“Polydioxanone” or PDO threads, literally surgical sutures used in the cardiac and
pediatric operating theatre for more than thirty five years, are specifically designed to
slide through the dermal layers, anchor to the underlying skin, and lift engaged tissues
in various vector plains.
Unlike older permanent sutures, PDO fibers absorb after four to six months, require, at
most, only a minute pin size, less than 1/10 of 1 milliliter, of anesthetic, are advanced
with a blunt edged cannula, rather than a needle, to safely navigate around underlying
nerve and vascular tissues.
The previous generation of threads were permanent, inserted via an incision, behind
the ear, were tied in a knot, and left lumps and scars. To add to the misery, the ties,
frequently slipped or broke.
Our newer, PDO threads, dissolve over time, are advanced over your skin like a shower
curtain rod over a curtain rod, lie flat, and when extruding through the skin, are cut in a
downward motion burying the thread. There are no ties. At most a minute opening for
the cannula insertion is closed with a polysporin ointment dressing and a tiny dot
Why use Polydioxanone Threads?
PDO threads create an “instant” gratification as one can see an immediate effect from
treatment. But what you see isn’t what you get as, over time, the treads induce a micro-
irritation in the dermal layer, inducing angiogenesis, fibroblast stimulation, collagen
induction, skin tone rejuvenation, rejuvenated skin elasticity, and a shrinking and
closing of pores.
The procedure requires minimal to no downtime and is described as minimally painful.
We apply a laser grade anesthetic cream for patient comfort, if needed, and inject a
minimal dose of lidocaine with epinephrine, < ¼ cc in the thread insertion site, for pain
control and to stem any bleeding. (The face is highly vascular and even a minimal nick
can cause significant bleeding.)
Collagen Production, Promotion of Local Blood Microcirculation and
Activation of the Reparative Processes
PDO threads create micro-traumas under the skin, agitates dermal tissue inducing a
regenerative processes. Fibroblasts, reparative cells that produce new structural
components, collagen, elastin and hyaluronic acid, in the “damaged” area.(1)
Looking through a 200x magnification, we see collagen fibers arrayed circumferentially
around the PDO threads along with neovascularization aligned along the longitudinal
axis of the dissolving PDO threads.