Updated: Feb 12
What is a PDO thread? Well easily explained it is a dissolvable suture. If you've ever visited the ER for a cut that needed to be stitched but dissolved on its own, most likely you are familiar with PDO. PDO stands for the material polydioxanone (PDO). There are three main types of threads currently available: polydioxanone (PDO), polylactic acid (PLA) and polycaprolactone (PCA). PDO has been around the longest and is the most common type of thread material used for skin rejuvenation in the US. Not only is it FDA approved but proven to be safe and effective.
PDO is a biodegradable synthetic polymer material that when inserted into the skin is absorbed into the body over 6 months by hydrolysis. Whereas PLA and PCA take much longer to dissolve, about 12-15 months respectively. As the material dissolves the hydrolysis process triggers fibroblasts to produce more collagen. As you may already know, there are many types of collagens in the body. Collagens 1, 2 and 3 are the most abundant. Collagen is the protein that gives your skin its structure and elasticity. Unfortunately, at the age of 30 our collagen production is lost a rate of nearly 10% a year causing the appearance of saggy aging skin.
PDO threads to the rescue! PDO threads can be used nearly anywhere lift or collagen building is desired. In fact, when the PDO dissolves the type of collagen bundle formed is very strong and said to be able to hold over 40lb of weight. There are several basic shapes and sizes available on the market depending on the manufacturer chosen used to create various effects on the skin.
Different companies refer to the structure of the threads with unique descriptive names. For the most part Mono, smooth, and "smuth", are your basic thread without any cuts or etching into the material and are used to smooth areas where there is scarring or stretch marks. Often multiple threads are placed in a targeted area in either a linear pattern or hash patterned depending on the goal of the treatment.
Cog, barbed or "Levo" threads are threads with tiny slices or cuts depending on the manufacturing process designed to grab tissue and lift as they dissolve. Whereas screw or "cyclone" threads have a purposes for plumping an area such as the lips. PDOMAX also has what is called the LEVO LOCK thread like that of the Cog N-Fix meant to help strengthen the lift of the barbed threads like an anchor. This approach is very effective when someone has a heavier tissue to lift.
In a nutshell PDO threads fully dissolve in about 6 months but continue to build collagen and look good for an additional 6 months or longer and may be repeated for increased tissue rejuvenation as needed (Khan, Ahn, Kim, & Park, 2021; Wong, 2017).
PDO threads have been studied for tissue rejuvenation for years and found to be safe with little complications (Cho, Shin, Heo, & Shim, 2021; Kang, Moon, & Kim, 2020; McClean et al., 2020; Suh, Jang, Lee, Lee, & Ryu, 2015). The most severe reaction being anaphylaxis, so if you are questioning any allergy to the material, you should see your allergist first to ensure your safety. Other complications on insertion include pain if not well anesthetized, mild to moderate bruising, thread protrusion or infection. All these compilations can be easily treated by a Practitioner who is well trained in PDO thread insertion.
Overall, PDO thread insertion is a well-tolerated in office, quick procedure with very little down time. Finally, depending on your preferred view point of your cup being half full or half empty is equivalent to the pros and cons of dissolvable threads because they are NOT permenant.
Atiyeh, B. S., Chahine, F., & Ghanem, O. A. (2021). Percutaneous thread lift facial rejuvenation: Literature review and evidence-based analysis. Aesthetic Plastic Surgery, 45(4), 1540-1550. doi:10.1007/s00266-020-02095-1
Khan, G., Ahn, K. H., Kim, S. Y., & Park, E. (2021). Combined press cog type and cog PDO threads in comparison with the cog PDO threads in facial rejuvenation. Journal of Cosmetic Dermatology, 20(10), 3294-3298. doi:10.1111/jocd.14092
McClean, M., Boen, M., Alhaddad, M., Hoss, E., Kollipara, R., & Butterwick, K. (2020). Suture lifting: A review of the literature and our experiences. Dermatologic Surgery, 46(8), 1068-1077. doi:10.1097/DSS.0000000000002297
Shin, J. J., Park, T. J., Kim, B. Y., Kim, C. M., Suh, D. H., Lee, S. J., . . . Ryu, H. J. (2019). Comparative effects of various absorbable threads in a rat model. Journal of Cosmetic and Laser Therapy, 21(3), 158-162. doi:10.1080/14764172.2018.1493511
Suh, D., Jang, H., Lee, S., Lee, W., & Ryu, H. (2015). Outcomes of polydioxanone knotless thread lifting for facial rejuvenation. Dermatologic Surgery, 41(6), 720-725. doi:10.1097/DSS.0000000000000368
Thread lifts - everything you need to know about this cosmetic procedure. (2016, Nov 3,). InfotechLead.Com
Wong, V. (2017). Hanging by a thread: Choosing the right thread for the right patient. Journal of Dermatology & Cosmetology, 1(4) doi:10.15406/jdc.2017.01.00021