Why Do Nasolabial Folds Appear? Exploring the Anatomical Perspectives and the Role of Thread-Based Interventions

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The pathogenesis of marionette lines involves a complex interplay of anatomical, physiological, and age‐related factors leading to the development of wrinkles around the oral commissures. This exploration delves into the distinct anatomical predispositions observed among different ethnicities, emphasizing the role of compact modiolus structures and muscle compositions. Notably, individuals of East Asian descent exhibit inherent facial structures that predispose them to pronounced sagging around the oral commissures during aging. The emergence of distinct facial lines, such as the commissural line and the melolabial fold, contributes to the formation of marionette lines. This specific wrinkle pattern, resembling a marionette puppet's mouth contours, is influenced by various factors like bone resorption, gravitational forces, fat compartment variations, muscle compression, ligament tethering, and skin aging. Treatment strategies for marionette lines encompass diverse interventions, including filler injections, botulinum neurotoxin, surgeries targeting fat reduction, thread lifting, and volumizing fillers. These approaches aim to address the underlying causes and mitigate the appearance of marionette lines. Botulinum neurotoxin injections, for instance, weaken specific facial muscles, reducing downward strain and aiding in tissue retraction. Anatomical considerations during procedures are crucial to avoid nerve or vascular damage. Delicate manipulation and precise entry points are essential to prevent inadvertent injuries, particularly concerning blood vessels like the facial artery and nerves like the mental nerve. Technical guidelines for procedures targeting marionette lines involve specific techniques like cogged thread reverse methods and volumizing thread placements. Attention to entry points, tissue engagement, and the direction of threads is crucial for effective treatment outcomes, minimizing complications, and ensuring patient safety.

“…Complications associated with this procedure are infrequent and generally minor. 20 , 25 Utilizing PDO threads for aesthetic facial rejuvenation and lifting is considered a safe method.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Why do marionette lines appear? Exploring the anatomical perspectives and role of thread‐based interventions

Hong,

Kim,

Park

et al. 2024

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“…The primary objective of thread lifting can be described as utilizing threads extensively to pull and secure these sagging tissues in the opposite direction of gravity, preventing their re-sagging. 6 The commonly used straight or moderately long floating-type threads, also known as floating threads, play a pivotal role in this task. 7 Their protrusions grip onto the lax tissues and are responsible for pulling these tissues in the opposite direction from where they are hanging.…”

Section: Definition Of the Termsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Basic concepts in facial and neck thread lifting procedures

Hong,

Kim,

Park

et al. 2024

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In this review article, our objective is to elucidate fundamental principles and offer practical illustrations concerning the procedures involved in facial and neck thread lifting. Moreover, we aim to explore associated concepts such as the fixing point, hanging point, and anchoring point terminologies, along with the elucidation of vectors. Additionally, we will provide anatomically oriented explanations of the lifting process required for each facial region using thread lifting methods like V, U, and I techniques using floating type threads (Secrete line, Hyundai Meditech., Inc., Wonjusi, Republic of Korea). Furthermore, our intention is to delve deeply into the concepts of tensile strength, anchoring strength, and holding strength, contextualizing their practical applications within this specific field.

Volumizing threads and hyaluronic acid filler for lip augmentation

Wan,

Chan,

Lee

et al. 2024

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The lips have long been recognized as a defining feature of youthfulness, attractiveness, and beauty. Lip augmentation procedures are popular in aesthetic practice, aimed at achieving defined and full lips.While hyaluronic acid fillers are commonly used for lip augmentation, their dynamic nature may lead to accelerated breakdown, necessitating additional measures to maintain results. [1][2][3][4][5][6] Volumizing threads, though relatively new in the literature, offer promise as an adjunct to fillers for lip augmentation. We present a successful case of lip augmentation using volumizing polydioxanone (PDO) threads, emphasizing significant lip volumization. Moreover, the potential benefits of PDO threads, such as collagen stimulation and minimal downtime, are delineated. Further research, including randomized controlled trials, is imperative to evaluate the long-term safety and efficacy of PDO thread procedures for lip augmentation.