of the face and neck. The Feather Lift Procedure can
provide quick and relatively bloodless lifting for patients who may need
only little to moderate rejuvenation. The Feather Lift is also been
called the APTOS Lift, the APTOS Thread Lift and Suture Suspension Face
Lift. Feather Lift is Kolster Methods, Inc.'s (K.M.I.) name for
using monofilament, polypropylene threads with cogs or barbs,
called also APTOS® threads to lift the underlying tissue and contour the
face. Other thread manufacturers have coined the technique as
the Silk Lift™, BPS® (Barbed Polypropylene Sutures) threads, and even
the Russian Lift or Russian Threads.
this procedure and the use of these monofilament threads was originally
pioneered by Marlen A. Salamanidze, M.D. of the
Clinic of Plastic and Aesthetic Surgery in Moscow, Russia in
1999. It also worthy of notation that the original,
Russian-made threads are different than the K.M.I. threads, as is another company's
threads in Brazil.
threads have cogs or barbs which lie in one direction and open up, so to
speak, when implanted into the subcutaneous fat and tugged into
place. The tissue is caught slightly in these cogs and the tissue is
then suspended and lifted. The
threads are placed in carefully predetermined areas if the face to support
the tissue and lift it.
Even better, the results are improved over time as your collagen
encapsulates and "bunches" around the threads causing an even
further lifting effect.
This procedure is considered
much less invasive than traditional mid-face, face and brow lifts,
requiring less operating room time and less downtime. The Feather
Lift is also becoming popular with younger persons wishing for subtle
changes or to possibly delay the signs of aging such as facial drooping.
There are only 12 clinical
sites for the FDA investigation on the efficacy and safety of the
Feather Lift. The Feather Lift name is trademarked and no one is
allowed to use it unless they are trained by KMI. They must also buy
the treads from KMI. Anyone not participating in the FDA studies are
probably not using KMI threads and must therefore call it APTOS lift and
not the Feather Lift. The Feather Lift threads are expected to
be approved by the FDA possibly this year.
Areas Can Be Treated?
The areas which may be treated
thus far with APTOS threads is the outer brow for zygomatic arch ptosis
(1), the cheeks for buccal and infraorbital ptosis (2); the jaw line for
mental ptosis such as jowls (3) and the neck for submental ptosis (4).
Diagram five (5) is an alternate suture suspension technique for the
Most younger patients will not need all these areas corrected. Common
areas for younger patients are the cheeks and brows since they are the
first in line to begin their descent. As you age the lower half of
the face begins to sag as well.
You A Candidate For Feather Lift (APTOS Thread Lift)?
If you are in good
physical and emotional/mental health, have realistic expectations, no
serious health defects, have reasonably normal skin thickness and have the
desire to rid yourself of loose sagging tissue of the face and neck, you
may be a good candidate for a Feather Lift.
considerable laxity may opt for a face, brow and neck lift instead. Please
discuss this with your surgeon at your consultation. Only a
qualified medical professional will be able to determine your needs as an
individual. It is also smart to have several opinions to help you
decide which options may be best for you. However, please know that
the Feather Lift is a newer procedure and many doctors will not agree with
or be familiar with this procedure.
Also, if you are
considering losing weight you may want to wait until after your desired
weight is met. You may need additional lifting or skin removal
surgery to alleviate excess skin after you have lost the desired weight
which would mean that the money spent on the procedure may be wasted.
To Expect At Your Consultation
After deciding on a
few doctors, you will make appointments for pre-operative consultations.
These appointments are basically interviews to help you decide which
doctor you wish to have your procedure with. At your consultations
you should discuss your expectations, desires and complaints that you may
have. Make sure you give your doctor full medical disclosure.
This is very important, if you do not alert your doctor to your specific
medical history you may have problems which arise at very critical times. Or
may experience complications due to decisions made on the information (or
lack thereof) your doctor was given.
disclose all medications you are presently taking and have taken within
the last 6 to 9 months, This can be very important. Do not be
embarrassed as your health can depend upon these factors. This
includes vitamins, supplements and over the counter medications.
The doctor should discuss in
detail the procedure and its risks and complications and what to expect
during the procedure. You will also discuss the available anesthesia that
will be used for your procedure. Most feather Lift procedures are
performed under regional or local anesthesia with the addition of an oral
sedative. However, increasingly, doctors are using twilight sedation
with local anesthesia.
discuss what areas will be treated such as the brow lift, the cheek or
jowl lift or even the neck lift. Not everyone will need all of
these. A full set
consists of 18 APTOS threads. A full face lift requires all 18 although
not everyone may need a full lifting procedure. The threads required
per area would be 2 for each brow, 3 for each cheek, 2 for each jaw line
and 2 for each side of the neck, equaling 18 threads.
discuss treatment protocol and discuss what to expect immediately post-op
and over the following few days after treatment. You should also
discuss the procedure fees and pre-op/post-op medications, and topical
creams, if necessary. Your doctor may take before photos of the area
to be treated, but usually this is reserved for the day of the procedure.
