Trish Hammond: Welcome everyone. And, I’m here today with the lovely Dr Jayson Oates from Academy Face and Body in WA and Crows Nest. And Dr Oates has been kind enough to have a chat to us today about a procedure that he does a lot of, which is the thread lift, which is what’s known commonly as the non-surgical face lift using threads. So welcome Dr Oates.
Dr Jayson Oates: Hi Trish. How are you?
Trish Hammond: Good, how are you?
Dr Jayson Oates: Yeah, good.
Trish Hammond: Excellent. Tell us about this procedure. We’ve actually had quite a few inquiries this week. I think what happens is people get over Christmas and they think, “Oh my god. I’ve been partying too much. I need to rejuv myself up a bit.” And people have been asking about threads.
Can you tell us first of all what they are?
Dr Jayson Oates: Okay. They started quite a few years ago now with Actos threads, and they were a permanent thread, what’s called polypropylene, which is a thread that we use a lot and your body doesn’t break it down, and have lots of little slices into it. Each one would create a little barb along the thread. And so the idea was that the thread could be passed underneath the skin in various methods, and then by pulling on it you could use those little barbs to hook the skin and lift it up.
That’s where it all sort of started. They’ve gone through lots of different variations and changes, different ways of putting them in, but basically they’ve all been based around the idea of having some anti-gravity type lifting effect without having to go through the bigger procedures like the face lift.
Trish Hammond: Okay, so it’s a little bit like, and I can only say this because I’ve actually had it done myself, it’s kind of like that puppet thing where, the ones that I had done kind of come out the side of your head and you kind of just pull the threads, and it kind of lifts up the skin all the way from the bottom.
Dr Jayson Oates: Yes. There’s different patterns of barbs, or in fact the ones that I use mostly now have little cones on them. But the idea is of securing them in one spot, then using the hooks, the barbs or the cones, to catch the deeper layers of the skin and then lift it up.
And in fact, part of it is not just sort of a lifting but the compressing of the tissue together, which is why they can be good over the cheeks. My initial concerns with threads is, well how does that thread know to lift the saggy bit up, as opposed to pulling the high bit further down because gravity, everything is wanting to descend. What makes it go up rather than down?
Trish Hammond: Mm-hmm (affirmative).
Dr Jayson Oates: The most common threads have what we call convergent barbs. So there’s a gap in the middle where there’s no barbs, then the barbs as they go on each side of the thread are pointing inwards, and so the idea is that you start in the middle where you want to elevate the skin, or mound the tissues up, say like on the point of the cheek, and you have one thread that goes down, and then one thread that goes up.
The one that goes up is sort of anchoring but it’s also pulling those tissues together to mound it up on the cheek, create a bit of height and volume on the cheek, and getting most of that tissue from what’s sagging down into the jowls.
Trish Hammond: Okay, yeah because that’s where I’ve noticed a difference in myself. It’s made my jawline a whole lot sharper.
Dr Jayson Oates: Yeah, it helps-
Trish Hammond: So that’s kind of-
Dr Jayson Oates: -define jawline. That’s one of the better places for it.
Trish Hammond: Okay. So tell me, so who do you generally say it’s really suitable for because I get inquiries from younger ladies, I get inquiries from older ladies. So is there a time when you’re going to be too old to have it done?
Dr Jayson Oates: I generally suggested Trish, it’s for younger ladies like yourself who don’t have a lot of sagging but are just starting to have a little bit. For years people would come in and say, “I just want this tiny little bit elevated.” And they’d be in their mid 40s say, and I would be saying, “Oh look, you don’t want to have a facelift for that.” The trade off with the scar and a big operation, and this was before we had threads.
And now I’m looking in the mirror and sort of tweaking my jawline up a little bit, and seeing that tiny little movement and thinking, “Yeah, I need threads too.”
Trish Hammond: Yep.
Dr Jayson Oates: So when somebody comes in, maybe in their 60s or 70s, and they’ve got a lot of gravitational descent of the soft tissues, and they’re saying can they just have a few threads. I generally try and talk them out of it, because it’s not the treatment for them.
You can put in more and more threads. The more threads you put in, the stronger the support you get but I still feel threads are a better treatment for somebody who’s only got that mild to most moderate descent.
Trish Hammond: Okay. So-
Dr Jayson Oates: I mean the other thing of course that changed with threads is that we use a lot less of the permanent threads, in fact I don’t use the permanent threads anymore, and only use the dissolving threads. Because what would happen is you’d have someone come in, in their mid 40s, and you’d put in some threads, and they’d support them for a few years but after two, three, four years there’ll be a little bit more ageing process going on, so they’ll have a few more threads put in. But eventually they get to the point where they’re ready to have surgery, and have a face lift. When you go in to do the face lift you find there’s all of these threads sitting in there. Generally I’d sort of pull them out and do a formal face lift.
