Improvement of aged lower eyelid by insertion of polydioxanone threads

Abstract

Orbital fat protrusion, skin laxity with wrinkling, and tear trough deformity with hyperpigmentation of the lower eyelid make individuals appear fatigued and elderly. For cosmetic correction of the aged lower eyelid, either invasive blepharoplasties or less invasive procedures such as filler, high frequency device therapy or laser therapy are popularly performed. Currently in Korea, polydioxanone (PDO) thread is commonly utilized to tighten and lift the aged face. We present a case report demonstrating improvement of orbital fat protrusion, skin laxity with wrinkles, and tear trough deformity following insertion of PDO threads into the lower eyelid of an aging patient. Twenty PDO threads (6.0 USP, 30 mm in length, New Up PDO suture Kit ® produced by Meditronic Dongjun) were inserted at 1-mm intervals into the submuscular layer and the protruded orbital fat pads of both lower eyelids of a 54-year-old patient. Two months following intervention, the patient presented with flattening of the protruded orbital fat, skin tightening and wrinkle improvement, volume restoration in tear trough deformity, and skin whitening; the patient was satisfied with the results of the therapy. Common complications such as persistent swelling, hematoma, skin irregularity, and infection were not observed during follow-up assessments. Our findings suggest that PDO thread insertion may be a useful, non-invasive procedure to rejuvenate the aged lower eyelid of patients with anxieties regarding potential complications due to invasive lower blepharoplasty.

Quantitative analysis of polydioxanone thread effects on lid-cheek junction

“…As previously documented in a case report [4], polydioxanone (PDO) thread insertion showed the potential effect of flattening of the protruding orbital fat, skin tightening, wrinkle improvement, volume restoration in tear trough deformity, and skin whitening.…”

“…In this study, we found the EJD/BJD ratios after PDO thread insertion significantly decreased in the tear trough grade 1 and grade 2 group but not in the tear trough grade 3 group. In a prior preliminary study [4], we reported the potential effects of PDO thread insertion on the improvement in orbital fat protrusion, likely due to contraction of the fat layer accompanied by fibrotic band formation in the subcutaneous fat layer. In the current study, EJD/BJD ratio decreased after the PDO insertion into the protruding orbital fat consistent with previously published results [8].…”

Correction of nasolabial fold by combination of polydioxanone thread and hyaluronic acid filler: a case report

“…The lifting of the mid and lower face appeared to be due to both tightening by the PDO thread and volumizing by the filler. According to Hwang et al [8], thread acts as a tissue scaffold, and activates intercellular interactions, collagen deposition, neovascularization, and mechanotransduction. Finally, it tightens and thickens the skin and subcutaneous fat.…”

Bioestimulação tecidual associando IPRF e fios de PDO em correção de cicatriz de fissura nasolabial

“…Fios de polidioxanona (PDO), lisos são estruturas sem nó ou travas, cuja função é a estimulação de colágeno e estruturação de sulcos 11 . A inserção de fios de PDO no tecido gorduroso induz a formação de colágeno e aumento da ativação celular pela conversão da estimulação mecânica em sinalização celular 12 . Causando alterações específicas nos tecidos circundantes que resultam em neocolagênese, efeito de fusão fibrosa, redução de gordura, contratura do tecido e melhora do ambiente vascular 13 .…”