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The Ultimate Generation of
Suspension Thread
For Aesthetic Medicine and
Cosmetic Surgery
Company
Aging & Lifting
Spring Thread® main characteristics
Implantation Methods and Recommendations
Clinical results
SUMMARY
French Company established in May 2007
Funder : Jean Frismand Medical doctor
Biomechanical engineer
More than 25 years experience in designing and
Manufacturing surgical implants
Owner & C.E.O. : Dominique Malard Business School (1989) + E-MBA (2010)
In biotech industry since 2006
Management + Business Development
COMPANY
Tourcoing nearby Lille
Between Brussels, Paris and
London
Known for textile, mining and
biotech industry.
LOCATION
Production :
100% Made in France (2 manufacturing plants)
Strong commitment for Quality
ISO 13485
CE Marked (Medical Device class IIb)
To Date :
More than 70.000 threads in place
Representations : 40 Countries Asia : Japan, Thailand, Indonesia, Malaysia, Vietnam, China,….
Europe : France, Benelux, Italy, Spain, Portugal, Russia, UK…..
Maghreb : Morocco, Algeria, Tunisia….
Middle East : Dubai, Qatar, Egypt, Saudi Arabia, Kuwait
Latin America : Colombia, Argentina, Chile, Venezuela, Mexico,
PRODUCTION
Four fundamental values
of the company
But moreover, we want that our doctors and patients have a
GOOD Spring Thread® EXPERIENCE
Good product
and Services
Good
Experience Happy Patients
Aging ? Facial Aging ?
Tissue Alteration :
Fillers
Cutaneous Modification : Peeling
Tissue Loosening :
Lifting
Other rejuvenation methods :
Botox, Lasers, Co2, Leds…
Facial Aging !
*Valeant Aesthetics
35 years 45 years 55 years
The aging process changes the main structures of the face,
including skin, fat, muscles and bone structure.
Aging has to be considered
as GLOBAL Phenomenon Answer Solutions
Skin structure modification Skin caring
Cosmetics, skin boosters,
Mesotherapy,
Peelings,
Lasers…
Loss of volume Filling Injectable,
Fat grafting
Ptosis Lifting Surgical Lifting
Thread Lifting
35 years 45 years 55 years *Valeant Aesthetics
What about Ptosis ?
Lifting
Surgical
Lifting
Thread
Lifting
Absorbable Threads
Biochemical
Stimulation
Permanent Threads
Mechanical
Suspension
Surgical lifting : lift the tissues + remove cutaneous excess Surgery
Recovery time
Non reversible
More horizontal action
Thread lifting : non invasive lift For moderate ptosis
No skin devascularisation
Very few social eviction : 2 to 3 days
More Vertical traction
Ptosis :
Surgical or Thread Lifting ?
Vertical traction
Natural support of adipose tissues without modification of the face features
Special thanks to Dr Denis Guillo and the SOMEREFs
No General anaesthesia,
No scars,
No contraindication (i.e. smokers),
Limited infectious risk,
Secured gesture : the threads are in the sub-cutaneous territory without getting over the SMAS,
Answer to younger patients who are refusing or who are refused by surgery,
Vertical traction : natural support of adipose tissues without modification of the face features,
Efficient on the three parts of the face, if well applied,
Less expensive.
Advantages of Thread Lift
How to choose?
Absorbable Threads : Biochemical Stimulation
Adapted to young patients
Rejuvenation effect (6 to 12 months maximum)
Limited risk in case of bad implantation…..
Non Absorbable Threads : Mechanical Suspension Adapted to all patients
Real Suspension and Reorganisation of the tissues for a long term effect (3 to 5 years minimum)
More technical possibilities
Permanent : Suspension
Absorbable : Rejuvenation
Between Biochemical stimulation or Mechanical Suspension,
the doctor will choose the best strategy according to the profile
and to the expectations of his patient.