So now they’ve got the dissolving threads, and that sounds like a crazy idea because everybody of course wants to have a permanent lift, but the threads will be completely dissolved within 12 months, but the effect usually will persist because your body has produced collagen, essentially a line of scar tissue around the thread, and then that’s what then persists in holding the face with that little bit of support.
Trish Hammond: Got it. So, although the threads may have been dissolved after 12 months, you’ll still have a bit of a lifting effect because the collagen. It’s activated the collagen because of the “damage” is making collagen.
Dr Jayson Oates: It’s stimulating that sort of healing response, and in fact we’re starting to see more options for that. So as well as using threads to lift, and as I was saying my favourite areas is sort of creating a bit of volume over the cheekbone, and redefining the jawline, and to give a little bit of lift to the outer eyebrow.
The next thing that is sort-of of interest is just that stimulatory effect that you get from having the threads. And not available in Australia in the moment, but becoming quite popular in the US, and it came from Korea, where a lot of these interesting ideas come from, is using threads without any barbs at all, but just putting in lots of these tiny, little threads under the skin to stimulate the collagen.
The collagen will then tighten and create a little bit of tightening, but it’s improving the texture and quality of the skin, and even looking at going into hair loss. That maybe, having that stimulating effect from the threads in the scalp, from putting the threads right in next to the hair follicles seems to stimulate hair growth.
That was reported last year in one brief paper. It only had one before and after photo but it was quite an impressive improvement. We might start trialling that and see if we can get that same sort of improvement because certainly there’s plenty of guys out there who would be keen on stimulating hair growth.
Trish Hammond: Yeah, of course. That would be a really interesting one. I know they’re using PRP but I’ve never heard of using threads before. So yeah, why not?
Dr Jayson Oates: It’s that similar sort of thing with PRP, and with needling, and with fractional resurfacing where you’re stimulating, creating a little bit of an injury, getting the body to start producing the growth factors, of doing the healing and that’s where the benefit comes from.
Trish Hammond: Awesome. So basically everyone will need a different quantity of threads depending on what they achieve.
Dr Jayson Oates: Yes, and what they have as far as their anatomy and the amount of gravitational changes that they have.
Trish Hammond: Okay, and also you said they dissolve after a month, so how long does the effect last for? Sorry not a month, sorry a year. Sorry. I want to get that one right.
Dr Jayson Oates: So they start dissolving after about four to six months, and have gone by a year. Most people are seeing a benefit that’s lasting two to three years. So I’ve got to admit, for the majority of people that I see, I still often feel that a facelift, or a mini face lift, is a better procedure.
A lot of people look for threads because they think it’s a lunchtime sort of procedure, and they’ll go back to work the same day. And depending on how aggressive you’re trying to be with the threads, that’s probably not going to happen.
If the person is a good candidate for threads, and they’ve only got a small amount of lifting needed, then yes, they may be fine within a day or two with minimal swelling and bruising. But every time you stick a needle in somebody there’s a chance of getting a bruise.
With people who are pushing the limits with what threads are good at, you tend to get a little bit more skin bunching up, the potential for a little bit of puckering underneath the skin where the cones or the barbs are. So there may be a bit to see that will last for a week or more. The idea that it’s a lunchtime procedure and you’ll be back at work the next day, for a lot of people it just isn’t going to be the case.
Trish Hammond: Yep, no. When I had mine done, I came home and I felt like my head had been run over by a truck. It was like … I was like wow, I wasn’t expecting that. So my expectation was exactly what you said. A lunch time procedure, go in, have it done and go home. But it wasn’t. I was actually on Panadol for a few days afterwards myself because it was a lot more intense than what I thought.
Dr Jayson Oates: Quite a lot of needles isn’t there?
Trish Hammond: Yeah. Having said that, I’d spoken to one of your patients who’d had it done a couple of days before and she was right to go the same day. So once again, it’s one of those things where everyone’s going to recover differently.
Dr Jayson Oates: It is. And some people know that they’re bruisers, and they’re going to get perhaps more bruising that most. As I said, for the right person who’s just having a subtle, little tweak, and just having a couple of threads, yeah sometimes the next day they’ll look great.
But, yeah, if you stick a lot of threads in perhaps a slightly older women, who’s got a lot of skin they need pulling up, more than likely you’re going to have some dimpling, and some skin bunching up and it’s going to look like you’ve had a procedure.
Trish Hammond: Yep. I’m glad I don’t look like I’ve ever had a pr- Well I don’t think I look like I’ve had a procedure but I’m like, yep, nope, ready for the necklift I think because it didn’t do anything to my neck but can …? I think probably when it gets to the point where there’s too much skin? It’s not-
Dr Jayson Oates: Yeah. I’ve got to admit, I’m not personally a huge fan of necks. We’ve got a couple of doctors in our clinics, one in Sydney and one here in Perth, who they do a lot of threads, and they like threads in the neck. And in fact I guess it’s one of these things, because I came from the surgical background and was comfortable doing face lifts, and by the time somebody’s coming to see me, they’re probably wanting a face lift, or a neck lift, or a surgical procedure. And when they see one of the other doctors, they’re doing that because they don’t want to have perhaps a bigger procedure.
