Wednesday, July 6, 2016

Silhouette InstaLift: Doctors on the device

It’s the device that could be paving the way to a thread lift comeback. But what do cosmetic surgeons really think about the recently FDA-approved Silhouette Instalift? We asked; they answered.


The Silhouette InstaLift (Sinclair Pharmaceuticals) uses a resorbable suspension suture with bidirectional cones for anchoring to lift and reposition subdermal tissue of the mid-face, with minimal downtime.

Made from polyglycolide/L-lactide, the implanted Silhouette InstaLift mechanically fixates the tissue until collagen production and encapsulation of the suture in collagen occurs. According to company literature, this results in a gradual increase in facial volume and shapeliness. The procedure, which typically takes 45 minutes, is done as an in-office/outpatient basis, under local anesthetic.

Sinclair announced in April 2015 that the Silhouette InstaLift had been FDA approved for mid-face suspension surgery to fixate the cheek sub dermis in an elevated position.

Miami, Fla., plastic surgeon Darryl J. Blinski, M.D., who tells Cosmetic Surgery Times that he has done 40 Silhouette InstaLift procedures since he started using the approach in February of this year, says the InstaLift works and patient satisfaction is high. It lasts from 18 months to two years, in most cases without involving incisions or causing preauricular scars.

But not everyone has the first-hand experience with this newer technology. Thus, we asked cosmetic physicians how this evolution in minimally invasive facial lifting might compare to traditional thread-lifting techniques, as well as the more invasive facelift. This is what they had to say:


Cosmetic Surgery Times advisor plastic surgeon Jason N. Pozner, M.D., of Boca Raton, Fla., says he’s onboard with using the resorbable suspension sutures for facial lifting because, he says, they are a significant advancement with better lifting capability and absorbability than traditional sutures used in thread lifting. Time will tell, however, how patients and physicians perceive their use and results.

“This is another tool for the right patient: the younger patient, who is not yet ready for facelift, or older patient, who medically is not a candidate for surgery,” Dr. Pozner says. “As experience is gained, it might replace some facelifts.”


Paramus, N.J., plastic surgeon William K. Boss, M.D., says he has been using thread lifts since they first came out about eight years ago and were known as the Contour threads. Although Dr. Boss has not used InstaLift threads, he says he is familiar with them.

“They are a modification of the silhouette sutures on an absorbable suture, whereas, the standard silhouette sutures are permanent sutures and require a small incision back in the hairline to anchor them. … the InstaLift threads dissolve over time and require no incision,” Dr. Boss says.

Dr. Boss says that while the procedure is minimally invasive and very quick, he is concerned about longevity with the absorbable sutures.

“In my experience with the permanent sutures, the effects only lasted two to three years at most,” he says. “It appears that the [InstaLift] procedure is most suitable for younger patients without a lot of skin laxity.”

“I really would like to see a comparative study between the InstaLift procedure compared to noninvasive skin tightening technologies, such as ultrasound and radiofrequency,” Dr. Boss says.


Layton, Utah, facial plastic and reconstructive surgeon Scott K. Thompson, M.D., has his doubts about the InstaLift. Dr. Thompson, who specializes in the facelift and mini (MACSlift) facelift surgery, says he does not perform any thread lift procedures.

“Although there have been many variations of thread lifting over the years (the latest being the InstaLift), any technique that doesn’t separate the skin from the underlying muscle and, then, address the sagging muscle tissue directly is unlikely to have significant impact for more than a few months,” Dr. Thompson says. “Unfortunately, many of these procedures approach the cost of a minimally invasive facelift, such as the MACS lift (a technique that while less invasive than a standard facelift, lifts and tightens skin and muscle independently). Those looking for a non-surgical option may be better served by reconsidering the costs and benefits of surgery or sticking with injectables and laser resurfacing procedures.”

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