Difference Between Silhouette Lift and Contour Thread Lift?

Question

Has anyone had experience using the new Thread lift product, Silhouette Lift? If so, how does it differ from Contour Lift. Looking for an alternative to a full blown Facelift.

Gregory S. Keller, MD, FACS · Answer

Since we, with three or four others, began thread lifting of the cheeks in the mid- 90's, early 2000's, the procedure has undergone multiple revisions. The contour thread lift used barbed sutures of prolene (permanent sutures) that could cause various abnormalities of skin texture and had a failure rate. The InstaLift is the latest thread lift of absorbable material and represents a quantum leap forward in safety and efficacy.  The cones that attach to the threads catch the tissue and hold it in place long enough (before dissolving) for the body's own scar tissue to provide a longer term "lift".  The insertion device is simple and only rarely causes bruising of significance.  The patient can do it over a "lunch time" and drive home.  There are only three small blebs of local used for each thread that is placed, with the patient sitting up in a "dental" type of chair.  Our patients have been happy with the results performed (off label) in the neck and jowls, as well as the FDA approved mid-face.  The procedure, unlike filler "camouflage" actually re-positions structure. For the patient who is not ready or too young to commit to a facelift, the procedure provides a 1-2 year improvement.

Daniel Butz, MD · Answer

Thread lifts have come back into popularity over the last several years. The newer options are dissolvable and have a much better safety profile. The contour threads are barbed PDO sutures that are really meant to volumization and provide minimal lift. The instalift is a PGLA/PLLA that has bidirectional cones. This provides volumization and lifting. These do not replace a facelift but can help with mild facial descent. See a board certified surgeon to ensure you're given all the options and provided with the treatment you need to achieve your goals.

Jeffrey S. Rosenthal, MD · Answer

The Silhouette Instalift is an absorbable thread attached to mini-cones that lift the mid, lower face, jawline and upper neck. As the body naturally absorbs the threads and cones they stimulate your own collagen to further contour and smooth out areas of the face. It was approved by the FDA in 2015 and has been extensively used for facial rejuvenation in Europe for many years prior to it arriving in the USA. Unlike other threads, the Silhouette Instalift is unique in design. The cones do the lifting and the entire thread is absorbed. This procedure is performed in the office using a touch of local anesthesia to numb the skin. There is limited downtime and discomfort. The Silhouette Instalift has revolutionized facial rejuvenation. It lifts and adds volume to the face. The manner in which the threads are applied and areas where they are used are crucial. So find an experienced plastic surgeon and look at the results from prior patients. It is truly an amazing procedure.

Cameron Chesnut, MD, FAAD, FACMS · Answer

The main difference between the different types of thread lifts is the material used for the thread or suture, and the type of fixation used to embrace and support the tissue. Thread lifting has a long history with both very beautiful results and happy patients mixed with poor results and dissatisfaction. Most of the latter stems from the use of permanent sutures and poor technique.
Most modern thread lifting utilizes absorbable sutures, which have many major benefits. These threads not only lift and support, but provide volume as they go away, creating a lift and fill effect. The risk of dimpling, an issue with the old thread lifts, is zero here as these are not providing a permanent pull. 
These modern thread lifts are best thought of like a filler. They will do their job for a year or two and then will need to be touched up, but the results in the meantime are beautiful.
Choosing your physician wisely here is key, as knowledge of normal facelift anatomy, tissue movement and technique is a highly valuable skill when placing these absorbable lifting threads.
To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
Cameron Chesnut#realself500 Physician

Young R. Cho, MD, PhD · Answer

Thank you for your question.  The Silhouette Instalift is a minimally invasive solution that delivers a great option to patients for whom a facelift surgery is not their preferred approach. There have been several different suture lifts in the past that may have been pulled off the market because due to complications.  The Instalift differs in that the material is resorbable and the suture material actually stimulates collagen as well.  One of the main materials used in the Instalift is the main active ingredient in Sculptra which is commonly used by advanced injectors for facial rejuvenation for collagen stimulation.  In addition, Instalift uses bi-directional cones to reposition the subdermal tissue and facial skin to a more lifted and youthful position.  Over time the implanted sutures and cones also stimulate your own collagen for natural and long lasting results. Please contact a Silhouette certified physician for a consultation.  Best of luck!