You may or may not
have a pre-operative appointment for the Feather Lift. Often you
will book the same day as your consultation, should you decide on that
particular doctor and then be given a date after partial or full payment.
You may either receive your info packet, medications and/or instructions
at your pr-operative appointment or at your consultation once you
pay. All offices are different so please discuss this at your
consultation should you decide to book.
You will be
told how to care for yourself and what to expect after your
procedure. Your doctor should tell you to avoid certain medications
which may increase your chances of bleeding, bruising, or even a negative
reaction with certain anesthetics and medications.
If you are not told well in advance of any of the above before your
procedure, please ask your doctor for specifics.
For Your Procedure
Be sure to follow your
doctor's guidelines regarding medication alerts and avoidances. Caffeine
and Nicotine may be on this no-no list as they are vasoconstrictors.
Vasoconstriction is when the bore of your blood vessels are narrowed,
decreasing the amount of blood to the treatment area. Obviously
hemoglobin and oxygen are vital for proper healing, so not smoking is
especially helpful. Vitamin E, alcohol, and aspirin increases the
chances of bleeding and bruising. Inquire about the cessation of
these two as well.
Vitamin C is
considered helpful in collagen synthesis and health by some doctors so
please ask your doctor if you may take this vitamin and what dosage.
Some doctors suggest that their patients take Arnica Montana or Bromelain
to help with bruising and swelling. However, it is very important to
ask of your own doctor's approval before consuming any of the above.
arrangements for someone to drive you to and from your procedure. The
medications and experience will make you drowsy and dizzy, thereby being
very dangerous for you to drive. You more than likely may not be
able to drive yourself home after your procedure.
As far as
directly before your treatment, you may be given an oral sedative an
hour in advance or be asked to take it before you arrive.
Feather Lift (APTOS Thread Lift) Is Performed
The face is swabbed
and scrubbed usually a Betadine solution to decrease the amount of surface
bacteria to help avoid infection. After you are dried your
face is carefully felt and measured and will be marked for the placement
of the threads. If the marker used is single use there is usually no
need for a re-washing of your face. If not or just to be doubly
careful, the face may be wiped again, leaving a faint but definitive lines
are on your face as a guide for your doctor.
then begins to infiltrate the area using a hypodermic needle with a local
anesthetic mixture comprised usually of Lidocaine, epinephrine, normal
saline and a sodium carbonate buffer. This ensures that you will not
feel any pain and also the epinephrine decreases the amount of blood loss
and anesthetic absorbed during the procedure. The epinephrine does
this by temporarily narrowing the bore (vasoconstriction) of the blood vessel.
After you are
adequately anesthetized, your surgeon inserts a hollow trocar (a stainless
tube with a needle-sharp end) at the specified entry points and through
the subcutaneous fat along a specified plane. The tissue is
dissected along this plane as needed based upon the individual
patient. The exit point is then made and the APTOS thread is then
inserted into the trocar. The thread is pulled through the other
side of the trocar and the trocar removed, with the thread staying in
place. The thread is positioned, tugging and testing its placement
and finally anchored when the needed placement is achieved, the threads
are cut just at the skin and inserted under the surface of the skin.
Each area is
treated and the treatment areas normally taped to prevent movement in the
first few days. Excessive movement can dislodge the intended
placement of the threads, altering the desired result.
all doctors have different surgical protocols so please discuss with your
surgeon his or her surgical technique as but may very well be different
than the above.
Lift Procedure - Gail Humble M.D.
I believe it is important for
patients to realize there are all sorts of off-label and
actually self-cut threads out there. The point of the
thread is that it has a middle and from there the threads go in different
directions. This allows the thread to pull the tissue to
the center, much like gathering a waist band.
The suture is the same as cardiac
prolene and is totally inert. More threads can be laid
after or they can be pulled during a later face lift. The
threads are blue to make them easier to find during the
procedure, if necessary, and after any following surgeries,
related and unrelated.
Candidates should not have a lot
of lax skin, but post face lift patients are a candidate even if
they are older because a lot of their skin has been previously
removed. The beauty of this procedure is that it lifts
instead of pulling. The average face loses 4-5cc of volume
per year and the Feather Lift augments and lifts the volume
remaining. In a sense it gives the appearance of pulling
the malar cheek pad up and lateral, although in reality it doesn't
Immediate Results: Because of
the volume of the local injected, the initial result is somewhat
of a Howdy Doody appearance. This dissipates in the first
24 hours. Also their is little bruising due to the
lidocaine being mixed with epinephrine which is a
vasoconstrictor. However the patient will go home with apparent
white areas and red areas. This will change by the next
morning or in a few hours when the normal blood flow returns as
the epinephrine wears off. I believe that the patient may lose
30% of the initial result seen. It is true that fibrosis
occurs and this tightens the area but most patients will only
remember the volume in the cheeks directly after the procedure,
which is a lot due to the anesthetic. The results are
subtle but quite beautiful.
