Extrafacial Loose Areolar (XFLA) Thread Lifting (A Novel Technique)

Thread lifting is one of the widely chosen procedures for minimally invasive facial rejuvenation. Traditional facial thread lifting has nearly inevitable side effects e.g. facial edema, facial bruising, prolonged recovery, skin puckering, and visible and/or palpable threads, as well as less common complications e.g. damage of facial vital structures. Applying the extrafacial loose areolar (XFLA) thread lifting technique by using loose areolar connective tissue, the fourth layer of the scalp, as insertion medium for the threads to be anchored to the layer above (epicranial aponeurosis or galea aponeurotica) and the layer below (pericranium), could help minimize most of the previously mentioned side effects. In this manuscript, technique steps will be detailed to prove its novelty.