Cheap face-lift is no bargain, a study finds

Thread-lifts -- less pricey kinds of face-lifts that tug the facial skin upward using implanted metal barbed threads -- don't work well and cannot be recommended, according to a study in the May/June Archives of Facial Plastic Surgery. Here's the abstract -- this is one of those journals that won't let you read the whole article unless you pay -- and here's a Reuters story on the study.

You can see why people have opted for the thread-lifts: they cost $1,500 to $4,500, according to the Consumer Guide to Plastic Surgery (www.yourplasticsurgeryguide.com). Face-lifts, according to the same site, cost $6,000 to $15,000.

In the small study of 33 patients, New York state researchers (using independent assessors) compared  the results of three kinds of treatments: thread-lifts alone, other kinds of procedures such as fat injection and chemical peels, or thread-lifts plus those other kinds of procedures.

At one month, all three groups showed improvement. But when faces were assessed an average of 21 months on -- a minimum of 12 months and a maximum of 31 months -- improvements persisted only in the groups who'd had nonsurgical treatments, plus or minus thread-lifts. Those who'd had thread-lifts alone showed no persistent improvement.

The authors' conclusion: thread-lift improvements probably relied only on temporary facial swelling. Once the swelling went away -- pretty much nada.

"Given these findings, as well as the measurable risk of adverse events and patient discomfort, we cannot justify further use of this procedure for facial rejuvenation," the authors concluded.

-- Rosie Mestel

The face tells the story

Plastic surgeons have always told women to look at their mothers if they want to see how they're going to age. Genetics is the best predictor of facial aging, but a new study shows that some lifestyle factors and life events also leave their marks on appearance.

The study, published online this week in the journal of Plastic and Reconstructive Surgery, was an ingenious examination of 186 pairs of identical twins, mostly women, who gathered in 2006 or 2007 for the annual Twins Day Festival in Twinsburg, an area near Cleveland. The researchers, from Case Western Reserve University, asked the participants to complete a questionnaire and pose for digital photos. Four judges reviewed the photos independently and recorded the twin pairs' perceived ages and individual facial features. The perceived age differences were then correlated with the factors from the questionnaire that could have influenced aging.

The current study includes only the results for the women. Not surprisingly, sun exposure and smoking led to a significantly older appearance. But some of the findings were enlightening, considering that identical twins share the same DNA. For example, twins who had been divorced appeared nearly two years older than their siblings who were married, single or even widowed. Antidepressant use was also linked to appearing older.

"We don't know exactly what it is about antidepressants that is causing the older appearance," said the lead author of the study, said Dr. Bahman Guyuron, chairman of the department of plastic surgery at University Hospitals Case Medical Center, in an interview. "We do know that all of the antidepressants sort of relax the muscles of the face," which may cause a sagging look.

Having a greater body mass index was found to make people under age 40 look older but people over 40 look younger. Use of hormone replacement therapy also contributed to a younger appearance. And twins who said they drink alcohol were also likely to appear older than their twin who didn't drink. The BMI finding is important, said Guyuron, because it supports the use of dermal fillers to give the face more volume and, thus, a more youthful appearance.

"This study gives a scientific boost to support what we do with fillers and some rationale for why individuals should receive fillers," he said.

Next, Guyuron will study the data from the male identical twins. And he hopes to start a study of identical twins (women) who will each undergo a different type of face-lift technique. The women will then be followed for a period of time to see how their faces hold up. The study might help resolve some of the arguments plastic surgeons have over whose face-lift technique is best.

The journal Plastic and Reconstructive Surgery is the official medical journal of the American Society of Plastic Surgeons.

-- Shari Roan

Photo: One twin (top photo), age 69, had 19 hours a week greater sun exposure than her identical twin (bottom photo). She also had received four more years of hormone replacement therapy. The difference in their perceived ages was 3.3 years. Credit: Dr. Bahman Guyuron