Do not confuse stimulation
and suspension
PRODUCTS ON THE MARKET
APTOS®
Non elastic monofilament of polypropylene
5 Aggressive cogs per cm
Inconstant result, extrusion risk
Deadpan aspect, figé, definitive positioning at starting
Painful surtension
SILHOUETTE LIFT®
Non elastic monofilament of polypropylene with nots
Polylactic Acid resorbable cone
Absorption of cones after 8 to 12 months
Result : about 2 years
Needs anchorage points
Korean Threads / Chinese Threads
Aptos Light Lift / Silhouette Soft
Absorbable (PDO or PLLA)
Non elastic
Fragile
Small cogs or no cogs
3 month to 6 months result
NOT SUSPENSION THREADS BUT REJUVENATION THREADS !
RESORBABLE THREADS CAN NOT BE EFFICIENT FOR
REAL PTOSIS CORRECTION
SPRING THREAD ® Body
SPRING THREAD ® Face
SILHOUETTE LIFT ®
UPACTIV ®
HAPPYLIFT ® résorbable
APTOS ®
Fil lisse
Copyright SOMEREFs
PRODUCTS ON THE MARKET
Spring Thread® answers optimally to market expectations
A NEW ERA IN
SUSPENSION THREADS
PATIENTS REQUESTS :
Security
Long Term Action
PRACTITIONNERS NEEDS :
Reliability
Simplicity
Spring Thread ANSWERS :
Elasticity – Flexibility
Strength
Excellent fixation
Permanent Thread
Moulded and non
aggressive cogs
Polyester Core
Silicone
4 MAJOR INNOVATIONS
Flexibility and elasticity
Solidity and controlled
elasticity
Excellent Fixation in the
tissues
Long Term Action
flexible, elastic, 24 convergent 3D cogs/cm
flexible, elastic, 24 convergent 3D cogs/cm
SPRING
THREAD®
Spring Thread® Silicone
The better accepted material by the body
100% Biocompatible and Biostable
No Inflammatory reaction
No extrusion or migration
Good fibrosis
Parameters
Conducted Tests
Conclusion
Standards Standards Title Name and
Reference Test
Cytotoxicity ISO 10993-5 : 2009 Biological Evaluation of Medical Devices –
Part 5: Tests for In Vitro Cytotoxicity
L929 MTT Cytotoxicity Test*
(TOXIKON 10-2121-G1)
Non-cytotoxic
Sensitization ISO 10993-10 : 2002
Amended 2006
Biological Evaluation of Medical Devices – Part 10: Tests for Irritation and Delayed –
Type Hypersensitivity
Kligman Maximization Test*
(TOXIKON 10-2121-G3) Non-irritant
Irritation and intracutaneous
reactivity
ISO 10993-10 : 2002
Amended 2006
Biological Evaluation of Medical Devices – Part 10: Tests for Irritation and Delayed –
Type Hypersensitivity
Intracutaneous Injection Test*
(TOXIKON 10-2121-G2) Non-irritant
Acute systematic
Toxicity
ISO 10993-11 : 2006 Biological Evaluation of Medical Devices –
Part 6: Tests for Systemic Toxicity
Systemic Injection Test*
(TOXIKON 10-2121-G4) Non-toxic
Subchronic Toxicity
ISO 10993-6 : 2007
Biological Evaluation of Medical Devices – Part 6: Tests for Local Effects After
Implantation
Subcutaneous Implantation Test*
(13 weeks)
(TOXIKON 10-2121-G10)
Non-irritant ASTM F981-04
Standard Practice for Assessment of Compatibility of Biomaterials for Surgical
Implants with Respect to Effect of Materials on Muscle and Bone
ASTM F763-04 Standard Practice for Short Term Screening
of Implant
BIOCOMPATIBILITY Tests realized with a certified laboratory on finished product
Parameters
Conducted Tests
Conclusion
Standards Standards Title Name and Reference
Test
Genotoxicity
Carcinogenicity
Reproductive Toxicity
ISO 10993-3 : 2003
Biological Evaluation of Medical Devices – Part 3: Tests for Genotoxicity, Carcinogenicity and
Reproductive Toxicity
Chromosomal Aberration Assay*
(TOXIKON 10-2121-G6)
Non-clastogenic
OECD 473 (21 July 1997)
Guidelines for the Testing of Chemicals, “In vitro Mammalian Chromosomal Aberration Test”
ISO 10993-3 : 2003
