Lift Sagging Skin With Sutures

Before and immediately after suture lift performed by Associate Professor Greg Goodman

Before and immediately after suture lift performed by Associate Professor Greg Goodman

Society will always be in awe of the force that keeps us grounded on earth, gravity. However, the great weight of this force in combination with other effects of ageing such as changes in our elastic fibres as well as the loss of collagen and deeper tissues, is also partly responsible for the downward pull of our facial tissue over time. As a result of this gravitational pull, we see facial skin laxity presenting as sagging skin and facial jowls.

 There are many options to fight the signs of ageing, ranging from creams, injectables through to intensive, invasive surgery in the form of a face lift. A middle ground between fillers and surgery is a technique referred to as suture lifting or thread lifting. This is a highly effective technique for those with mild to moderately sagging skin and is a welcome alternative to a full facelift.


Why is it often called thread lifting?

 Thread lifting is the perfect descriptive name as this is exactly what the practitioner performs. The procedure involves inserting surgical threads, like those used to stitch wounds or incisions, under the skin and suspending them sideways and upwards which results in a realignment and lift of sagging skin.


What is the difference between a suture lift and facelift?

 While a full facelift provides a most effective way to reposition sagging skin, with it comes potential long surgery times, hospital stays and lengthy recovery times due to the invasive nature of the surgery. Facelifts involve the removal of skin and suspension of the face with the patient usually under general anaesthesia. In the case of suture lifts, a small cannula is used to insert the threads under the skin, which then lift and reposition the descended facial tissue. There is no removal of skin during this method. Performed under local anaesthesia, it has exceptionally low medical risk and is a substantially less invasive procedure than its alternative. Common side effects of facelift surgery include swelling, soreness and bruising, all of which are minimised with the suture lifting method.


What are the advantages of suture lifting?

 In addition to being an alternative to a facelift, suture lifting can combat ageing in a secondary manner by triggering the body's natural healing response. When the body experiences trauma it activates a response system which, in this case, provides a positive anti-ageing outcome. After the sutures are inserted, the body directs large surges of collagen to the threaded areas as a form of healing. This stimulation of collagen results in a gradual improvement of the skin's tone and firmness. In other words, this process provides ongoing and progressive rejuvenation for the facial tissues.

Creative Concierge Consulting

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How Fat Dissolving Injections & Dermal Filler Can Help You Achieve The Jawline You Have Always Wanted

Mike Before.jpg

Before treatment with aesthetic nurse Mike Clague

Mike after.jpg

After treatment with aesthetic nurse Mike Clague

Sub mental fat, otherwise known as a ‘double chin’, is a collection of fat that can make people look older or heavier, and is a real ‘problem area’ for many. A ‘double chin’ can occur at any age and is not exclusive to those who are overweight.

Since its introduction into Australia, fat dissolving injections have gained significant traction as a non-surgical alternative to liposuction, helping patients achieve a defined jawline and neck with minimal downtime.

We interviewed Mike Clague Aesthetic Nurse BSC on how he achieved the above result for a patient.

What are fat dissolving injections?

Mike: Fat dissolving injections are FDA-approved injectable treatment that destroys fat cells in the area under the chin to improve your profile. Fat dissolving injections contain a synthetic version of a naturally occurring agent that occurs normally in the body to dissolve fat in your diet. When injected under the chin, it works by bursting the fat cells like a balloon. The fat released by the fat cells is then removed by the body’s repair system. The fat dissolving treatment is permanent. There is some swelling with this treatment and you may need a few treatments for best results.

We teach other practitioners to use this agent through our training academy, Facecoach. 

Does the double chin tighten with a fat dissolver?

Mike: This product forms mild scar tissue after the fat has dissolved thus producing collagen and firms up the area.  I love how it tightens the skin.

Did the patient have any other treatments?

Mike: Yes, we find that for real wow-factor, fat dissolving combined with lower face filler creates an outstanding result. I have filled her cheeks and under her eyes with dermal filler.  In the lower face I have filled her jawline, jowls, chin and lips. 

How do you inject fillers without it looking fake?

Mike: Performing injectable treatments is an art. You need a good aesthetic eye and an ability to plan out treatments to deliver outstanding results.  All of us will have our own aesthetic, our own view of what looks good.  For me, I prefer a natural aesthetic, focusing on enhancing an individuals natural features.

