Combination Treatment: Threads and Dermal Fillers

The process of facial ageing includes skin laxity, tissue sagging, and depression of facial contours caused by loss of bony support and volume of soft tissue. A natural, rejuvenated look can be achieved through a balanced improvement in each aspect of ageing—the loose skin tightened, the sagged tissue lifted, and the depression of facial contour restored. It is often necessary to combine different modalities to achieve this goal non-surgical. Until recently, some injectable fillers and their original indication for correcting volume loss have also been advocated for ‘lifting’. Injecting the fillers into the bases of the retaining ligaments reinforced the ligaments, weakening and tilting because of age and resulting in a ‘lifted’ appearance. As a non-surgical option for lifting, thread lifts are faster than energy-based devices in the onset of action, while their longevity remains in debate. The author proposed the ‘The Dual Lift technique’ to improve the tissue sagging and facial contour with the optimal combination of bi-directional cog threads and injectable fillers. The filler-reinforced ligaments synergistically enhance the effect of lifting by threads, and the longevity of fillers complements the threads and leads to a longer-lasting result of the procedure.