AI-Guided Ultrasound Enhances Safety of Thread Lifting with Energy-Based Devices

Thread lifting using poly-L-lactic acid (PLLA) and polycaprolactone (PCL) sutures appears to be safe when performed under artificial intelligence (AI)-guided high-frequency ultrasound—even when combined with energy-based modalities on the same day, according to a new retrospective study published in Cureus.

Researchers evaluated 246 patients who underwent thread lifting with APTOS Excellence Visage® sutures (APTOS LLC) in a single-center real-world aesthetic setting. All procedures used real-time AI-assisted ultrasound to guide placement within the superficial musculoaponeurotic system (SMAS). A subset of patients also received same-day treatments with either linear focused ultrasound, monopolar radiofrequency, or CO₂ laser.

The overall incidence of adverse events was under 5%. The most common complications were mild and transient, including postoperative pain (4.1%), ecchymosis (2.0%), granulomas (1.6%), and hematomas (0.8%). There were no reports of infection, thread extrusion, allergic reaction, or removal, and no serious or irreversible adverse outcomes were observed.

The study concluded that “thread lifting with PLLA/PCL sutures demonstrated a favorable safety profile when performed under AI-assisted ultrasound guidance. The use of real-time imaging enhanced anatomical precision. The combination of threads with same-day energy-based modalities was also safe, with no increase in complication rates.”