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A Meta-Analysis and Systematic Review of the Incidences of Complications Following Facial Thread-Lifting

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  • Facial Surgery
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Abstract

Background

Facial thread-lifting (FTL) has gained more popularity, but the incidences of complications following FTL remain controversial. We aimed to perform a meta-analysis and systematic review to estimate the incidences of complications and to compare the short- and long-term satisfaction rates following FTL.

Methods

We searched PubMed, Web of Science, Embase and Cochrane library for eligible studies. The primary outcome was the incidences of complications following FTL. The secondary outcome was the satisfaction rate immediately and 6-month after FTL. The pooled incidences of complications and 95% confidence intervals were estimated using random-effects models.

Results

A total of 26 studies were included in this meta-analysis. Swelling was the most commonly reported complication with a pooled incidence of 35%, followed by skin dimpling (10%), paresthesia (6%), thread visibility/palpability (4%), infection (2%), and thread extrusion (2%). Absorbable threads were associated with a significantly lower risk of paresthesia (3.1% vs. 11.7%) and thread extrusion (1.6% vs. 7.6%) than non-absorbable threads. Patients older than 50 years had a significantly higher risk of dimpling (16% vs. 5.6%) and infection (5.9% vs. 0.7%) than their younger counterparts. In addition, the pooled long-term satisfaction rate was significantly decreased compared to it immediately after FTL (88% vs. 98%).

Conclusion

Non-absorbable threads and older age of patients are associated with higher risks of complications. Therefore, we recommend a judicious use of non-absorbable threads and FLT in older patients. Furthermore, it should be discussed with patients preoperatively that the rejuvenation effect of FTL may not maintain in the long-term.

Level of Evidence III

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 www.springer.com/00266.

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Author notes

  1. Zehao Niu and Kexue Zhang have contributed equally.

Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Beijing, 100853, China

    Zehao Niu, Wende Yao, Yan Li, Weiqian Jiang, Youbai Chen & Yan Han

  2. Department of Pediatric Orthopedic, Chinese PLA General Hospital, Beijing, 100853, China

    Kexue Zhang

  3. Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, 77030, USA

    Qixu Zhang

  4. Harvard School of Dental Medicine, Boston, Massachusetts, 02115, USA

    Maria J. Troulis & Meredith August

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  1. Zehao Niu
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Niu, Z., Zhang, K., Yao, W. et al. A Meta-Analysis and Systematic Review of the Incidences of Complications Following Facial Thread-Lifting. Aesth Plast Surg 45, 2148–2158 (2021). https://doi.org/10.1007/s00266-021-02256-w

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