Silhouette Instalift: The Ability to Nonsurgically Redrape Facial Tissue

I've long been a proponent of the liquid facelift—made possible with the emergence of injectable neutrotoxins and fillers,” says Houston dermatologist Suneel Chilukuri, MD. By adding energy-based devices to address skin texture and pigmentation, aesthetic surgeons have been able to address three of the four Rs of rejuvenation: Relaxation, Revolumization, and Resurfacing.

Until now, a safe, reliable non-surgical approach to the fourth R has remained elusive: Redraping. With the introduction of Silhouette InstaLift, Dr. Chilukuri says, aesthetic physicians can finally redrape the skin and truly optimize minimally-invasive, non-surgical rejuvenation.

Courtesy of Suneel Chilukuri, MD

A Novel Approach

Silhouette InstaLift is a suture lift. The sutures have tiny cones that are comprised of poly-L-lactic acid (PLLA) and polyglycolide/L-lactide (PLGA). PLLA is well-known to aesthetic physicians, as it has long been a component of certain suture materials and is the basis for an injectable filler product, Dr. Chilukuri says.

To place the sutures, a small puncture is made in the skin with an 18-gauge needle. Through this puncture, the suture is threaded and is then manually shifted, tugging the tissue taut to create an instant lift. Noticeable results are immediate.

For Washington, DC laser surgeon Tina Alster, MD, the InstaLift standouts from other technologies. “The InstaLift literally lifts the skin rather than simply ‘tightening' it (as can be achieved with other devices such as Ulthera and Thermage RF). As the sutures are absorbed and incorporated into the skin, the skin quality and dermal volume is improved by the stimulation of collagen production—similar to the clinical effect of nonablative lasers and filler injections,” she says.

“In addition to having that immediate lift, you have a long-term solution that occurs because as the PLLA breaks down, it stimulates the fibroblasts to grow new collagen,” Dr. Chilukuri explains. “With new collagen formation, the skin looks more taut, it looks more healthy, and patients get this glow.” Patients see continued improvement over several months following treatment.

The entire procedure takes about an hour, including numbing and patient counseling/post-op instructions. There is no downtime.

“Our patients have been thrilled with the immediate change that they see,” Dr. Chilukuri says. He notes that an occasional patient may develop a bruise at the insertion site, but this is not the norm.

Courtesy of Suneel Chilukuri, MD

Expanding Options

As aesthetic interventions have become less invasive, more accessible, and associated with less downtime, they appeal to a wider array of patients. This includes younger patients, seeking to address signs of aging early on or to prevent them altogether, Dr. Chilukuri observes.

“I'm thrilled that we're able to address all four of the R's that we've talked about for several decades now,” Dr. Chilukuri says. In his practice, the Silhouette InstaLift is performed in conjunction with fillers, toxins, and/or laser, depending on the patient's specific needs.

The ability to redrape the skin can be especially beneficial for younger patients, Dr. Chilukuri maintains. Patients in their mid-40s to early 50s often are, “just starting to get that little bit of sagging near the jowls. I can now improve the actual skin positioning to strengthen the jaw line, recreating that sharp mandibular angle.”

“I recommend InstaLift for patients with mild to moderate laxity of the cheeks and mandible/upper neck whose condition is not severe enough to undergo a surgical lift or in those who do not desire surgery,” Dr. Alster agrees.

The rapidity of the treatment and the lack of downtime seems especially attractive to younger patients.

With that said, Dr. Chilukuri points out that he uses the InstaLift across all age groups. Older patients who are candidates for surgery but wish not to have it can see some worthwhile improvement with InstaLift.

Courtesy of Tina S. Alster, MD

The Full Package

Despite a slew of minimally invasive aesthetic advancements in recent years, “what we've not been able to do is actually re-drape or reposition the face,” Dr. Chilukuri says. “We actually have a solution for that now.”

His experience administering InstaLift and his patients' reaction to the new treatment have both been positive. “Our patients are incredibly satisfied,” he says.