Biological Evaluation of Medical Devices – Part 3: Tests for Genotoxicity, Carcinogenicity and
Reproductive Toxicity
Salmonella Typhimurium and
Escherichia Coli Reverse Mutation
Assay*
(TOXIKON 10-2121-G7)
Non-mutagenic
OECD 471 (21 July 1997)
Guidelines for the Testing of Chemicals, “Bacterial Reverse Mutation Test” (Ames Test)
Implantation
ISO 10993-6 : 2007 Biological Evaluation of Medical Devices – Part
6: Tests for Local Effects After Implantation
Subcutaneous Implantation Test*
(2 weeks)
(TOXIKON 10-2121-G9)
Non-irritant ASTM F981-04
Standard Practice for Assessment of Compatibility of Biomaterials for Surgical
Implants with Respect to Effect of Materials on Muscle and Bone
ASTM F763-04 Standard Practice for Short Term Screening of
Implant
Hemocompatibility ISO 10993-4 : 2002
Amended 2006
Biological Evaluation of Medical Devices – Part 4: Selection of Tests for Interactions with Blood
Hemolysis Human Blood
Indirect Contact*
(TOXIKON 10-2121-G8)
Non-hemolytic
Pyrogenicity**
ISO 10993-11 : 2006 Biological Evaluation of Medical Devices – Part
6: Tests for Systemic Toxicity Rabbit Pyrogen Test*
(TOXIKON 10-2121-G5)
Non-pyrogenic
USP 32
Formula 27 :2009 <151> Pyrogen Test Non-pyrogenic
Components Security Tests
Conclusion
Standards Name / Supplier
Bioburden ISO 11737-1 : 2006
Sterilization of medical devices – Microbiological methods : Determination of a population of
microorganisms on products
Conform
Sterilization
ISO 11135-1 : 2007
Sterilization of health care products – Ethylene oxide : Requirements for development, validation and routine
control of sterilization process for medical devices
Conform
ISO 11135-2 : 2008 Sterilization of health care products – Ethylene oxide :
Directive on the application of ISO 11135-1 Conform
ISO 11138-1 : 2006 Sterilization of health care products – Biological
indicators : General requirements Conform
ISO 11138-2 : 2006
Sterilization of health care products – Biological indicators : Biological indicators for ethylene oxide
sterilization
Conform
ISO 10993-7 : 2009 Biological evaluation of medical devices : Ethylene oxide
sterilization residuals Conform
Residual ethylene oxide,
ethylene chlorhydrin and ethylene glycol
ISO 10993-7 : 2008 Biological evaluation of medical devices : Ethylene oxide
sterilization residuals Conform
ISO 11135-1 : 2007
Sterilization of health care products – Ethylene oxide : Requirements for development, validation and routine
control of sterilization process for medical devices
Conform
ISO 11135-2 : 2008 Sterilization of health care products – Ethylene oxide :
Directive on the application of ISO 11135-1 Conform
STERILITY Tests realized with a certified laboratory on finished product
Sterilization realized by a certified sterilizer subcontractor
IMPLANTATION TECHNIQUES
From 35 to 75 years old,
Good psychism,
No important general disease,
Small or medium ptosis,
People : • too young for surgical lifting,
• who don’t need surgical lifting,
• who don’t want surgical lifting,
PATIENT SELECTION
Face oval
Nasolabial folds
Marionette Lines
Cheeks
Eyebrows
GOOD INDICATION
Too important sagging
Too much fat
Too much skin
Elastosis wrinkles or heliodermic skin
BAD INDICATION
STRONG ASEPTIA IS
FUNDAMENTAL
Soft needle : no risk to touch
nerves or vessels
The thread has to be placed in
the subcutaneous fat, before the
SMAS (between 2 and 3 mm
deep), but not too superficial not
to touch any hair follicle
(Especially in the hair area)
Implantation : Subcutaneous Fat
No Anatomical Risk !
