Skip to main content
SpringerLink
Log in

Thread lifting: a minimally invasive surgical technique for long-standing facial paralysis

Fadenlifting: eine minimal-invasive Operationstechnik bei lange bestehender Fazialisparese

  • Originalien
  • Published:
HNO Aims and scope Submit manuscript

Abstract

Background

Chronic facial paralysis induces degenerative facial muscle changes on the involved side, thus, making the individual seem as older than their actual age. Furthermore, contralateral facial hypertrophy aggravates facial asymmetry. A thread-lifting procedure has been used widely for correction of a drooping or wrinkled face due to the aging process. In addition, botulinum toxin injection can be used to reduce facial hypertrophy. The aim of study was to evaluate the effectiveness of thread lifting with botulinum toxin injection for chronic facial paralysis.

Methods

A total 34 of patients with chronic facial paralysis were enrolled from March to October 2014. Thread lifting for elevating loose facial muscles on the ipsilateral side and botulinum toxin A for controlling the facial muscle hypertrophy on the contralateral side were conducted. Facial function was evaluated using the Sunnybrook grading system and dynamic facial asymmetry ratios 1 year after treatment.

Results

All 34 patients displayed improved facial symmetry and showed improvement in Sunnybrook scores (37.4 vs. 83.3) and dynamic facial asymmetry ratios (0.58 vs 0.92). Of the 34 patients, 28 (82.4%) reported being satisfied with treatment.

Conclusion

The application of subdermal suspension with a reabsorbable thread in conjunction with botulinum toxin A to optimize facial rejuvenation of the contralateral side constitutes an effective and safe procedure for face lifting and rejuvenation of a drooping face as a result of long-lasting facial paralysis.

Zusammenfassung

Hintergrund

Die chronische Fazialisparese induziert degenerative Veränderungen der Gesichtsmuskulatur auf der betroffenen Seite. In der Folge wirkt der Patient älter, als er tatsächlich ist. Des Weiteren verstärkt eine kontralaterale Hypertrophie die Gesichtsasymmetrie. Ein Fadenliftingverfahren findet breite Anwendung zur Korrektur eines durch den Alterungsprozess hängenden oder faltigen Gesichts. Zusätzlich kann Botulinumtoxin injiziert werden, um die Gesichtshypertrophie zu verringern. In der vorliegenden Studie sollte die Wirksamkeit eines Fadenliftings mit Botulinumtoxininjektionen bei chronischer Fazialisparese beurteilt werden.

Methoden

Von März bis Oktober 2014 wurden insgesamt 34 Patienten mit chronischer Fazialisparese eingeschlossen. Ein Fadenlifting zur Hebung schlaffer Gesichtsmuskeln auf der ipsilateralen Seite und Botulinumtoxin-A-Injektionen zur Behandlung der Gesichtsmuskelhypertrophie auf der kontralateralen Seite wurden durchgeführt. Ein Jahr nach Behandlung wurde die Gesichtsfunktion mit dem Sunnybrook Grading System und anhand der dynamischen Gesichtsasymmetrieverhältnisse („dynamic facial asymmetry ratios“) beurteilt.

Ergebnisse

Alle 34 Patienten hatten eine verbesserte Gesichtssymmetrie und zeigten Verbesserungen im Sunnybrook-Score (37,4 vs. 83,3) sowie in den dynamischen Gesichtsasymmetrieverhältnissen (0,58 vs. 0,92). Von den 34 Patienten äußerten 28 (82,4 %) ihre Zufriedenheit mit der Behandlung.

