EP 11: The Surgical Reality of Thread Lifts | OR DIARIES

In this episode, I break down what I’m actually seeing in the operating room when patients have had prior thread lifts. From persistent foreign material and linear fibrosis to biofilm-related inflammation that can flare after surgery. I explain why threads often fail to deliver meaningful lift, how they can complicate future procedures, and the long-term tissue changes they may leave behind. You’ll learn the real risks that don’t get talked about, what happens beneath the skin years later, and how proper surgical planning, removal, and a targeted pre- and post-op protocol can help minimize inflammatory complications and protect your final result.

CONNECT WITH HOST 
Website: https://clinic5c.com/ 
Instagram: https://www.instagram.com/chesnut.md/ 
YouTube: https://www.youtube.com/@chesnutMD 
LinkedIn: https://www.linkedin.com/in/cameron-chesnut-a6910baa/ 

WAYS TO WATCH/LISTEN 
YouTube: https://www.youtube.com/@5CodesPodcast 
Spotify: https://open.spotify.com/show/1FZ7vpmq21iA1noPcFhixb?si=992ef6c8d859463f 
Apple: https://podcasts.apple.com/us/podcast/5-codes-podcast/id1866214238 
Instagram: https://www.instagram.com/5codespodcast/
 
TIMESTAMPS 
00:00 - Intro
01:30 - Finding Old Threads During Surgery
03:09 - Post-Op Inflammation, Fibrosis, and Biofilm
04:31 - Why Threads Don’t Actually Lift
05:52 - Outro

ABOUT HOST 
Dr. Cameron Chesnut is the host of the 5 Codes podcast and the founder of Clinic 5C, where he leads a team dedicated to integrative cosmetic surgery, regenerative medicine, and functional health. An internationally recognized facial plastic surgeon, Dr. Chesnut is known for producing natural, refined results that enhance rather than alter one’s appearance. His approach blends surgical precision with biological optimization and disciplined restraint, drawing patients from around the world who value excellence, longevity, and holistic care. On 5 Codes, Dr. Chesnut uncovers the mindsets and evidence-backed strategies he lives by, helping high performers perform better, recover smarter, and feel their best in every area of life. 

DISCLAIMER 
The views shared on this podcast are my own and are not associated with, affiliated with, or representative of my clinical teaching role at the University of Washington School of Medicine. This content is for general educational purposes only and should not be considered individualized medical advice.