The thread has to be placed in the subcutaneous fat,
between fat and muscle (3 to 5 mm deep)
Choose the right plane
Straight Laying
Products used :
• 3 FA threads per side. 1 box for 1
face
Advantages :
• Simple and Efficient for small and
medium ptosis
Direct Effect :
• Malar Fat Pad support
• Lower jowl rectification
Indirect effect :
• Revive the look
• Neck Retention
Inversed V with temporal suture
Products used :
• 2 FA threads per side
Advantages :
• Simple and Efficient for small
and medium ptosis
• Retention possibility
Direct Effect :
• Malar Fat Pad support
• Lower jowl rectification
Indirect effect :
• Revive the look
• Neck Retention
X Laying
Products used :
• 4 or 5 FA threads per side
Advantages :
• Very good suspension
• Possibility to pass 1
additional thread
Direct Effect :
• Malar Fat Pad support
• Lower jowl rectification
Indirect effect :
• Revive the look
• Neck Retention
Y Laying
Products used :
• 1 FY + 1 FA threads per side
Advantages :
• Very good suspension
• Possibility to retighten
Direct Effect :
• Lower jowl rectification
Indirect effect :
• Neck Retention
Easylift® (Dr Guillo)
Products used :
• 1 FY + 1 FA threads per side
Advantages :
• Very good suspension
• Possibility to retighten
Direct Effect :
• Lower jowl rectification
Indirect effect :
• Neck Retention
Special thanks to Dr Denis Guillo and the SOMEREFs
Threads + Fat grafting +++
Threads + Hyaluronic Acid +++
Threads + Peeling +++
Treatments’ Combination
STRAIGHT LAYING
How to introduce the
needles properly
Present the needdle
perpendiculary to the skin
With that simple procedure once inserted , there will be no risk of
extrusion of the thread nor any anaesthetic node
Once the needdle introduced, tilt it
and push the needle under the skin
Punct perpendiculary to the skin
at about 3 mm depth
STRAIGHT LAYING
Drawing Anaesthesia, incision, 1st needle
2nd needle Other threads
STRAIGHT LAYING
Sitting Position
Traction on thread / pushing on tissue
Sitting position
Final traction /cutting
STRAIGHT LAYING
PRE CARE Antiseptic shampoo eve and morning,
Preventive antibiotic treatment (Amoxicillin – Augmentin or eq).
Light oral sedation (hydroxyzine - Atarax or eq.)
POST CARE Preventive antibiotic treatment,
No massage for 2 weeks,
Soft cleaning from bottom to top,
No bandage, no compression garment, quiet life …
Sleep on back if possible.
Visit before 8 days to control and adjust
PRECAUTIONS
COMPLICATIONS
Complication Answer
Per Operative hematoma Press and wait
Oedema 1 hour to 1 week
Slight temporary pain Conventional analgesic
i.e. Paracetamol
Inflammatory reaction Conventional anti- inflammatory
---> look for sepsis
Sepsis Take out the thread
Antibiotic coverage
Visibility of a thread path Before 8 days : unhook the thread
After 8 days : Filler
Visit before 8 days to control and adjust
Good patient selection / Good indication
Realistic expectations
Strong Aseptia
Work quietly
Good settings (not too much over correction)
Technically superior thread
THE WAY TO SUCCESS
RESULTS
Results are visible in 2 steps
In addition to the immediate effect, the results
still improve during the months following the
intervention.