 How long to the fillers last?

Mike: At DIV we use premium fillers that are listed on the ARTG. Depending on the filler used these last from approximately 12 months to 2 years. It is important to choose clinics that use genuine products and remember you are entitled to do your research and ask questions around the product they have recommended for you.



Mike presenting for FaceCoach in Chicago earlier this year.

How many sessions was this result achieved in?

For this patient, a 6 month treatment plan was created.  She had a budget of around $1000 per month to achieve this result (over 6 months)

She now will just return for maintenance treatments at her convenience.



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The Truth About Permanent Dermal Fillers

In an era where loss of facial volume and wrinkling of facial tissue is “fixable” many Australian’s are rapidly embracing the chance to use cosmetic injections to reverse and prevent some unwanted signs of facial ageing.

Let us state at Dermatology Institute of Victoria we only use temporary dissolvable fillers for your safety.  It is important for you to make an informed decision when it comes to your filler treatment.

It is important to know there are 3 types of dermal fillers in the Australian marketplace.  There are temporary hyaluronic acid fillers (last 2 years, dissolvable),  Semi-permanent fillers (last 2-3 years, not dissolvable) and permanent fillers (last 10 years to forever).

With the use of permanent fillers being published more and more in the media, it begs the question, is it worth making a lifetime commitment? We spoke to A/Professor Greg Goodman to discuss your options and whether this modality causes more harm than good.

What are permanent fillers?

Permanent fillers are dermal fillers that remain in place and do not dissolve spontaneously over time. They include occasionally ones own fat, but mostly are materials that resemble broken down contact lenses called acrylates. Silicone is also a permanent filler that has been used for many years and does have some good medical use but not when it comes to implanting into patients for cosmetic reasons.

Why are some injectors using this permanent filler method?

Injectors using permanent fillers are using this modality more frequently due to patient demands for something permanent. In part, they are also offering this because they perceive it as a point of difference to temporary fillers. Temporary fillers have the advantage that you can sometimes reverse the potential issues that might occur from the product. Sometimes the physician can buy the permanent fillers for a cheaper price and they consider this important to the consumer. Cheaper filler is not better filler. 

What are the possible complications?

Infection and inflammation of the fillers - The body may reject or respond unfavourably to permanent fillers, which are made with non-body like substances. Additionally, when permanent fillers are accidentally injected into blood vessels or the “injection danger zones,” they can cause blockages and may lead to serious complications and ischemic events. If you inject into an artery with a dissolvable filler you can treat the area and have a good chance of reversing any issue.  If you inject a permanent filler into an artery, then the skin may die with no chance of you reversing the treatment. This is why at Dermatology Institute we choose only temporary fillers for your safety.

Fillers dropping in position or changing in position - What may seem as the right amount of plumpness for more youthful lips for a woman in her early 30s-40s may look “overly enhanced” 10 to 15 years later. Also the cheeks that may look good on you today, may not look good on you in 10 years time.

Likewise, some patients may have permanent fillers injected into recessed acne scars. Although this will level out the scar when the filler is first applied, as the patient ages and experiences volume loss, the previously injected areas may become raised.

Can you reverse permanent fillers?

You can only reverse hyaluronic acid filler implantation at the present time. Other temporary fillers such as polylactic acid and hydroxyapatite do not have the ability to be dissolved but do disappear in time. Acrylates and silicone do not have any possibility of being dissolved and would need to be surgically removed if there was an issue.

 Consider the evidence before your filler treatment and meet with a professional, clinical practice to discuss your options.  We enjoy giving our patients long consultations so that you can discuss all possible adverse events and outcomes.  We pride ourselves on our treatment plans and our results.   

 At Dermatology Institute of Victoria -

Most of our injectors are clinical trainers for pharmaceutical companies and lecture regularly at conferences.  We choose to buy our temporary fillers from reputable companies from Sweden, France, USA and Switzerland.   We believe in natural results for our filler patients.



There’s a lot to be said for genetics when it comes to our skin. We are all endowed with basic structural and surface conditions that mean healthy virgin skin from birth. However, over time, environmental stressors, diet and simple aging cause our skin to deplete.

So what are some of the dermatologically recommended options available? When is the right time to start paying attention to your skin and giving it a little helping hand?

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