PDO threads help eliminate wrinkles, but there is no legislation for the procedure

Known as PDO threads, polydioxanone threads combat the effects of the relationship between time and gravity on the most visible layer of the body: the skin. They promise to reduce dark circles, sagging cheeks and the “Chinese mustache”, in addition to giving more arch to the eyebrow, definition to the contours and firmness to the tissue.

They are the latest version of the so-called “support threads”, a treatment with local anesthesia, but not surgical, which contributes to the improvement of sagging and static wrinkles – those that are there regardless of muscle movement.

The procedure consists of inserting four to eight filaments under the skin to fill or reposition the tissues, especially the fat that is displaced in the aging process. The treatment promises naturalness and costs from R$1,500 to R$6,000.

According to the SBD (Brazilian Society of Dermatology), there is no specific legislation for the procedure. Therefore, the organization recommends care when choosing the professional who will perform the treatment.

Alessandra Romiti, 49, adviser to the cosmiatry department at SBD, says that many complications occur due to lack of technique or poor indication of the filament. “The thread has a risk of complication, infection and malposition, with anesthetic result and formation of nodules”, she says.

Nurse Marilena Lessa, 61, underwent the procedure six months ago and has no regrets, despite the initial pain and discomfort. “I knew [a técnica] by my dermatologist. She was recommended by her to treat my contour. The bulldog’s fat bothered me. It has improved a lot”, says Lessa.

She says the treatment needs rest and care with chewing harder foods. The patient may feel discomfort for about 1 month until the final result – which is little compared to surgical procedures that take 6 months to 1 year to achieve stability.

According to Romiti, there are traction and collagen stimulation threads.

The traction ones can be placed in the region close to the cheek and eyebrows to ‘lift’ the face and help support. Those that stimulate collagen production are smooth, thin and offer a progressive treatment.

The application is not limited to the face and, according to the dermatologist, the medical literature has records of use in several places with sagging, such as the neck, arms, thighs and even the abdomen.

Made of biocompatible synthetic material, PDO differs from other older threads, such as Russian or gold thread, due to the ability to be absorbed by the body and less risk of breakage. The procedure can be added to other treatments such as botulinum toxin (known as botox), fillers with hyaluronic acid and collagen stimulators, for example.

Durability will depend on patient characteristics. The effects of traction threads last a few months, while collagen ones guarantee tonicity that can last for one to two years. The indication must be made by physicians.

Ana Carulina Moreno, dermatologist at AMB (Brazilian Medical Association) and SBD, is a specialist in support threads and says that PDO has the ability to stimulate the formation of new collagen, improving the quality and thickness of the skin.

“Depending on the characteristics of the thread, it can help in the treatment of localized sagging, in the ‘filling’ of furrows or even in the repositioning of structures of the face, making a non-surgical ‘lifting’ effect. And they are not apparent”, he says.

The PDO is contraindicated, according to Moreno, for pregnant women, people with skin inflammation and patients who already have permanent wire implants, in addition to other conditions to be evaluated in a medical consultation.

Dermatologist Paula Periquito, who has been working with support threads for 15 years and now trains doctors throughout Brazil to use the procedure, says that polydioxanone has gained notoriety in the Brazilian market for being much less invasive.

“It brings natural results with more modern techniques and faster recovery. It has the ability to support even faces with more volume, which do not benefit from traditional fillers or biostimulators”, says Periquito.

The professor also said that the collagen PDO threads are ideal mainly for more difficult treatment areas, such as the lower eyelids and perilabial, with the advantage of not volumizing the face or changing the characteristics of the treated individual.

Periquito warns that treatment with traction threads is not indicated for patients with excess skin or who have undergone significant weight loss processes, since the plan of action is the layer of fat, not the immediate retraction of skin. Collagen PDO can be applied to all skin types.