2013 Pre Op
RESULT PRE AND POST
Doctor Glancey - UK
After 6 weeks After 3 Weeks 2013 Per Op
Pre Op
RESULT PRE AND POST
Doctor Chambers - UK
After 6 months
2013 Pre Op
RESULT PRE AND POST
Doctor Glancey - UK
2014 After 8 Months
Day 0 3 months
RESULTS PRE AND POST
Dr Guillo - France
PreOp PostOp 1 Year
RESULTS PRE AND POST
Dr Sakaï - Japan
PreOp 1 month
RESULTS PRE AND POST
Akiko Clinic - Japan
PreOp 3 weeks
RESULTS PRE AND POST
Dr Freteur - Belgium
Day 0 1 year
RESULTS PRE AND POST
Dr Foumenteze - France
Day 0 6 months
RESULTS PRE AND POST
Dr Lamquin - France
Day 0 1 year
RESULTS PRE AND POST
Dr Foumenteze - France
Day 0 3 months
RESULTS PRE AND POST
Dr Guillo - France
Day 0 6 Months
RESULTS PRE AND POST
Dr Guillo - France
Day 0 4 months
RESULTS PRE AND POST
Dr Guillo - France
RESULTS PRE AND POST
Dr Glancey - UK
Day 0 8 Months
RESULTS PRE AND POST
Dr Dubois - France
Day 0 2 Days 8 Days
2007 - Before 2 months later
RESULTS PRE AND POST
Dr Butnaru – France
2012 - 5 years later 1 month after 2nd Spring Thread
RESULTS PRE AND POST
Dr Amgar – France
Day O 6 months
RESULTS PRE AND POST
Dr David – France
Day 0 6 months
RESULTS PRE AND POST
Dr David – France
Day 0 Post-Op
RESULTS PRE AND POST
Dr Metanomski – France
Day 0 6 months
RESULTS PRE AND POST
Dr Marthan – France
M + 2
M
M
Day 0 8 months
Before Post Op
RESULTS PRE AND POST
Dr Malakovskaya - Russia
After
Before After 3 months
RESULTS PRE AND POST
Dr Kruglik - Russia
2 or 3 threads on each side
Each thread enters behind the ear. One
half goes up, one half goes down.
The Threads are crossed (about 1 cm)
under the middle part of the neck.
PROPOSED SCHEMES NECK
Product recommendation
BL50-350 x6 + BASE 16-250 STE
or
FA6-300 x6 (thin skin)
RESULTS PRE AND POST
Dr Glancey - UK
Day O 9 months
Before Post Op
RESULTS PRE AND POST
Dr Amgar - France
EYEBROW
• One thread per side in V or U shape
• Adjust the angles according to the desired effect
Internal part Central part External part
Indication :
Small or medium breast
Minor or moderate ptosis
No augmentation wish
For small breast :
passage of long threads BL 50-350 in U
shape under the glande.
Or passage of threads BL 8-300 in L and J
position on each side of the breast.
For standard breast :
Passage of 6 threads BL 8-300 and BL 50-
350 set up in X.
BREAST
RESULTS PRE AND POST
Dr Chambers - UK
Before After 3 months
Fat grafting reinforced by Spring Thread®
RESULTS PRE AND POST
Dr Chambers - UK
Before After 3 months
RESULTS PRE AND POST
Dr Mart - Thailand
Before After 6 months
BUTTOCKS
According to the patient morphology
Passage of 4 threads BL 8-300 in L and J on
each side of each buttock
You can :
• Cross on to focus on the buttock
• Straight passage of threads BL 8-300
• Passage of Threads BL 50-350 in V
inverted shape with fixing the point of V
by deep suture or horizontal thread
RESULTS PRE AND POST
Dr Chambers - UK
Before After 3 weeks
Reshaping using fat grafting and Spring Thread®
RESULTS PRE AND POST
Dr Chambers - UK
SOMEREFs : French Scientific Society for Thread Lift
1. Long and bi oriented Thread (15 + 15 = 30 cm)
2. Controlled elasticity (20%) for natural and painless result
3. Very strong thread to give good suspension
4. Numerous cogs (24 per cm) for easy settings and better anchorage
5. Round cogs to avoid tissue injury and induce large fibrosis
6. Permanent and inert for longer secured lasting effect
7. Two long flexible blunt end needles minimizing operative risks
8. Simple laying techniques
9. 100% French production + CE Marked
10. Best value market price
10 reasons to prefer Spring
Thread®
Dominique Malard Owner and CEO
+33 / 663 23 62 88
1st SurgiConcept - D. Malard 92
Thank you !!