Aesthetic Plastic Surgery

, Volume 42, Issue 4, pp 1151–1156 | Cite as

Does Simultaneous Liposuction Adversely Affect the Outcome of Thread Lifts? A Preliminary Result

  • Yong Woo Lee
  • Tae Hwan Park
Original Articles Basic Science/Experimental



Along with advances in thread lift techniques and materials, ancillary procedures such as fat grafting, liposuction, or filler injections have been performed simultaneously. Some surgeons think that these ancillary procedures might affect the aesthetic outcomes of thread lifting possibly due to inadvertent injury to threads or loosening of soft tissue via passing the cannula in the surgical plane of the thread lifts. The purpose of the current study is to determine the effect of such ancillary procedures on the outcome of thread lifts in the human and cadaveric setting.


We used human abdominal tissue after abdominoplasty and cadaveric faces. In the abdominal tissue, liposuction parallel to the parallel axis was performed in one area for 5 min. We counted 30 passes when liposuction was performed in one direction. This was repeated as we changed the direction of passages. The plane of thread lifts (dermal vs subcutaneous) and angle between liposuction and thread lifts (parallel vs perpendicular) were differentiated in this abdominal tissue study group. Then, we performed parallel or perpendicular thread lifts using a small slit incision. Using a tensiometer, the maximum holding strength was measured when pulling the thread out of the skin as much as possible. We also used faces of cadavers to prove whether the finding in human abdominal tissue is really valid with corresponding techniques.


Our pilot study using abdominal tissue showed that liposuction after thread lifts adversely affects it regardless of the vector of thread lifts. In the cadaveric study, however, liposuction prior to thread lifting does not significantly affect the holding strength of thread lifts.


Liposuction or fat grafting in the appropriate layer would not be a hurdle to safely performing simultaneous thread lifts if the target lift tissue is intra-SMAS or just above the SMAS layer.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Thread Lift Liposuction Fat graft Tension 



This work was supported by the National Research Foundation of Korea (NRF) grant, funded by the Korea government (MSIP; Ministry of Science, ICT & Future Planning) (No. 2017R1C1B5017180, TH Park) and was also supported by a grant of the Research Driven Hospital R&D project, funded by the CHA Bundang Medical Center (Grant no. BDCHA R&D 2017-013, TH Park).


None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Sulamanidze M, Sulamanidze G (2009) APTOS suture lifting methods: 10 years of experience. Clin Plast Surg 36(2):281–306CrossRefPubMedGoogle Scholar
  2. 2.
    Sulamanidze M, Sulamanidze G, Vozdvizhensky I, Sulamanidze C (2011) Avoiding complications with Aptos sutures. Aesthet Surg J 31(8):863–873CrossRefPubMedGoogle Scholar
  3. 3.
    Isse N (2008) Silhouette sutures for treatment of facial aging: facial rejuvenation, remodeling, and facial tissue support. Clin Plast Surg 35(4):481–486CrossRefPubMedGoogle Scholar
  4. 4.
    Isse NG, Fodor PB (2005) Elevating the midface with barbed polypropylene sutures. Aesthet Surg J 25(3):301–303CrossRefPubMedGoogle Scholar
  5. 5.
    Sulamanidze MA, Fournier PF, Paikidze TG, Sulamanidze GM (2002) Removal of facial soft tissue ptosis with special threads. Dermatol Surg 28(5):367–371PubMedGoogle Scholar
  6. 6.
    Villa MT, White LE, Alam M, Yoo SS, Walton RL (2008) Barbed sutures: a review of the literature. Plast Reconstr Surg 121(3):102e–108eCrossRefPubMedGoogle Scholar
  7. 7.
    Park TH, Seo SW, Whang KW (2014) Facial rejuvenation with fine-barbed threads: the simple Miz lift. Aesthet Plast Surg 38(1):69–74CrossRefGoogle Scholar
  8. 8.
    Park TH, Whang KW (2015) Facial rejuvenation using a combination of lateral SMASectomy and thread-lifts. J Plast Surg Hand Surg 49(1):8–12CrossRefPubMedGoogle Scholar
  9. 9.
    Sapountzis S, Kim JH, Li TS, Rashid A, Cruz PC, Hwang YS (2012) Successful treatment of thread-lifting complication from APTOS sutures using a simple MACS lift and fat grafting. Aesthet Plast Surg 36(6):1307–1310CrossRefGoogle Scholar
  10. 10.
    Zhang H, Landmann F, Zahreddine H, Rodriguez D, Koch M, Labouesse M (2011) A tension-induced mechanotransduction pathway promotes epithelial morphogenesis. Nature 471(7336):99–103CrossRefPubMedGoogle Scholar
  11. 11.
    Jang HJ, Lee WS, Hwang K, Park JH, Kim DJ (2005) Effect of cog threads under rat skin. Dermatol Surg 31(12):1639–1643 discussion 1644 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  1. 1.Department of Plastic SurgeryMedipium ClinicSeongnamRepublic of Korea
  2. 2.Department of Plastic and Reconstructive Surgery, CHA Bundang Medical CenterCHA UniversitySeongnamRepublic of Korea

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