Aptos facelift has been the earliest generation of thread used. It is make of mono filament 2/0 Prolene suture material. It is non-absorbable and last long term.
Aptos is a bidirectional thread with no anchoring at both ends. It is easy to insert using a spinal needle.
The barbs gives the hold of the tissue towards its center point of the thread.
The prolene is long lasting giving it an effect that is effective.
The prolene provoke collagen synthesis which when mature can contract and gives rise to a pull like a spring.
These various developments and the resultant experience have led to elucidation of certain principles which determine the outcome of success in thread lifting. These factors are:
These factors are now further described in detail.
Prominences or the barbs or cogs on the threads are located in every 0.5 cm and each of them is responsible for holding its own tissue area to be lifted. The number of prominences on each thread is about 20. This is why Aptos lifting is very even and uniform along the line. This is the major difference of Aptos pull as compared to the traditional, classical and endoscopic lifting methods, where mobilized tissues (skin, Subcutaneous Muscle Aponeurosis (SMAS) are lifted and hung only to points fixed by stitches. The force of distribution is only concentrated at the few points of stitching.
It is known that facial and cervical layers of soft tissues can be shifted relative to each other, but only in specific and different blocks of tissue. Take for an example, it is far easier to shift skin of lateral areas of the forehead, eyebrow tail, mental area, cheek and malar areas.
On the contrary, any attempt to shift tissues of the posterior area of the face above the malar bone and its arch perimeter is difficult. This is because in this area the skin is closely tied to the periosteum and pretty fixed.
It is not advisable to lift soft tissues in the active muscle area, especially vectorially; it would counteract the normal movement of muscle. Such areas need elastic lifting by Aptos Springs. This is because the spring effect will allow it some degree of movement which is a natural muscle kinetic.
The soft tissues ptosis is of a localised or focal nature; some areas droop and slide more than others. Some areas are resistant to sagging as they are held up by bundles (raper points) of connective tissues, vessels and nerves. Therefore, it is logical to lift in places, where these anatomic formations do not create any impediments. That is to say that more mobile area can be easily lifted than area more fixed onto the bone.
The same methods shall not be advised to all and everybody. There is no one size fit all concept. It must be tailored make for every individual. It is important to assess the suitability of different aesthetic techniques and then recommend the most suitable method or combination of methods applicable in a specific patient. Note that no two are exactly the same.
The commonly used is local anaesthesia. When a lunch time thread lift alone has been planned, only a local anaesthetic can be infiltrated along the expected track. At most other times, if the patient is willing for a longer day care stay, twilight IV sedation with local anaesthetic is given. The last is the common choice.
A special spinal needle is inserted from the pre-tragal area just in front the ear, in a curved direction to a point below the cheek, and then up again towards a point stopping just short of the smile line the naso-labial line. As this needle is advanced, it is actually progressed in a sinuous manner, moving the needle tip from side to side. Please note that the depth of the needle is at all times maintained at the same sub dermal level, gliding just above the fat layer.
A similar needle is passed about 1.5 centimetres above this line. Through the two needles, the bi-directional threads are inserted.
The thread is then passed through, it is positioned such that the centre of the thread gets placed in the centre of the track. The needle is then slowly withdrawn. The tissue can be ‘gathered’ over the thread at the centre, and once the desired effect has been achieved, the ends of the thread are then cut off.