Combining Floating and Fixed Threads for Natural, Functional Facial Rejuvenation: MINT PDO Thread Lift
- Admin
- May 15
- 4 min read
Updated: May 16
Based on Hyun Ho Han et al. | Archives of Aesthetic Plastic Surgery, 2014
Introduction: Enhancing Facial Rejuvenation with MINT PDO Thread Lifts
Thread lifts, particularly the MINT PDO (Polydioxanone) technique, have grown in popularity for patients seeking facial rejuvenation with minimal downtime and less invasiveness compared to traditional facelift surgery. However, achieving a natural look while providing durable lifting results, particularly for Asian patients, can be challenging.
Dr. Hyun Ho Han and colleagues introduced a "combined-type" thread lift, merging floating-type and fixed-type PDO threads based on anatomical zones of the face. This innovative technique respects facial mobility and expression while delivering structural support to sagging areas, achieving highly satisfactory results in 83% of patients during short-term follow-ups.
Dividing the Face by Mobility and Fixation for Effective Thread Lifting
Facial anatomy, according to Mendelson et al., can be functionally divided into two regions:
The mobile anterior face, responsible for dynamic facial expressions.
The fixed lateral face, supported by the masticatory muscles, providing structural stability.
Dr. Han’s technique tailors PDO thread placement to these functional zones:
Floating threads are placed in the mobile anterior face to maintain dynamic expressions.
Fixed threads are anchored in the stable lateral face to create a strong and stable lift.
Surgical Technique: Combining Strength and Flexibility for Natural Results
The procedure begins with an anatomical landmark drawn from the lateral orbital rim. A fixed-type barbed PDO thread is inserted through a small slit incision and anchored in the deep temporal fascia to create a stable lift vector for the lateral face.
Figure 2: Fixed-type lift for the lateral face(A) A vertical line divides the face into anterior and lateral regions. The fixed PDO thread is inserted, pulled, and anchored into position.(B) The ptotic soft tissue is lifted toward the deep temporal fascia.(C) The lifting force vector (yellow arrows) directs toward the temporal area.
Floating-type PDO threads are then inserted into the anterior face to lift sagging tissue gently, with no fixed ends. These threads gather soft tissue and elevate it toward the midline, preserving the natural contour of the face.
Figure 4 – Before cutting the end of the fixed-type threads, the ends exited the inferior and medial sides. Floating-type threads are shown in the entrance. The ends of the threads were pulled appropriately and cut so as not to expose the threads.
Key Technique Highlights:
Slit incisions provide minimal access, reducing the risk of scarring.
PDO threads feature dented barbs, which preserve tensile strength and enhance the lifting effect.
Floating threads ensure no distortion of facial animation, while fixed threads provide strong support for sagging regions.
Clinical Results: High Satisfaction and Natural Appearance
In a study of 28 patients, 18 were followed for over three months. Most patients reported significant improvements in midface sagging, jowl formation, and nasolabial fold prominence.
Addressing Malar Broadening in Asian Patients with Floating Threads
One of the study's key findings is the potential for malar broadening, particularly in Asian patients with wider facial structures, when using fixed-type PDO threads. By using floating-type threads in the anterior region, the lift is directed toward the midline, reducing lateral fullness and preserving a balanced appearance.
Key Clinical Insight:
Use floating threads in the anterior regions to avoid unnatural cheek widening, especially in patients with wider facial profiles.
Why This Combined Technique Matters
Dr. Han’s combined approach provides a customizable, anatomically-based method for PDO thread lifting:
Natural expression in dynamic facial zones with floating threads.
Strong, stable lift in static regions with fixed threads.
Balanced contour that avoids puffiness and distortion.
This technique also provides durable results, improves patient satisfaction, and is ideal for patients seeking a minimally invasive, non-surgical facelift with short recovery times.
Limitations and Considerations
While minimally invasive PDO thread lifting offers many benefits, it is important to note that the lift from absorbable PDO threads is temporary. Results vary, and the procedure may need to be repeated for sustained effects. The study also acknowledges its small sample size and the short-term nature of follow-up.
Despite these limitations, the combined floating and fixed thread technique offers a non-permanent, customizable solution that aligns well with the growing preference for non-surgical aesthetic treatments like Botox and dermal fillers.
Conclusion: A Balanced, Anatomically Respectful Thread Lift
Dr. Han's innovative approach to PDO thread lifting, incorporating both floating and fixed threads, presents a clinically validated, customizable solution that respects facial anatomy while delivering natural, long-lasting results. This technique is ideal for surgeons looking to offer a minimally invasive, effective thread lift with reduced recovery times and high patient satisfaction.
Quick Takeaways for Practitioners:
Divide the face anatomically: Use fixed threads laterally and floating threads anteriorly.
Anchor fixed threads in the deep temporal fascia for a stable lift.
PDO threads offer superior strength without cutting barbs, ensuring a secure lift.
Prevent malar widening by using floating threads in the anterior regions, especially for Asian patients.
This combined technique is an excellent option for patients seeking a non-surgical facelift with low risk and quick results.
Reference:
Han, H. H., Kwon, J., & Kim, W. S. (2014). Combined, minimally invasive, thread-based facelift. Archives of Aesthetic Plastic Surgery, 20(3), 155–160. DOI: 10.14730/aaps.2014.20.3.160
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