"Elm Lift," a non-surgical treatment for sagging skin: Explanation of the differences from conventional thread lifts, the procedure, and downtime.

Introduction | Sagging occurs when "fat is lost"

Director Shiramizu

In your 20s, your face has a smooth, inverted egg shape. However, as you age, the ligaments that support the fat loosen, causing the fat to sag. The areas where the fat was originally located become thinner and hollow, while the areas that have sagged bulge, creating unevenness and sagging in the face.

Nasolabial folds, marionette lines, sunken cheeks—all of these are caused by the shifting of fat due to sagging skin. At Elm Clinic, we offer our unique thread lift, "Elm Lift," which aims to "return this lost fat to its proper position."

In this article, Chief Director Shiramizu provides a detailed explanation of the Elm Lift procedure, its differences from general thread lifts, the treatment process, downtime, and maintenance, based on actual treatment videos and three case studies.

*This article is a revised and expanded version of the content from the YouTube video.

What is Elm Lift? | Differences from General Thread Lifts

Elm Lift is a thread lift technique uniquely adopted by Elm Clinic. It differs from typical thread lifts in three main ways.

Director Shiramizu

The depth at which the threads are inserted is extremely important; if they are inserted too shallowly, the skin will be pulled along with the threads, causing wrinkles and indentations, while if they are inserted too deep, they will enter the muscle and cause severe pain. The greatest advantage of Elmlift is that it allows you to change or return to the correct layer midway through the procedure, enabling precise insertion into the appropriate central layer of fat.

Treatment plan | Combination of temples, mid-face, and hyaluronic acid

Elmlift treatment is performed not only on the lower face (face line) but also on the lower face.Threads are also inserted into the mid-face (around the cheekbones).This is a distinctive approach. By lifting the fat in the mid-face, it results in a long-lasting and well-balanced finish.

• Temple route (for lower face)Three threads are inserted through a single incision. The fat in the lower face, which causes marionette lines, is lifted to fill in the hollows of the cheeks.
• Mid-face routeThree incisions are made in the cheekbone, and threads are passed through each to the temporal fascia. The fat above the nasolabial folds is then lifted towards the marionette lines.
• Hyaluronic acid supplementationHyaluronic acid is injected into the inner part of the nasolabial folds (Golgo lines) where thread lifts cannot be performed due to the presence of the eyes, resulting in a smoother finish.

Director Shiramizu

Inserting too many threads close to the mouth can make it difficult to open the mouth or cause indentations due to movement. When the skin is pulled from the outside, the inside also lifts, so the correct approach is to pull firmly from the outside rather than forcing threads into the high-risk inside.

Procedure Flow | Design, Anesthesia, Insertion, Lifting

The procedure, from consultation to design, anesthesia, insertion, lifting, and finishing, is completed in approximately 1 hours.

• that’s a joy to receive.First, decide on the desired goal after lifting, and then work backward to determine the starting position and route so that the fat falls precisely on the sunken part of the cheek.
• 麻 酔Local anesthesia is injected at the entrance and along the path of the sutures. Nitrous oxide anesthesia (inhaled gas) is available for those who are concerned about pain.
• InsertCarefully insert 12 Elmlifts (total for both sides). If a dent occurs during insertion, it can be reversed and readjusted.
• Lifting and adjustmentRaise the bed and adjust the amount of elevation according to the patient's wishes while looking in the mirror.
• FinishingThe procedure is completed by injecting hyaluronic acid into the inner part of the nasolabial folds that cannot be lifted with threads.

Director Shiramizu

The reason we use nitrous oxide anesthesia is for safety reasons. With intravenous anesthesia (sedation), the patient falls completely asleep and becomes unresponsive. The feeling of "pain" when the thread is too deep and gets close to the muscle is an important safety criterion for determining that the thread is in the correct layer. With nitrous oxide anesthesia, the patient remains conscious but relaxed, allowing us to proceed with the procedure safely.

Downtime, aftercare, and maintenance

Director Shiramizu

Immediately after the procedure, we intentionally pull the skin up about 120% more than necessary. This is because the threads will settle into place and return to their ideal position as you move your facial muscles during the first week, and we take this into account when we finish the procedure. The effect is at its peak immediately after the procedure, and then gradually diminishes. If you come back for maintenance six months after your initial visit, and we adjust the number of threads accordingly, you will eventually be able to maintain the results with just one treatment per year.

*The perceived effects and the length of downtime may vary from person to person.

Case studies showing the effects of Elmlift

Elmlift 10 threads + Hyaluronic acid 3 injections | Case immediately after treatment

This is a case study of a patient who was concerned about nasolabial folds and marionette lines.By combining 10 Elmlift threads with 3 hyaluronic acid injections, you can see a lifting effect on your face line and a change in your facial contour immediately after the procedure.

*The effects may vary from person to person.

A case involving 6 Elmlift threads + 1 hyaluronic acid injections.

This is a case study of a patient who was concerned about sagging in the jawline and hollow cheeks.With a combination of six Elmlift threads and one hyaluronic acid injection, my facial contours appeared noticeably firmer immediately after the procedure.

*The effects may vary from person to person.

A case involving 12 Elmlift threads + 2 hyaluronic acid injections.

This is a case study of a patient who desired overall improvement in sagging skin and facial contours.Using 12 Elmlift threads and 2 hyaluronic acid injections, my face line was noticeably lifted and firmer immediately after the procedure.

*The effects may vary from person to person.

Summary | Find the optimal plan through counseling

The optimal number and method of Elmlift injections vary depending on the amount of facial fat, mobility, age, and skin firmness. If you have concerns about sagging or facial contours, please feel free to consult with us for a consultation.

*This article is a revised and expanded version based on a YouTube video. Individual results may vary. Please confirm the treatment details, fees, and risks during your consultation.