Face Lifts: Threads vs RF vs Ultrasound

Dr Sonam Yadav, MD Juverne, says:

In my clinical practice I have been fortunate to have worked with the finest energy based devices (EBD) and lasers for facial sculpting and skin rejuvenation. This unique position has given me a bias for EBD and I certainly do prefer these and Injectables (Fillers, Botox, Growth Factors) over Thread Lifts. However, I do use threads and there is a place for them even in my practice. Let's discuss this a bit.

In the last, almost, ten years, I have worked with the following Energy Based Devices on a regular basis (I've tested many more):

Radio Frequency: Thermage CPT and NXT, Exilis Elite, Endymed, Ematrix, Tripollar

Ultrasound: Ultherapy, UltraFormer

Threads: PDO, Cog Threads, Silhouette Soft


What RF is great for: 

1) Improving skin texture and collagen. 2) Improving the neck lines and 3) iron out thin loose skin. 4) Delaying aging in young persons who do not have much sagging 5) Gentle lift & contouring of a heavy face 

Where it fails:

1) RF cannot tighten skin as much as ultrasound can 2) RF takes many sessions thus is not useful for patients who are short on time and need a lot of change 3) RF cannot target deeper fat layers and give a strong mechanical lifting effect.

These flaws in RF can be overcome by a combination of UltraFormer and threads. The UltraFormer is a strong skin lifting technology than a strong skin crease reducing agent. It works at a higher temperature and deeper levels in the skin. 

Threads are for those patients who need an additional mechanical lift. 

Who should consider threads: 

1) A large amount of loose hanging tissue whether skin alone or skin plus fat - which cannot be completely addressed by EBD

2) Budget concerns. PDO Threads can be cheaper than EBD treatments, but that's also because they are non specific and last only a short time (6 months if you're lucky). The superior quality of COG threads like Silhouette Soft are not inexpensive and may cost much more than EBD face lifts.

3) Auto Immune Conditions: Threads are a foreign body which will remain in the body for a few weeks to months. Patients need to be selected wisely to ensure there are no undue reactions/side effects from this.

My opinion: 

1. Every doctor evaluates a patient and tries to achieve the best result for them, with the age / skin condition/ goals / time constraints and budget in mind. Have an open discussion with your doctor to know which option suits you best and why.

2. Combination approaches tend to work better because each facial area can have different needs. My personal technique is to combine small doses of UltraFormer and EndyMed RF with injectables- and rarely threads to achieve a natural face lift.