The Surgeon Minute

The Silhouette Lift – A Non-Surgical Facelift Alternative

The Silhouette Lift – A Non-Surgical Facelift Alternative

If you find yourself in front of a mirror moving your cheeks upward with your fingers, you might be ready to entertain options to keep them up there. This situation describes would-be patients of facial rejuvenation, but probably doesn’t point to a need for surgical intervention. If you’re young and your face is only mildly starting to “fall,” you may be a good candidate for the Silhouette Lift. It’s an effective, minimally-invasive alternative to the traditional, and surgical, facelift.

Massachusetts board certified plastic surgeon Dr. Christine Hamori says it’s not uncommon for women to contact her office in the weeks leading up to an important life event for a procedure. They want to refresh their look with little or no downtime. “Let’s say their daughter is getting married, and they contact the office with three months to go until the wedding. They want to look the best they can. They don’t have time to recover from a facelift, or they don’t want the expense of surgery,” shares Hamori. By combining a Silhouette Lift with a little bit of filler, she is able to provide her patients both lift and volume within a short time frame.

Traditional Thread Lift vs. Silhouette Lift

The Silhouette Lift is a technological advance on the thread lift that become popular in the 90’s. Thread lifts used surgical sutures, called threads, with little barbs that made it easy to move the thread in one direction (upward) but very difficult to move in the opposite direction (downward). If you’ve ever used a zip tie, you can visualize how barbs can make movement in one direction easy and movement in the opposite direction difficult. During a thread lift, the thread was inserted in the lower portion of the cheek, then pulled through the tissues below the skin, lifting them upward, and finally anchoring them into position.

The permanent sutures used in thread lifts posed several problems. Once anchored, the sutures had a tendency to cut through the soft tissues of the face, a condition referred to as cheese wiring. When permanent sutures cut through the deeper tissues of the face instead of holding them in a lifted position, it negated the purpose of the lift. In some cases the permanent sutures even became visible.

Movement of the cheeks via the Silhouette Lift.

Instead of permanent threads, the Silhouette Lift utilizes a fully-absorbable suture. As your body slowly absorbs the suture, it replaces it entirely with collagen. Each absorbable suture contains pea-sized, cone-shaped beads. These cone-shaped beads are also fully absorbable. Unlike the permanent sutures used in thread lifts that could only lift skin in one direction and had to be anchored, the cones on the absorbable sutures are bidirectional and self-anchoring.  

The Silhouette Lift accomplishes 3 goals:

1) Tighten skin from the inside

2) Lift tissues below the skin

3) Stimulate collagen production

Silhouette Lift - before and after.

How It’s Done

Dr. Hamori administers a local anesthetic to the area that will be treated, keeping the patient awake for the approximately hour-long procedure. Next, a fine needle is used to insert the Silhouette thread. The bidirectional cones on the thread anchor it into position just below the skin. Since the cones oppose each other, the tissue above the suture serves as an anchor and the tissue below is both tightened and lifted. Where the needles exit the face, Dr. Hamori cuts the suture flush with the skin. She repeats this process, placing three threads in each cheek to provide optimal lift and tightening.


When the Silhouette Lift is complete, the results are immediate and they last up to eighteen months. “There’s a bit of bruising in the area,” shares Hamori, who goes on to add that the most difficult part of the recovery for her patients is the restriction on smiling for ten days following the procedure. For the first week or two, the cone shaped beads are palpable. After several weeks you can no longer feel the beads, as they become integrated into the tissues they are lifting. Eventually, your body replaces the sutures entirely with collagen.

Silhouette Lift before and after.

The Ideal Candidate for a Silhouette Lift

The best candidate for a Silhouette Lift is someone who has only a small amount of skin laxity. It should not be done on someone who has a lot of loose skin on their face and neck. In those cases, the best option to lift the face would be surgery. “On someone with heavy skin, it doesn’t work well either,” says Hamori. “Those little peas, those little shuttles, can only pull so much. You have to choose your patients correctly.”

Fillers replace lost volume. Botox can help smooth wrinkles. Laser resurfacing can address skin tone and texture. And until recently, the lifting of fallen facial tissues could only be addressed with surgery. For the right patient, the Silhouette Lift fills a previously unmet need for providing lift with little downtime.

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