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The Buttock Lift with Hyaluronic Acid and Threads
Barbara Claysset* and Maurizio Cavallini
Department of Aesthetic medicine, Curative and preventive foreign medicine, Italy
Received Date: 18/06/2023; Published Date: 07/11/2023
*Corresponding author: Barbara Claysset MD, Department of Aesthetic medicine, Curative and preventive foreign medicine, via di Corticella 184/10 Bologna, Italy
Introduction
The buttock area may present a depletion due to a natural ageing process, a significant weight loss or simply due to genetics. However, talking about skin laxity, we are referring to that common imperfection present in various parts of the body representing the most frequent and visible sign of skin ageing. Skin laxity is a gradual sagging of the skin tissue due to loss of elasticity and tone.
This phenomenon is determined by a natural ageing process tied to genetic, metabolic and hormonal factors: skin cells (as well as cells in other body tissues) are subject to a natural slowing down of the metabolism with a more gradual turnover.
Aims
The indication aims at restoring the buttock area by adding volume and reshaping. The protocol consists in a first treatment to reshape and add volume with fillers in the upper third of the buttock after 30 days, followed by 1/2 treatments with traction threads and bio-stimulation in order to lift the buttock in the lower middle third of the buttock.
This combination allows a better outcome in this complex area.
Methods and Materials
The volumizing filler contain hyaluronic acid cross-linked with cross-linking agent BDDE (1,4 Butanediol diglycidyl ether) with SOFT SHELL TECHNOLOGY has been used.
SOFT SHELL technology provides that totally hydrated hyaluronic acid structures are inserted in certain points of the hyaluronic acid chains (FULLY HYDRATED HA TECHNIQUE), making the product extremely bio-compatible with the tissue in which it is injected. A further advantage is that it doesn't allow water retention from the surrounding tissue as it usually happens after 2/3 days from the injection with other hyaluronic acids that don't have this technology, therefore, we can see the final result immediately. The product undergoes an isovolemic breakdown and thanks to its ability to retain water it will preserve its volumizing characteristic even if gradually metabolised.
In order to antagonise tissue sagging, the most innovative treatment to date is soft-lifting with the use of PDO (polydioxanone) traction threads; a biocompatible synthetic structure, well tolerated, known for decades, it is reabsorbed in 6 months by hydrolysis in water and carbon dioxide.
Used in numerous surgeries thanks to the fact that it causes minimal inflammatory reactions due to reduced bacterial colonization.
The traction threads respond to two fundamental projects: the first is mechanical, they create an anti-gravity counterforce by using the Langer's lines, the second respond to a stimulus project by determining the production of type 1 and type 3 collagen at 30 days.
The traction threads used are intended to lift the body areas. These are bidirectional wires made in a mold with pins shaped like anchors, conveyed by a 18Gx100mm W-type cannula.
The particularities are: the blunt tip, the easier detachment of the suture, the length of the thread,165mm and the important gauge of the thread (USP 3 = 0.60mm).
On the other hand, the 25Gx90mm bio-stimulation threads determine a production of collagen after 30 days which adds to the effect of the use of the traction threads.
The protocol consists in an initial reshaping and volumizing treatment with filler, followed after 30 days by 1/2 treatments with traction threads and bio-stimulation to lift the buttock.
The volumizing filler: the treatment lasts 8 to 10 months depending on the depth of the area injected, the amount of product used and the human features.
The filler is injected into the upper third of the buttock with an 18G cannula using 30 to 60 ml of product depending on the patient.
Traction threads: the traction thread effect is mechanic due to the traction it generates to lift heavy areas like the buttock, abdomen and internal part of the leg, as well as bio-stimulating for the production of collagen type 1 and 3 in 30 days.
1/2 treatments 30 days apart with 2/4 traction threads each and 10/20 bio-stimulating threads each.
The traction threads are positioned with an inverted V technique from bottom to top after local anaesthesia and with an invitation hole with a 18G needle.
Bio-stimulating threads: in the same session 5 to 15 bio-stimulating threads are placed to increases the skin texture and to guarantee a better skin tone to the area treated.
Threads are placed in a cross position to determine the production of type 1 and 3 collagens.
Results
We compared two groups of patients with the same therapeutic indications: emptying of the upper third and laxity of the lower middle third.
The first group consisted in 45 patients, all women average age of 40 years, they underwent treatments with dedicated electro-medicals and showed a satisfactory initial post-treatment in terms of improvement of the skin texture and lifting of the treated area, while after 30 days they showed a reduction in satisfaction with the result obtained.
The second group consisted in 45 patients who underwent volumizing filler treatment in the upper third of the buttock and traction and bio-revitalisation thread implants in the middle-lower third after 30 days.
On average, the patients underwent three sessions, one for the implantation of fillers and two with traction and bio-stimulation threads.
In the immediate post-treatment the result was less satisfactory but in the long-term for the correct positioning of the hyaluronic acid associated with the mechanical traction and the production of type 1 and 3 collagen, after 30 days the patients expressed satisfaction thanks the improvement of the curvature on the buttock and for the lifting achieved.
No significant complications were found with the application of this protocol, only 1 patient presented a significant skin outgrowth due to the threads appearing on the surface which was resolved with three sessions of saline infiltrations one week apart from each other.
Conclusion
The buttock is a complex area subject to depletion with a support muscle that loses tone throughout time. First, we must add volume with hyaluronic acid fillers, then we need to lift and improve the skin texture with PDO traction threads combined with bio-stimulating threads.
This synergy guarantees a visible and lasting result of the volumes, the lift and an overall improvement of the skin texture, which is maintained in the medium-long term thanks to the synergy between hyaluronic acid, traction and bio-stimulation threads.
References
- Lee W, Jung YC, Yang EJ. Gluted Soft-tissue repositioning using Polidioxane threads. Dermatolog Surg, 2021; 47(7): 195-199.
- Oh CH, Yang SB, Kang CM, Shiw JS. Buttock lifting using Elastic thread (Elasticum) with a new classification of gluteal ptosis. Aesthetic plastic surg, 2018; 42(4): 1050-1058.
- HA YII Kim JH, Park ES. Histological and molecular biological analysis on the reaction of absorbable thread; polidioxanone and polycaprolactone in rat model. Cosmetic Dermatol, 2022; 21(7): 2774-2782.
- Hede'n P. Update on body shaping and volume restoration: the role of hyaluronic acid. Aesthetic Plastic Surg, 2020; 44(4): 1255-1299.
