Posture-based Assessment: Thread Lift Versus High-intensity Focused Ultrasound in Asians

Background: Minimally invasive facial laxity treatments, such as thread lifts and high-intensity focused ultrasound (HIFU), are increasingly popular in Asia, but standardized guidelines are lacking. Treatment outcomes are often subjective and heavily dependent on the physician’s expertise. Earlier studies indicate that facial soft tissue shifts significantly between supine and seated positions in cases of laxity. This study aimed to objectively evaluate facial laxity improvements after thread lift and HIFU treatments in Asians. Methods: Photographs of 143 Japanese individuals (mean age, 41.0 ± 15.5 y; mean body mass index, 21.2 ± 3.2 kg/m 2 ) taken between February and May 2024 were analyzed. Frontal and lateral facial measurements in both seated and supine positions were compared across untreated, HIFU, and thread lift groups using ImageJ software. Statistical significance was determined using t tests with a threshold value of P less than 0.05. Results: The soft tissue shifts were measured as 20.8% (SD = 19.4) in untreated, 20.7% (SD = 14.1) in HIFU, and 14.1% (SD = 11.6) in thread lift groups for frontal views. Lateral views showed shifts of 41.4% (SD = 20.9), 38.2% (SD = 20.7), and 33.4% (SD = 23.2), respectively. Significant reductions in tissue movement were observed in the thread lift group (frontal, P = 0.0092; lateral, P = 0.02) but not in the HIFU treatment group. Conclusions: Thread lifting significantly reduces facial tissue movement between seated and supine positions, indicating superior efficacy in preventing facial laxity. This study underscored the importance of assessing facial laxity in the seated position to accurately gauge treatment effects.