Down Time: Patients should not
talk for the first 24 hours. They will find their
facial movement limited for the first two weeks. It
also may hurt to laugh for two weeks. No massage or facial
pressure for one month. Maximum tensile strength
usually occurs at 21 days.
Complications: The threads
must be cut low and the skin forced down. Still one may
have a bubble under the skin. The options are to try to
redirect the thread down or to make a small stab incision and
cut the end. If the end of the thread actually ever comes
out it, the correction is very simple. The thread is cut
again to shorten and redirected downwards again.
Scarring: Scarring from the
needle injection is minimal but it is a large bore needle.
Pre treating for very ethnic patients with Hydroquinone an
assist in lessening the chances of hyperpigmentation.
Cost: The average costs vary
from doctor to doctor and region to region. Averages are
anywhere from $300. to $600. per thread. The threads intended
for Feather Lift are not yet FDA approved.
Source: Dr. Gail Humble, M.D.
- Hermosa Beach, California
Road To Recovery
Although not as
invasive as other lifting procedures, this procedure will cause swelling
and possibly bruising. The area will be sore, and puffy and possibly
discolored from the minor intraoperative bleeding (aka a bruise).
You are told not to make exaggerated facial expressions, massage the face,
rub the face in anyway, not the sleep on the face or disturb the face if
at all possible. Any of the above can, again, disrupt the placement
of the threads.
You can resume
normal activities (light walking, sitting up, watching television,
computer, etc.) within the hour and are told to take it easy during the
first few days. This means no exercise, no sexual activities, no
excessive talking or exaggerated facial movements, again no facial
massage, no shaving of your face, scrubbing, rubbing, chemical peels,
harsh cleansers, or facial sleeping for 5 days.
The Months Ahead
There is often
immediate results however, the results continue to improve over a 3 to 6
months period. This improvement is due to the collagen synthesis and
individuals where the lift may not have taken effect at all. Please discuss
your options beforehand with your doctor in the event this may occur (or
not occur for that matter).
& Complications Of Feather Lift (APTOS Thread Lift)
Risks include an
allergic reaction to the anesthetic, hematoma, seroma, infection, palpability
pf the APTOS threads resulting in a telltale line. Sometimes a
thread end my poke through the skin, if this should happen contact your
doctor immediately for an in-office visit. Do not attempt to re-insert
the thread yourself, at any time. This may possibly result in an
the thread may occur resulting in a lopsided or crooked result
(asymmetry). Please contact your surgeon as soon as possible for an in
office visit. Please discuss your options beforehand with your doctor in
the event this may occur (or not occur for that matter).
Average Prices Of Feather Lift (APTOS Thread Lift)
The average prices
in the United states for this procedure is about $300 to $350 per thread,
although I have heard others charging as much as $600. per thread. Some surgeons may also charge a separate fee for O.R. time
UPDATE! Improved Technique and Product!
There is now a thread type and technique using the same concept
but, in my opinion improved, called the Contour Lift. The barbed
polypropylene threads are now clear for less visibility in
patients with thinner skin, and each two threads are anchored
together via a surgeon's knot. The technique allows for less
slippage, longer lasting results and less visibility. Read more at ContourThreads.com
UPDATE! Would I Do It Again?
I am not entirely sold on the procedure. I honestly do not
know if it keeps my face in place, for lack of another term.
I know that at times I have really regretted it in that I could
see the edges of the threads in the nasolabial area (where I had
the extrusion problem) upon manual manipulation of the face.
I can no longer get facials either. However, for some
reason, in the last 2 years I have not noticed any problems.
I can, however, press my face inward and the thread ends still
make a bump which is visible and palpable. But when do I ever
actually do this? I have had problems in the past when
sleeping on my face which caused a thread to hit a nerve and
caused discomfort. But again, I haven't noticed any recent
issues. In fact, I do not notice them at all anymore.
Feather Lift Website
Lift Procedure Video - K.M.I. (Graphic: Viewer Discretion Advised)
My Feather Lift Photo
Lift - Prollenium Medial Technologies, Inc
- The Clear Choice
Gail Humble, M.D. -
Hermosa Beach, CA
APTOS - Russian Thread Lift
with my own Feather Lift to cheeks
with Feather Lift patients