Transcript

0:00

Welcome to the Five Codes Podcast, where we discuss evidence-based methods to elevate yourself to the next level, through optimizing the way you look, move, perform, feel, and connect.- Just finished my last day of surgery this week and had some interesting topics to discuss in our O.R. diaries this week. Today, actually, in my procedure, the patient I was working with had threads, had had a history of threads interface and this was very interesting overall. She had worked in the aesthetics industry when she was younger and had a bunch of different types of procedures done. Nothing crazy or egregious, honestly, just, had had a little bit of a variety done. She knew that she had some matting and some fibrosis of her skin from where she'd had some radio frequency microneedling in the past. Like, it had changed the quality of her skin and the fat pads underneath like a flat spot matted, fibrodic kind of firm. And so we knew that going into this. We knew that that was gonna be a thing. But she'd also had threads in the past. Very vaguely, had had threads, couldn't remember exactly where they were when it was or some like vagueness around that. And when I was doing her surgery, we had a heavy regenerative focus on the area of matting from the radio frequency microneedling, which is pretty common. If we really look, you could see stamping on her face. I could see exactly with a pattern of where this device had been used all over her face on her skin surface, which was kind of wild to see. But when I got into her soft tissue when I was doing her lifting procedure, I was finding the old threads, seeing them there. Now, different types of threads have different lives and different behaviors and cause different issues in the long term or no issues. Whether they have any resulted all, there's all kinds of questions around this. And back in the day, they used to use more permanent types of threads, things that didn't dissolve now, it tends to be more on the dissolving. And in the dissolving end, there's ones that are threaded or not threaded or smooth or barbed or have all these types of lifting on it. And she had said that the threads never really gave her any result. There was nothing meaningful from them ever. So she had forgotten about them. Well, I got to see them in action. And I saw a few different things. So it looked to me as though she'd had different threads at different times, honestly, because I saw some intact threads that should have been gone theoretically. And I'm not sure she was not getting any results from these things at all. She had intact threads that have been gone. She had some fibrotic areas that I could tell where threads had been. This is the collagen building. This is sold. It's like, oh, they build collagen when I go away. They cost scarring, as they're resorbed, basically. So not necessarily a good thing. I was able to remove her threads. I have other patients where I've seen them after their surgery having had threads. And it's led me to this, which is when I'm in there, and I'm seeing threads in fibrosis, I'm going to manage it as much as I can to return things to a normal state. That means removing any threads that I can, which takes extra time, extra energy, extra surgery, whatever. But I want to get them out of there. And there's a reason for that is because, if I flip into another story, this gets into an old OR diary, if you will. I've had patients over time who've experienced different things after having threads in their face. Some of them get more inflammation in the area of the threads, which sort of makes sense when we're going into a surgical procedure that causes healing types of changes in inflammation, these foreign bodies that are essentially still in the face sort of light up. And they can do that for different reasons. It's very interesting to us always in this linear pattern. There's no question. There's a straight line. And there's a few things in our body that are perfectly straight. So when you see the straight line of inflammation in somebody who's had threads after surgery, it becomes very, very clear what it is. It's these threads. And sometimes it could be from a biofilm on the thread, which is basically how bacteria adhere to things. They make these called biofilm. So it's almost like an infection that gets exposed or gets re-inflamed from the procedure. It could just be that the thread itself was walled off. And our immune system is recognizing it again. But in some very extreme examples of this, I've seen some really firm fibrosis in patients after they've had prior surgery. I saw a patient she didn't have her lift with me, but after her prior lift, where she'd had threads, she almost had like a scarring and matting and binding down reaction in the area of her prior threads after her subsequent lifting surgery. So this gets into this whole idea too of every procedure that we do carries risk and consequences. And you do a thread, which carries very little to no benefit in the long term. There's just no air on that. They don't do anything. They don't actually lift. And the risks of that down the road are you have the immediate risks, like the expense and the nerve damage and all the things that can happen with it. But then you get into this other avenue that is like, well, what's going to happen when you want to go do the actual procedure that you needed the first place? Let's be honest. Threads are just a crutch for somebody who needs the lift and doesn't want to do it. So you get this down. It does nothing. At the very best, you just wasted your money and you move down the road. And you actually get the procedure that you want to have. This doesn't get talked about. And a lot of people say, oh, there's no risk down the road. It's all technique dependent. I've seen it. In my own patients, I've seen it. It's like to think that you're going to put a foreign body in the human face and not have any consequences of it down the road is naive at best. Or people just aren't paying attention to their results close enough. So I've seen it very dramatically. And I've seen it very subtly in patients as I've had threads post-procedurally. This is also one of the reasons I like to really heavily prepare patients with my pre-cubary protocol. And then, of course, my recovery protocol is I can help to manage some of the inflammatory aberrency, the abnormal inflammation and people can get around their threads. My whole recovery protocol is going to help that in addition to just making that procedure better. So there's a lot that goes into what threads look like in the long term. And afterwards, prior devices, the matting, it's just really interesting because threads are so linear by definition. The types of reactions they cause is a bit eye-opening. And it's hard to miss once you see it. So I feel like other surgeons see this and just don't understand or recognize what it is necessarily. So I hope this peaks everybody and helps understand what surgery looks like after threads. It's by no means a deal breaker. You can certainly do it afterwards. You just want to be dealing with a surgeon who carries a mindset towards them that is, let's make sure they're gone. Everything we can find and let's make sure we manage the things that could happen post-operatively because of the parasites. If you have any questions or topics you would like me to explore further, please leave them in the comments. I read them all and they often help shape the future conversations here. If you would like to learn more about my surgical practice, you can visit clinic5c.com where you will find additional information on my approach to surgery, recovery, and performance focus care. I also want to be clear that the views shared on this podcast are my own and are not associated with or representative of my clinical teaching affiliation with the University of Washington School of Medicine. Nor should this be taken as individual medical advice. Thank you for spending your time with me. I appreciate you being here and I will see you on the next episode.