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Background <p>Adjunct jowl-fat liposuction is commonly combined with absorbable thread lifting to enhance lower facial contouring. However, previous studies have mainly relied on subjective assessments, such as patient satisfaction, Global Aesthetic Improvement Scale scores, or photographic evaluation. Objective three-dimensional quantification of regional volumetric changes after combined thread lifting and jowl-fat liposuction remains limited. This study aimed to evaluate whether adjunct jowl-fat liposuction increases the inter-zonal volumetric difference after absorbable thread lift using VECTRA 3D imaging.</p> Methods <p>This single-center retrospective matched-pair study included patients who underwent absorbable thread lift alone or absorbable thread lift combined with jowl-fat liposuction between December 2023 and December 2025. Patients with available preoperative, 2-week, and 1-month postoperative VECTRA 3D images were included. After matching for sex, age, and total thread count, 12 patients in the thread lift only group and 12 patients in the adjunct jowl-fat liposuction group were analyzed. Two anatomically defined regions of interest were used: Zone 1, corresponding to the perioral–jowl region, and Zone 2, corresponding to the mid-cheek region. The primary outcome was the inter-zonal volumetric difference index at 2 weeks, defined as S = |ΔV(Zone 2) − ΔV(Zone 1)|. A Wilcoxon signed-rank test was performed as a sensitivity analysis for the primary outcome.</p> Results <p>At 2 weeks postoperatively, S was significantly greater in the adjunct jowl-fat liposuction group than in the thread lift only group (1.66 ± 0.46 mL vs. 0.76 ± 0.37 mL; paired mean difference, 0.91 mL; 95% confidence interval, 0.46–1.36; <i>p</i> &lt; 0.001). The geometric mean ratio of S was 2.33 (95% confidence interval, 1.57–3.46; <i>p</i> &lt; 0.001), and the Wilcoxon signed-rank sensitivity analysis yielded consistent results (<i>p</i> = 0.0024). Zone-wise analysis showed that the increase in S was mainly attributable to greater volume reduction in Zone 1 in the adjunct jowl-fat liposuction group. At 2 weeks, ΔV Zone 1 was − 1.42 ± 0.48 mL in the adjunct jowl-fat liposuction group and − 0.54 ± 0.32 mL in the thread lift only group (<i>p</i> &lt; 0.001), whereas ΔV Zone 2 did not differ significantly between groups (0.25 ± 0.14 mL vs. 0.21 ± 0.09 mL; <i>p</i> = 0.506). At 1 month, ΔV Zone 2 was significantly greater in the adjunct jowl-fat liposuction group (0.18 ± 0.10 mL vs. 0.11 ± 0.04 mL; <i>p</i> = 0.041), and exploratory Zone 2 retention was higher in the adjunct jowl-fat liposuction group (72.9 ± 2.6% vs. 50.3 ± 2.3%; <i>p</i> &lt; 0.001). Inter-rater reliability was high for all volumetric measurements.</p> Conclusions <p>Adjunct jowl-fat liposuction increased the inter-zonal volumetric difference after absorbable thread lift, primarily through enhanced volume reduction in the perioral–jowl region rather than early mid-cheek volume gain. The higher Zone 2 retention observed at 1 month should be interpreted as exploratory. These findings suggest that adjunct jowl-fat liposuction may objectively enhance the contouring-related component of absorbable thread lift, although further prospective studies with larger cohorts, recorded aspirated volume, and longer follow-up are warranted.</p> Level of evidence <p>Level III, therapeutic study.</p>

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Adjunct jowl-fat liposuction increases the inter-zonal volumetric difference after absorbable thread lift: a matched-pair VECTRA 3D analysis

  • 期刊论文

  • 发表日期：

    2026年7月31日

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  • Keisuke Matsumura,
  • Takahiko Tamura,
  • Kohki Okumura,
  • Hiroo Teranishi

摘要

Background

Adjunct jowl-fat liposuction is commonly combined with absorbable thread lifting to enhance lower facial contouring. However, previous studies have mainly relied on subjective assessments, such as patient satisfaction, Global Aesthetic Improvement Scale scores, or photographic evaluation. Objective three-dimensional quantification of regional volumetric changes after combined thread lifting and jowl-fat liposuction remains limited. This study aimed to evaluate whether adjunct jowl-fat liposuction increases the inter-zonal volumetric difference after absorbable thread lift using VECTRA 3D imaging.

Methods

This single-center retrospective matched-pair study included patients who underwent absorbable thread lift alone or absorbable thread lift combined with jowl-fat liposuction between December 2023 and December 2025. Patients with available preoperative, 2-week, and 1-month postoperative VECTRA 3D images were included. After matching for sex, age, and total thread count, 12 patients in the thread lift only group and 12 patients in the adjunct jowl-fat liposuction group were analyzed. Two anatomically defined regions of interest were used: Zone 1, corresponding to the perioral–jowl region, and Zone 2, corresponding to the mid-cheek region. The primary outcome was the inter-zonal volumetric difference index at 2 weeks, defined as S = |ΔV(Zone 2) − ΔV(Zone 1)|. A Wilcoxon signed-rank test was performed as a sensitivity analysis for the primary outcome.

Results

At 2 weeks postoperatively, S was significantly greater in the adjunct jowl-fat liposuction group than in the thread lift only group (1.66 ± 0.46 mL vs. 0.76 ± 0.37 mL; paired mean difference, 0.91 mL; 95% confidence interval, 0.46–1.36; p < 0.001). The geometric mean ratio of S was 2.33 (95% confidence interval, 1.57–3.46; p < 0.001), and the Wilcoxon signed-rank sensitivity analysis yielded consistent results (p = 0.0024). Zone-wise analysis showed that the increase in S was mainly attributable to greater volume reduction in Zone 1 in the adjunct jowl-fat liposuction group. At 2 weeks, ΔV Zone 1 was − 1.42 ± 0.48 mL in the adjunct jowl-fat liposuction group and − 0.54 ± 0.32 mL in the thread lift only group (p < 0.001), whereas ΔV Zone 2 did not differ significantly between groups (0.25 ± 0.14 mL vs. 0.21 ± 0.09 mL; p = 0.506). At 1 month, ΔV Zone 2 was significantly greater in the adjunct jowl-fat liposuction group (0.18 ± 0.10 mL vs. 0.11 ± 0.04 mL; p = 0.041), and exploratory Zone 2 retention was higher in the adjunct jowl-fat liposuction group (72.9 ± 2.6% vs. 50.3 ± 2.3%; p < 0.001). Inter-rater reliability was high for all volumetric measurements.

Conclusions

Adjunct jowl-fat liposuction increased the inter-zonal volumetric difference after absorbable thread lift, primarily through enhanced volume reduction in the perioral–jowl region rather than early mid-cheek volume gain. The higher Zone 2 retention observed at 1 month should be interpreted as exploratory. These findings suggest that adjunct jowl-fat liposuction may objectively enhance the contouring-related component of absorbable thread lift, although further prospective studies with larger cohorts, recorded aspirated volume, and longer follow-up are warranted.

Level of evidence

Level III, therapeutic study.