Schlussfolgerung

Die Applikation einer subdermalen Suspension mit einem resorbierbaren Faden in Kombination mit Botulinumtoxin A, um die Gesichtsverjüngung auf der kontralateralen Seite zu optimieren, stellt ein wirksames und sicheres Verfahren zum Facelift und zur Verjüngung eines Gesichts dar, das bedingt durch eine lange bestehende Fazialisparese hängt.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bradbury ET, Simons W, Sanders R (2006) Psychological and social factors in reconstructive surgery for hemi-facial palsy. J Plast Reconstr Aesthet Surg 59:272–278

    Article  CAS  PubMed  Google Scholar 

  2. Sulamanidze MA, Fournier PF, Paikidze TG, Sulamanidze G (2002) Removal of facial soft tissue ptosis with special threads. Dermatol Surg 28(5):367–371

    CAS  PubMed  Google Scholar 

  3. Abraham RF, DeFatta RJ, Williams EF 3rd (2009) Thread-lift for facial rejuvenation: assessment of long-term results. Arch Facial Plast Surg 11(3):178–183

    Article  PubMed  Google Scholar 

  4. Choi KH, Rho SH, Lee JM, Jeon JH, Park SY, Kim J (2013) Botulinum toxin injection of both sides of the face to treat post-paralytic facial synkinesis. J Plast Reconstr Aesthet Surg 66(8):1058–1063

    Article  PubMed  Google Scholar 

  5. Chaffoo RA (2013) Complications in facelift surgery: Avoidance and management. Facial Plast Surg Clin North Am 21:551–558

    Article  PubMed  Google Scholar 

  6. Lycka B, Bazan C, Poletti E, Treen B (2004) The emerging technique of the antiptosis subderma suspension thread. Dermatol Surg 30:41–44

    PubMed  Google Scholar 

  7. Lee S, Isse N (2005) Barbedpolypropylene sutures formidface elevation. Arch Facial Plast Surg 7:55–61

    Article  PubMed  Google Scholar 

  8. Isse NG, Fodor PB (2005) Elevating the midface with barbed polypropylene sutures. Aesthet Surg J 25:301–303

    Article  CAS  PubMed  Google Scholar 

  9. Wu WTL (2004) Barbed sutures in facial rejuvenation. Aesthet Surg J 24:582–587

    Article  PubMed  Google Scholar 

  10. Sulamanidze M, Sulamanidze G (2009) APTOS suture lifting methods: 10 years of experience. Clin Plast Surg 36(2):281–306

    Article  PubMed  Google Scholar 

  11. Rachel JD, Lack EB, Larson B (2010) Incidence of complications and early recurrence in 29 patients after facial rejuvenation with barbed suture lifting. Dermatol Surg 36(3):348–354

    Article  CAS  PubMed  Google Scholar 

  12. Garvey PB, Ricciardelli EJ, Gampper T (2009) Outcomes in threadlift for facial rejuvenation. Ann Plast Surg 62(5):482–485

    Article  CAS  PubMed  Google Scholar 

  13. Oge AE, Yayla V, Demir GA, Eraksoy M (2005) Excitability of facial nucleus and related brain-stem reflexes in hemifacial spasm, post-facial palsy synkinesis and facial myokymia. Clin Neurophysiol 116(7):1542–1554

    Article  PubMed  Google Scholar 

  14. Choi D, Raisman G (2005) Disorganization of the facial nucleus after nerve lesioning and regeneration in the rat: Effects of transplanting candidate reparative cells to the site of injury. Neurosurgery 56(5):1093–1100

    PubMed  Google Scholar 

  15. Torii Y, Akaike N, Harakawa T, Kato K, Sugimoto N, Goto Y, Nakahira S, Kohda T, Kozaki S, Kaji R, Ginnaga A (2011) Type A1 but not type A2 botulinum toxin decreases the grip strength of the contralateral foreleg through axonal transport from the toxin-treated foreleg of rats. J Pharmacol Sci 117(4):275–285

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anaesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Gyeonggi-do, Korea (Republic of)

    W. J. Choe

  2. Department of Otorhinolaryngology, Head & Neck Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Gyeonggi-do, Korea (Republic of)

    H. D. Kim, B. H. Han & J. Kim

Authors
  1. W. J. Choe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. D. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. H. Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Kim.

Ethics declarations

Conflict of interest

W.J. Choe, H.D. Kim, B.H. Han, and J. Kim declare that they have no competing interests.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Choe, W.J., Kim, H.D., Han, B.H. et al. Thread lifting: a minimally invasive surgical technique for long-standing facial paralysis. HNO 65, 910–915 (2017). https://doi.org/10.1007/s00106-017-0367-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00106-017-0367-3

Keywords

Schlüsselwörter

Search

Navigation