Trish Hammond: Yeah.
Dr Jayson Oates: And so they do the threads lift in that case, and they’re very happy with the results that they’re getting.
Trish Hammond: Yep. They probably want the confirmation of whether to, or not to.
Dr Jayson Oates: Yeah, and obviously sometimes the other doctors look at them and say, “Look, you really should be thinking about surgery.” And then they’ll send them over to me. But otherwise I think they have the majority of them. They do threads and are getting nice results.
Trish Hammond: Awesome. And just with the cost factor, I know it varies on the amount of threads but what … Would it be half the price, or a third of the price, or a quarter of the price of a facelift? Is there a gauge?
Dr Jayson Oates: Yeah, it’s a lot less than a face lift. I guess that’s the … So by the time we’re doing a deep plane face lift, which is going to take three and a half hours under sedation with all the hospital costs, and everything that’s involved. You’re starting to get pretty close to $20,000, whereas you might have some threads, and you may have say $3000, or $3500 of your total cost. So it’s significantly different obviously.
Trish Hammond: Yep, yep. Got it alright, I reckon you’ve answered any questions that anyone would want to, except one last question. Does it hurt? Should it hurt?
Dr Jayson Oates: Yeah, the real art with it is to avoid making it painful. When I first started doing threads, more than a decade ago, we used to actually inject local anaesthetic the entire length of where the thread went, and it was the injecting local anaesthetic that was the painful bit.
Now we tend to just inject a local anaesthetic where the needle goes in and comes out, but the path along where the needle travels you don’t put local anaesthetic, and initially I thought that sounded like a terrible idea, and yet again I’m proven wrong.
So long as you’ve got the needle in the right plane, so not too close to the skin, that’s when it starts getting painful again, and not too deep, not starting to get down towards the muscle. There’s the right plane where you want to be for the lift, and it’s also got the least sensation. So it’s amazing, most people, they barely really notice the needle going through, so that’s not such a big deal.
So, no. You don’t expect it to be a painful procedure.
Trish Hammond: Yep. Okay. The other thing I thought I should probably ask you is, are there any contra-indications, because I know that I forgot to mention that I’d had filler in my temples and-
Dr Jayson Oates: Filler is the main issue, and permanent fillers always worry me a lot. I, personally wouldn’t put threads where someone has permanent fillers. Of course the majority of people who we’re looking at treating have already had some fillers done already, and the fillers have done the job that the fillers can do, and now they’re looking for something a little bit more.
One particular thread company had said that they don’t like fillers being done six months before or after the threads. Most other thread companies don’t have any precautions like that. I just think it’s really important to be very clean. Have it as a sterile procedure, as a surgical procedure because you’re implanting something under the skin. And it’s infection that’s the main thing that we’re worrying about. Taking those threads, carrying in a bacteria and then seeding the filler that’s in there.
Trish Hammond: Yeah, of course. Say for example, if it isn’t a filler, can you not rupture it, but can it leak? Surely if a needle’s gone through, if it’s a solid filler, needle’s gone through is there a chance of it leaking or …?
Dr Jayson Oates: No, not really because the filler actually gets well integrated into the skin. The vast majority of our fillers are the hyaluronic acid. And hyaluronic acid is that natural sugar that’s in the tissues between the cells anyway so unless you really inject one big blob of filler and create like a ball, filler is actually all dispersed within the tissues and integrated. It’s got blood vessels going though it, and cells in it, so no, it doesn’t sort of pop and then leak out.
Trish Hammond: Yep. Okay. So there’s no danger of that.
Dr Jayson Oates: No.
Trish Hammond: No, alright. Cool. Well I reckon you’ve answered all my questions, and I do believe if you’re going to get them done, do them a little bit sooner rather than later because-
Dr Jayson Oates: That’s probably the main thing.
Trish Hammond: I think so, yeah. I think so. From the results that I’ve seen, like the girl that I saw was 37, compared to myself who’s 54, like it was a massive difference. There was just such a big difference with her, but with myself being older, it wasn’t as dramatic as what she was. So yeah, sooner rather than later, and save up for your face lift hey?
Dr Jayson Oates: Yeah. Save up for the face lift eventually.
Trish Hammond: Yeah.
Dr Jayson Oates: And we’ll let you know how we go with trialling these smooth threads and hair stimulation and see if we’ve got something to report back.
Trish Hammond: Yeah, that would be very interesting. Well thank you so much for your time today Dr Oates. It’s been an absolute delight as per always.
Dr Jayson Oates: Yeah, no. Thank you. Great to talk to you again.
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