Andrew T. Lyos, MD, FACS · Answer

The Silhouette lift is a new, improved version of the threat lift. The suture itself is stronger and works with bioabsorbable cones rather than barbs, as with Contour Threads. The technique has been refined over the past several years, initially in Europe and now in the United States. The procedure can be done under local anesthesia. It works best for those with jowl and nasolabial folds, but can provide improvement in the neck. The threads can be re tightened for further lifting if needed. It can be combined with fillers and Botox for facial wrinkles, eyelid lifts, liposuction of the neck for an overall facial improvement. The results of the procedure last up to 3-4 years. This may be the best option for those with early signs of aging and not ready for a cheek and neck lift. The procedure is affordable making it an excellent option. These advantages have to be compared to the temporary improvement provided. The results of a face and neck lift, although more expensive, can provide spectacular results and is much longer lasting.

	I recommend consulting with a Board Certified Plastic Surgeon to discuss you options.

	Best regards, Andrew Lyos, MD, FACS

David Hansen, MD · Answer

The silhouette lift is a stronger suture with cones along the lenght of it rather that spikes which the contour threads have.  The silhouette threads hold better and probably longer . Both are easy to put in under local anesthesia and are a good alternative to a full blown expensive facelift. Most patients like the silhouette lift better.
Sincerely, Dr Hansen

Kaete A. Archer, MD · Answer

The Silhouette Instalift procedure is a new and exciting minimally invasive procedure designed to lift and re-position drooping cheek skin.  
In 2004, the FDA approved
thread lifting (Contour Lift, Aptos Lift) for mid and lower facial rejuvenation.  These sutures were permanent, barbed sutures intended to catch and lift the dermis in one direction, allowing for fixation of the skin and to a lesser
extent, the soft tissue in an elevated position.  Despite their revolutionary approach, these
barbed sutures caused many complications. 
Patients had severe pain, skin dimpling, and foreign body reactions.  Cutting the suture to create the barbs left the
overall suture weakened leading to breakage and decreased longevity (3-6
months).  Because
these sutures were permanent, infection and extrusion were common.  Because of the barbed nature, they were
difficult to remove.  Contour Lift lost
FDA approval in 2007 due to these serious complications.
More recently, the
cosmetic market has been re-introduced to “thread lifting” with absorbable
suture suspension using the Silhouette InstaliftTM (Silhouette InstaLift, Sinclair
Pharma, Irvine, CA).  The Silhouette Soft sutures were first introduced to the European market in 2013.  The company then released an upgraded product, the Silhouette Instalift, to the US market, making this suture with knots and
cones fully absorbable and fully biodegradeable using polyglycolide/L-lactide
(PLGA) and poly-L-lactic acid (PLLA).  A fully
absorbable product reduces the risk of infection or need for removal.  By using biodegradable cones, instead of
barbs, the structural integrity of suture was kept intact along with a decreased
risk of dimpling, extrusion, and being able to feel the sutures. 
Another important difference between the Silhouette Instalift and previous barbed lifts is that as the Silhouette sutures break down, they stimulate a collagen response in the skin.  Similar to Sculptra®,
the sutures stimulate both Type I and Type III collagen as they degrade. It is thought that the collagen
growth fixates the sutures for long-lasting results, even when the sutures have reabsorbed.  By doing so, the suture
adds to the volume loss of the cheek area creating a longer-lasting smooth,
contoured appearance.  Based
on the total collagen production and fat content, along with outcomes of the
European data, it is believe that the results begin to peak between 3 and 6
months and may last anywhere from 18 to 36 months.

Elysa Fisher, MD · Answer

Thank you for your question.  I have performed both procedures and much prefer the Silhouette InstaLift for my patients.  The procedure is much more efficient, comfortable to go through and recovery is much quicker.  It is not as effective as a facelift, but does definitely provide a natural lift that my patients have been very happy with.

Robert F. Jackson, MD · Answer

Thank you for your question. The Contour Threadlift&trade; uses permanent threads to lift the skin and tissue of the lower face, while the Silhouette InstaLift&trade; uses specialized, dissolvable threads to accomplish the same goal. Dissolvable threads are safer for the skin and tissue, and remain in place long enough for your skin to form natural scar tissue for more lasting results.

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