Outcomes in threadlift for facial rejuvenation.

The search for less invasive surgical techniques to address the effects of facial aging led to the development of barbed polypropylene sutures for facial suspension. Theoretical advantages of these "threadlifts" included limited scarring, rapid recovery, relative safety, and reduced cost when compared with a standard rhytidectomy. The goal of this study was to evaluate the outcomes of patients undergoing threadlifts to determine the actual complication rates, the durability of results, and the rates of reoperative surgery. A single surgeon's initial 2-year experience with 72 patients undergoing threadlifts was retrospectively reviewed. Preoperative patient demographical and clinical data, operative information, and postoperative outcomes data were compiled and evaluated. A total of 72 thread lifts were performed by 1 surgeon over a 24-month period. Of these patients, 76% underwent threadlift alone, whereas concomitant procedures were performed in 24% of patients. Minor complications were common and usually self-limited. Forty-two percent of patients underwent a secondary procedure after primary threadlift, an average of 8.4 months after the original surgery. Thirty-one percent of patients required revisional surgery for cosmetic reasons an average of 8.7 months after their threadlift. Eleven percent of the patients ultimately required removal of palpable threads. Threadlift is a safe procedure associated with minor complications. Rates of revisional surgery for cosmesis are high after threadlift. Time to revisional surgery for cosmesis is short. Results achieved by threadlift are subtle and short-lived. Threadlift is not a minimally invasive replacement of surgical rhytidectomy. Patients should understand the limitations of this technique and its high rates of revisional surgery.

Biomechanical changes in the low back following reduction mammaplasty surgery.

OBJECTIVE: To give evidence of the mechanical consequences of reduction mammaplasty (RM) on the low back. DESIGN: A repeated-measures analysis was implemented to test the effect of RM on the external loads and angular velocity of the back during both static and dynamic lifting tasks. BACKGROUND: Patient follow-up surveys have documented a decrease in the frequency of low back pain following RM, but there is no quantitative data regarding biomechanical changes following surgery. METHODS: Patients were evaluated before and 4-8 weeks following RM. Flexion moment, compression and shear forces at L3-L4 were quantified for isometric flexion angles between 0 and 40 degrees. External loads and angular velocities of the back were studied during rapid dynamic lifting tasks. RESULTS: Isometric external flexion moments at L3-L4 decreased following RM. RM did not effect the applied flexion moment in the lumbar spine, but a trend suggested that RM resulted in increased lifting velocity. CONCLUSIONS: RM does act to reduce the loads on the lumbar spine during simple isometric tasks. During dynamic tasks, subjects may be able to lift faster without generating larger loads.