As the skin ages, it moves downward with gravity creating a drooping
of the brows, cheeks, jowls, corners of the mouth, and neck.

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What is the skin stitch?
The skin stitch is a minimally invasive procedure
where stitches are placed under the skin to reposition droopy
or loose areas of the face. No skin is cut away, so there
is no real surgery.
There are new barbed threads called Contour
Threads
The stitches are made of nylon material and are left permanently
under the skin. After a few weeks, the body develops a tissue
reaction around the stitches, which holds the skin in its
new position.
Is this like a face lift?
The skin stitch is not like a
face-lift as it does not involve cutting and removing skin, and is not a substitute
for a face-lift.
The procedure is often useful for patients who have previously
had a face-lift, but have a few residual loose or droopy areas
- it can tidy up these areas.
The Skin Stitch procedure is also useful for younger patients who are not
ready for face-lift surgery, or for those who do not want the scars which may
result from surgery.
How long does it last?
The stitches can last for years,
but they may loosen with time. The face may also continue to droop with age.
What does the procedure involve?
The skin stitch procedure
can be performed either under local anaesthesia or light sedation. A small puncture
is made in the skin either behind the ear or in the hairline and a long needle
with a suture is threaded directly under the skin until it reaches the area that
is droopy. The stitch is then fixed in this position and the needle returned
to the original puncture. The stitch is then tied and buried under the skin.
Several stitches are used to keep the skin in the correct position.
How will I look after the suturing procedure?
You may be
a little swollen after the procedure especially on the outer cheeks. Bruising
may occur in some people, but not in most cases. Swelling in most people is mild
and usually lasts about 10 days.
There may be some irregularities in the skin which may last for a few days or
even weeks.
Is the skin stitch painful?
During the skin stitch there
should be no pain as local anaesthesia is used. After the procedure there is
often some pain behind the ears, so painkillers should be used. This usually
settles after 24 hours.
Are there visible scars with the suturing procedure?
Because
only small punctures are made in the skin, and no skin is removed, there is usually
no visible scarring.
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What happens to the “excess skin”?
The stitches
reposition the skin, so there may be a slight pucker in front of the ear initially,
which usually settles. If it does not settle, collagen induction therapy may
be used to tighten the skin.
What if the stitches are too tight?
The stitches may initially
feel too tight, but they will loosen to some extent after a few weeks. If they
remain tight, the stitches may be removed and replaced with other looser stitches.
What if the stitches are too loose?
If the stitches are
too loose, further stitches can be placed in the skin, which are tighter.
What if I don’t like the look of the
skin stitch procedure?
If
you don’t like the look, the sutures can be removed altogether or
replaced with other stitches. This is best done in the first 4 weeks after the
procedure before the stitches become fixed in the skin by the tissue reaction.
What if I have already had a face lift?
The skin stitch
procedure can be performed on someone who has had a previous face-lift, to touch
up any droopy areas.
What are the risks associated with the skin stitch?
The
skin stitch is a relatively non-invasive procedure, so there are few risks associated
with it. However, with any procedure there are some potential complications.
These include:
- Sutures too tight. If this occurs, the sutures can be removed and others
put in their place.
- Sutures too loose. If this occurs, the sutures can be removed and others
put in.
- Breakage of sutures. If sutures break, new ones can be substituted.
- Infection. Infection is rare, but can be treated with antibiotics.
- Bleeding. Bleeding and bruising may occur. Avoiding aspirin and vitamin
E may minimize this risk.
- Asymmetry. This can be corrected by adjusting the sutures on one side.
- Bunching of the skin. When the sutures lift the skin up and back, there
may be some bunching of the skin near the ear. This usually settles with time.
- Fullness in the cheeks. There is usually some fullness in the cheeks, which
lasts for a few weeks.
- Feeling the sutures. Occasionally it is possible to feel the sutures behind
the ear. It is rare to feel the sutures on the face.
- Seeing the sutures. It is rare to see the sutures as they are placed deeply
in the skin.
- Not liking the end result. If you do not like the sutures, they may be removed.
This is best performed within the first few weeks after the procedure, before
the tissues have “fixed” the sutures into position.
- Skin irregularities. These are usually temporary but may last for a few
days or a few weeks.
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Australia
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