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CONTOURS OF CHANGE: The before-and-after effects of the procedure

On the face of it, the procedure is far simpler, less time-consuming and involves less surgical trauma than traditional facelifts or most other forms of cosmetic surgery. It was introduced in India last year and is fast gaining ground in the country's plastic surgery and cosmetology fields, not to mention among Page 3 aspirants. However, the contour thread facelift cannot guarantee results as good as a conventional facelift. It is said to be 60 to 70 per cent as effective as the traditional invasive facelift. "It may not give as much lift as an open facelift. But since its results are not dramatic, the candidate seems to look refreshed and rejuvenated," says Rashmi Taneja, plastic surgeon at Delhi's Ganga Ram Hospital.

Like its name suggests, the treatment resets facial features to get rid of sags and folds. Contour thread facelift has been approved by the US Food and Drug Administration, which follows stringent standards for clearing new medical procedures or drugs. Believed to have originated in Russia, it is fast becoming a fad in America.

Here, too, the technique has given facelifts, well, a facelift. Requesting anonymity, a Delhi-based socialite in her mid-50s said, "The best thing about it is that you don't have to stay in a hospital for days. Therefore, you don't have to explain your absence to friends. Plus, with no cuts or bruises (unlike in invasive face surgeries), nobody can ever figure out that you have had a facelift."

HOW IT'S DONE

Incisions measuring 3mm are made along the hairline so that the scars are not visible. Contour threads are inserted through the holes from the hairline and follow a slightly zig-zag path under the facial skin before exiting along the laugh lines. Once inserted, the thread's barbed end is used to suspend it and create tension that gently lifts sagging tissues of the brow and face. The surgeon gently contours the facial features upwards for a youthful look and tighter skin. The threads are anchored to the scalp tissue to avoid migration.

Getting down to the basics, the ageing process happens due to thinning of connecting tissues and breakdown of collagen and elastic fibres, leading to sagging, wrinkles and folding of skin. While Botox has been the most fashionable option to iron out the wrinkles (though it cannot correct the sagging), the conventional facelift-an invasive procedure-surgically removes sags and folds. The latest contour thread procedure is a breakthrough. Apart from causing less surgical trauma, it gives subtle and seemingly natural results in a little over an hour compared to the four to six hours an invasive facelift surgery takes. Moreover, the threads can be used to lift any select region of the face, like the eyebrows, lower face or neck, rather than the entire face.

Unlike the long (about 10 to 13 cm) incisions made during traditional rhytidectomy (plastic surgery for facelift), contour thread technique necessitates only 3mm incisions along the hairline so that the scars are not visible. Contour threads are inserted through the holes from the hairline and follow a slightly zig-zag path under the facial skin before exiting along the laugh lines. Imported from the US, contour threads are non-absorbable polypropylene threads (same as those used in most heart and abdominal surgeries). While conventional sutures are smooth, contour threads have tiny barbs or cogs, spaced apart evenly, which hold on to the facial tissue.

Once inserted, the thread's barbed end is used to suspend it and create tension that gently lifts sagging tissues of the brow and face. The surgeon gently contours the facial features upwards for a youthful look and tighter skin. The threads are anchored to the scalp tissue to avoid migration. Post operation, patients need to take certain precautionary measures for a period of three to four weeks until new collagen is created. As the newly formed collagen sets around the threads, the facial features remain in an uplifted position, naturally. The chance of a thread breaking is highly unlikely. "These threads are pretty strong. They don't break," said Dr Sunil Choudhary, senior consultant, plastic surgeon, max Healthcare.

Till the time the tissues get firm, the candidate cannot make any vigorous facial movements, not even laugh. Also, facial massage is a strict no-no and so is biting into hard substances. In case a thread is dislodged from its set position during the first three to four weeks, the surgeon can gently contour it back. And if required, an extra thread can be inserted at a later date. Since it is minimally invasive, the procedure can be performed under local anaesthesia and requires no overnight hospital stay. Patients can resume work in a day or two. Some bruising and swelling are the only discomforts felt for about 24 to 48 hours. But there is no visible scarring. "The results of this surgery last anywhere between five and 10 years depending upon the patient's age and type of skin," says Choudhary.

A full facelift using contour threads costs Rs 50,000 to Rs 80,000; a pair of threads between Rs 8,000 and Rs 10,000. A complete facelift calls for about seven to 10 pairs of threads depending upon the skin quality and the candidate's age. Apart from cosmetic changes, contour thread facelifts have other uses as well. The procedure can be used to correct asymmetry of facial features, a common problem faced by those suffering from paralysis. It can also be used to lift drooping eyelids for blepharochalasis patients (usually women) who suffer recurrent swelling of the eyelids, and by those afflicted with eyebrowptosis, a condition that results in a tired look.

In extremely rare cases, the thread can cause some adverse reactions being a foreign body that some patients could be allergic to. "Also, it is not recommended for someone with very thin facial skin as the threads could be felt or be visible," says Dr V.D. Singh, plastic surgeon, V.M. Plastic Surgery Centre, Chandigarh. But with almost immediate results, contour thread facelift promises to turn back the clock, literally.

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