Wednesday, July 6, 2016

This New Nonsurgical Face-lift Can Change Your Face in Less Than an Hour

Z. Paul Lorenc, an aesthetic plastic surgeon in New York City, has given 12 patients a "face-lift" that didn't involve any surgery whatsoever. Lorenc is one of a few doctors in the United States who are offering the new Silhouette Instalift, a nonsurgical procedure that inserts threads of biodegradable cones into the skin to temporarily lift sagging skin. The Instalift has been popular in Europe, but it's only now been cleared by the FDA for use in the United States. I spoke with Lorenc about the procedure and how it differs from other types of face-lifts.

How exactly does the Instalift work?

"I perform an Instalift by inserting a absorbable thread with cones on it into the face. The thread is made out of polylactic acid, which means it will be completely absorbed by the body. The cones on the thread are bidirectional, so when I put the first needle through, I point the cones one way, toward the bottom. When I put the other needle in, I point the cones in an opposing way, or above the other ones. What that does is utilize the tissue above the cones as an anchor, which then advances the tissue below it toward it. That's how it 'lifts' the skin. Since the cones are orientated so that they're facing each other, it ends up squeezing the tissue together. The cones then sort of catch onto the tissue, and that's what holds it in place initially. Then, as the thread and cones are being processed by the body, scar tissue forms around it, and then the tissue is suspended in that position."

What makes this procedure different from the similar Contour Thread procedure? 

"While the Contour Thread face-lifts were also using a form of suture made to suspend tissue, those threads had little notches in them, which resulted in not allowing any tension to build up. Therefore, the tissue would just slip through them and not be properly lifted. In the Instalift, the surface area that engages the tissue is much larger than just the contour sutures. The other difference is that Contour Threads were permanent. With the Instalift, the sutures are made out of lactic acid, so they disappear; your body processes it. As it disappears, your body builds collagen because the lactic acid stimulates collagen production. So not only do you get that initial lift, you get a volumization of the face as it's being degraded."

How long does the procedure take and how much does it cost? 

"It takes me about 40 to 45 minutes. It depends on how many sutures I have to place on each side. I've done as little as two to four. It all depends on the anatomy and the extent of the lift that needs to be done. As for cost, it's very region-dependent. We charge $5,500, but it depends on how many sutures I need to use, because they're expensive. The range is about $3,500 to $5,500."

What's the healing process like? 

"In about 24 hours, you have a little bit of swelling. You'll have some swelling around where the insertion is from the suture, and you can put makeup on it 24 hours later. I have a patient who's a real estate broker, and I did the procedure on a Wednesday. She had an open house on Thursday, and nobody knew that she'd had anything done."

Have there been any negative side effects? 

"In Europe, about 300,000 Instalifts have been placed already, and there were no reported side effects with this procedure. One of the reasons why you don't have major complications is because it's placed right underneath the skin in the subcutaneous tissue. The other reason is that it's completely absorbable.  If the placement isn't correct, you can just take it out and it easily slips out."

Since it gets absorbed by the body, how long will the effects last? 

"Since it's absorbable, it lasts about 18 months. It doesn't replace a face-lift."

So why would someone choose to get the Instalift over a traditional face-lift?

"It's way less invasive and there's less downtime. Look, I love doing traditional face-lifts. I'm a plastic surgeon—that's my passion. But in certain patients, I think it expands what we can really do. It brings in patients who aren't quite ready yet for a face-lift. I've also used it in patients who have had previous face-lifts and need a little bit of a tweak. But it certainly doesn't replace the face-lift. Someone who has a huge, heavy neck and jowls, you're not going to be using the Instalift for them. It's more appropriate for the younger generation—those in their early to mid-40s who want to delay a surgical intervention later on."

Renee Jacques

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