Nghệ Thuật Và Khoa Học Căng Da Bằng Chỉ: Dựa Trên Giải Phẫu Pinch (The Art and Science of Thread Lifting)

261
© Springer Nature Singapore Pte Ltd. 2019
B. Kim et al., The Art and Science of Thread Lifting,
Infection
47.1
Thread Lifting and Infection
According to Park TH et al., when nonabsorbable
thread lifting was mainly used in the past, cases
of chronic inflammation like foreign body granu-
loma as well as infection occurred in low
incidence.
Wu et al. discussed that infection or granuloma
formation can occur during thread lifting proce-
dure. However, fortunately, the most complica-
tions such as infection are not severe and can be
treated easily. However, Benny Yau et al. reported
a case of Mycobacterium abscessus infection
after performing a thread lifting procedure on the
face. It is an important case which shows severe
infection can occur although it is rare.
Infection after absorbable thread lifting is
evaluated to be less frequent than infections after
nonabsorbable thread lifting. If the operating
room maintains good hygiene, infection on the
thread insertion area does not occur easily.
Also, in case of the PDO (polydioxanone)
which is used the most in absorbable thread lift-
ing, it can be manufactured with smooth surface
and in the form of monofilament. Therefore, it
tends to have higher resistance against infection
relatively.
However, recently, cases of mycobacterium
infections were reported after PDO thread lifting
procedures in Korea. Shin Jung Jin et al. reported
a case of a 47-year-old woman who came in with
erythematous plaque on both sides which
occurred in the second week after the procedure
from a nonmedical practitioner. The patient was
treated with antibiotics for 1 week at a local clinic
and transferred to general hospital, and it was
finally diagnosed as Mycobacterium massiliense
infection.
Therefore, medical practitioners should keep
in mind all possibilities of infections and try to
maintain a sterile environment before and after
procedures.
47.2
Prevention of Infections
To prevent infections, areas around entry points
must be disinfected thoroughly, and aseptic tech-
nique should be used during the procedure.
• Disinfect entry points.
• Disinfect all of the skin area within the range
of cannula manipulation.
• If there is hair within the access of cannula or
if insertion is done inside the scalp, hair must
be prepared using suitable tools.
• Hair must not be dragged into the entry points
during the procedure.
• After the procedure, check once more whether
any hair got in the entry points.
• Education for prevention of infections at the
entry points and the exits.
47

262
47.3
Treatment
Infection after thread lifting procedure is gener-
ally treated easily by taking antibiotics.
However, in rare cases, as mentioned above,
mycobacterium infection needs a long-term
treatment with intravenous antibiotics and
drainage process.
In case of infection which is irresponsive to
antibiotics treatment, transferring a patient to the
general hospital must be considered and aggres-
sive treatment is required.
In the case of Mycobacterium massiliense
infection, as mentioned above, a long-term treat-
ment with clarithromycin and amikacin was done
after drainage.
47  Infection

263
© Springer Nature Singapore Pte Ltd. 2019
B. Kim et al., The Art and Science of Thread Lifting,
Appendices
1.1
Appendix 1: Summary
Why Pinch Anatomy?
Area where manipulation of pinching is useful
·· 61
PART 03

Importance of thread selection and patient selection
83
Importance of design and vectors
84
Solutions of Entry Point Bleeding
93
PART 05

264
Design Method
115
Cautions to be Considered during Designing
117
Hairline preparation and draping
118
Measures for Bleeding While Anchoring: Long Threads
122
Responding to Bleeding at the Time of Anchoring: Silhouette Soft® U Technique
142
Method of Inserting a Needle at a Constant Depth Using Pinch Technique
146
Method of Checking the Depth After Inserting a Needle
147
Cause and Prevention of Breakage of a Thread When It Passes Through
147
Method of Gentle Retraction Without Having the Thread Cut While It Passes
Through
147
How to Solve When the Last Cone Does Not Enter into Entry Point
149
Importance of Traction
149
PART 06

Factors Which Affect the Outcome of the PMA Technique
Tips for Passing an 18G Needle (Puncture Needle) at Entry Point
156
160
161
162
162
154
Cautions in the Crisscross Technique
Tips for the Silhouette Soft® Technique: Position of the Procedure
Prevention and Treatment of the Entry Point Dimple
Tip for the Silhouette Soft® Technique: Recommended Position for the Procedure
Various Tips for the Silhouette Soft® Procedures
163
Side effects after Silhouette Soft® procedure
Difference in Density of Fat Tissues Depending on the Facial Area
A Checklist to Explain Patients Prior to the Procedure
163
167
167
169
Prognostic Factors that Affect the Outcome of Thread Lifting:
Checkpoints to Predict the Prognosis Prior to the Procedure

Appendices

265
Procedures for Each Area
Setting an Entry Point Around the Mastoid Process
Mechanisms of the Necklace Technique
Simulation Prior to the Procedure (Frontalis Pulling/Traction Test)
174
193
197
PART 07

Side Effects and Treatments
Utilization of lateral canthus elevation
Summary
Distinguishing entry point dimples - normal dimple vs side effects
When local anesthesia for thread lifting and botulinum toxin treatment
on forehead are performed simultaneously
260
230
251
258
PART 09

Appendices

266
1.2
Appendix 2: Procedure
Records
Further Readings
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Amuso D, et al. Histological evaluation of a biorevitalisa-
tion treatment with PDO wires. Aesthetic Medicine 13
October–December 2015.
Atiyeh BS, et al. Barbed sutures “lunch time” lifting: evidence-
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Beer K.  Delayed complications from thread-lifting:
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Dermatol Surg. 2008;34:1120–3.
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Carron MA, et  al. Biochemical analysis of anchor-
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Date:
Name:
Thread:
Age:
Temporal muscle hypertrophy (
)
Masseter muscle hypertrophy (
)
Temporal hollowness
(
)
Marionette line
(
)
Zygomatic bone prominence (
)
Cheek fat
(
)
Zygomatic boneop scar
(
)
Submental fat
(
)
Jaw surgery
(
)
Sunken cheek
(
)
Lat. Canthus elevation
(
)
Liposuction
(
)
Asymmetry
(
)
Acne scar
(
)
Zygomaticus muscle action
(
)
Thread lifting / HIFU
(
)
Simulation vector
(
)
Patient’s demand:
Effect:

Appendices

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Appendices