Thread lifting

Manufacturer: Dr. Vancsó Péter

Aptos threads face lifting

 The aptos procedure is a very simple way of performing a facelift. This procedure was first developed in Russia by Dr. M. Sulamanidze, and further developed by Dr. Des Fernandes from South Africa. This procedure has largely replaced traditional face lifts for patients who have mild laxity of the skin and would like a subtle tightening of his or her facial features without undergoing a major face lift. The lift is done by a modified suture thread.

The point of the thread is that it has a middle and from there the threads go in different directions. This allows the thread to pull the tissue to the center, much like gathering a waist band.

The suture is the same as cardiac prolene and is totally inert. More threads can be laid after or they can be pulled during a later face lift. The threads are blue to make them easier to find during the procedure, if necessary, and after any following surgeries, related and unrelated.

Candidates should not have a lot of lax skin, but post face lift patients are a candidate even if they are older because a lot of their skin has been previously removed. The beauty of this procedure is that it lifts instead of pulling. The average face loses 4-5cc of volume per year and the Feather Lift augments and lifts the volume remaining. In a sense it gives the appearance of pulling the malar cheek pad up and lateral, although in reality it doesn't do this.

Immediate Results: Because of the volume of the local injected, the initial result is somewhat of a Howdy Doody appearance. This dissipates in the first 24 hours. Also their is little bruising due to the lidocaine being mixed with epinephrine which is a vasoconstrictor. However the patient will go home with apparent white areas and red areas. This will change by the next morning or in a few hours when the normal blood flow returns as the epinephrine wears off.

I believe that the patient may lose 30% of the initial result seen. It is true that fibrosis occurs and this tightens the area but most patients will only remember the volume in the cheeks directly after the procedure, which is a lot due to the anesthetic. The results are subtle but quite beautiful. Down Time: Patients should not talk for the first 24 hours. They will find their facial movement limited for the first two weeks. It also may hurt to laugh for two weeks. No massage or facial pressure for one month. Maximum tensile strength usually occurs at 21 days.

Complications: The threads must be cut low and the skin forced down. Still one may have a bubble under the skin. The options are to try to redirect the thread down or to make a small stab incision and cut the end. If the end of the thread actually ever comes out it, the correction is very simple. The thread is cut again to shorten and redirected downwards again.

Scarring: Scarring from the needle injection is minimal but it is a large bore needle. Pre treating for very ethnic patients with Hydroquinone an assist in lessening the chances of hyperpigmentation.


With age, the effects of gravity become noticeable on the face.

  • The supporting tissue of the cheeks may sag.
  • There is a softening around the jawline and causing early jowls.
  • Sagging of the lower face and neck

Unless there is a significant amount of redundant or sagging skin, there is no need to remove any excess skin. This is particularly so in the over sixties age group, but results are still significant in any age group, especially if combined with other procedures are mentioned below.

The effects of the skin tightening using the aptos threads lasts up to five years.


The face is first cleaned with a broad spectrum antiseptic such as Chlorhexidine or Betadine solution to decrease the amount of surface bacteria to help avoid infection. After you are dried your face is carefully felt and measured and will be marked for the placement of the threads.

If the marker used is single use there is usually no need for a re-washing of your face. If not or just to be doubly careful, the face may be wiped again, leaving a faint but definitive lines are on your face as a guide for your doctor.

Your doctor then begins to infiltrate the area using a hypodermic needle with a local anesthetic mixture comprised usually of Lignocaine, adrenaline, normal saline and a sodium bicarbonate buffer. This ensures that you will not feel any pain and the adrenaline also decreases the amount of blood loss and anesthetic absorbed during the procedure. The does this by temporarily narrowing the bore (vasoconstriction) of the blood vessel.

After you are adequately anesthetized, your surgeon inserts a hollow trocar (a stainless tube with a needle-sharp end) at the specified entry points and through the subcutaneous fat along a specified plane. The tissue is dissected along this plane as needed based upon the individual patient. The exit point is then made and the APTOS thread is then inserted into the trocar.

The thread is pulled through the other side of the trocar and the trocar removed, with the thread staying in place. The thread is positioned, tugging and testing its placement and finally anchored when the needed placement is achieved, the threads are cut just at the skin and inserted under the surface of the skin.

Each area is treated and the treatment areas normally taped to prevent movement in the first few days. Excessive movement can dislodge the intended placement of the threads, altering the desired result.


There may be bruising immediately following the procedure which will settle down in the days following the surgery

  • All swelling will disappear within the first few weeks
  • It takes up to three months for the desired firmness and tightening of the face to occur, due to the formation of fibrous and collagen tissue which occurs around the threads.


Mild infection may rarely occur at the site of the thread insertion, although every precaution is taken to prevent this.

In a very small number of individuals, the threads do not work as satisfactorily or for as long as usual.

Fortunately, because the procedure is superficial and done just under the skin, the possibility of nerve or vessel damage, is minimal.

  • Allergic reaction to the anesthetic, hematoma or seroma.
  • Palpability pf the APTOS threads resulting in a telltale line.
  • Thread poking through the skin ( if this should happen contact your doctor immediately for an in-office visit. Do not attempt to re-insert the thread yourself, at any time. This may possibly result in an infection.)

Dislodging of the thread may occur resulting in a lopsided or crooked result (asymmetry). Please contact your surgeon as soon as possible for an in office visit. Please discuss your options beforehand with your doctor in the event this may occur (or not occur for that matter).