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Suspension wire and rejuvenation of the face and body.

 It is a Georgian surgeon Dr. Sulamanidze, who is the founder of this technique more than 20 years ago. The indications are mainly the beginning ptosis and the loss of the oval of the face. The threads can be permanent or absorbable and are placed in subcutaneous, with an indispensable rigor of asepsis.

 The installation of tensor wires can be isolated or combined with injections of hyaluronic acid or combined with a surgical technique. The threads will help to firm, strengthen and reposition the tissues while hyaluronic acid will help to fill, illuminate and smooth the tissues.

The aging process is variable, depending on the person. It depends on the quality of the skin and can be accompanied by a collapse of the features, a skeleton look or a wheelbase of the face. Changes can concern muscle, bone or fat.

 A young face can fit into a downward-pointing triangle, but as it ages  the base is down. The principle of face rejuvenation must prevent, stop or reverse this process without weighing down the skin tissues.

The installation of tensor wires is perfectly adapted to counter this ageing process, but will not replace a lifting indication.

 There are different types of wires, absorbable and permanent. These two types of wires have common characteristics, the same indications, the same anatomical placement in subcutaneous fat, the same rigorous asepsis protocol, the same recommendations for follow-up and precautions, and the same learning curve for the practitioner.

 The permanent threads, are often silicone or polyester threads, covered with ergots in all directions, held for 5 to 10 years with the risk of visibility in case of improper installation, or in time in case of changes in the volumes of the face (weight loss in particular). The technique is more complex than with absorbable wires.

 The absorbable threads are monofilaments with notches or smooth, resulting in a biostimulation effect of the skin but with a limited lifespan between 6 and 18 months, a technique of installation with needle or cannula. They can be edgy or smooth.

 I use absorbable wires of the brand Croma which are based on polydioxanone, (like surgical wires), inert, hydrophobic thread, which does not cause antigenic processes, induces a neo collagen and degrades by transforming into water and CO². It creates a fibrosis weft around it during its resorption, it creates anchor points in the dermal tissue and allows a draping of the superficial tissue.

 The evolution of the integration process of this absorbable thread is a skin tissue repair process between 6 and 10 days, activation of local microcirculation from the first week to the 6th month, activation of fibroblast metabolism and collagen synthesis, elastin and hyaluronic acid until the 6th month.

 There are different types of threads, of different diameters, of different lengths depen-ding on the area or areas to be treated (cervical ptosis, cheeks, raising an eyebrow, treatment of the crow’s feet or wrinkles of the white lip. The main indication is the overall management of the patient to fight against negative vectors and shadows that make a face tired, sad or in loss of volumes.

 The insulated thread laying, from 1 to 4 per hemiface, allows a refreshment with a quick natural result, without social eviction, with an accessible budget.

 This treatment can be offered to younger people from 30 years, with a reversibility compared to surgery, but without replacing it..

Combination may be done with hyaluronic acid or botulinum toxin or in addition to surgery.The ideal patient is rather young with a limited ptosis and a defect of definition of the mandibular angle, with a beautiful quality of skin. It is more difficult to treat the upper third or the palpebral pockets or in case of too much ptosis with wheelbase and thickening of the tissues.

 The contraindications are the risk of total inefficiency, loss of volume, too thin skin, too heavy or thick skin and sometimes the shape of the face, but also pregnancy, skin infections or cancer in progress, History of keloid scar.

 The doctor appreciates the benefits and risks and will clearly inform the patient of the choice of technique and the number of wires to be laid and of the precautions post laying. The gesture is done in the medical office, under local anaesthesia at the points of introduction of the wires and on the route.  Avoid dental care and face massages, sauna and hammam for 3 weeks. Violent sports and sun exposure for 15 days.

Sleep raised head for 3 days.

 The risks are mainly bruising or hematoma, or an infection, a temporary irregularity (wires too tight), the feeling of tightness or small cracking during the week following the laying of the wires. A new laying of wires, filling injections or botulinum toxin can be considered at any time.

 After a year of personal practice, this technique allows me to provide a simple, effec- tive solution and a natural result in addition to other aesthetic medicine techniques.