An anatomy-guided multi-vector thread lifting strategy for nasolabial fold correction: Technique refinement and clinical outcomes in a 22-patient case series.

Background: The nasolabial fold (NLF) is a key aesthetic concern in facial aging. Thread lifting offers a minimally invasive alternative to surgery but requires precise anatomical planning to ensure safety and efficacy. Objectives: To describe an anatomically informed, multi-vector thread lifting technique for NLF correction and evaluate clinical outcomes in 22 patients. Methods: Between March 2020 and December 2022, 22 patients (17 female, 5 male; mean age 47.2 years) underwent NLF correction using barbed threads for structural lifting and monofilaments for superficial volumization. Thread types and vectors were selected based on NLF subtype, skin thickness, and facial anatomy. Outcomes were assessed using standardized photographs and the Global Aesthetic Improvement Scale (GAIS) over a follow-up period of 6-18 months. The number and type of threads used in each patient were determined individually based on anatomical assessment and fold characteristics, rather than a fixed protocol, to allow personalized optimization of outcomes. Results: At 6 months, 90.9% of patients showed "improved" or "much improved" results. At 12 months, this remained in 77.8% of those followed. Type II NLFs showed strong initial results but greater regression over time, while Type III folds demonstrated better long-term stability. Complications were minor and self-limiting, with no serious adverse events. Conclusions: This technique offers a safe, tailored, and effective approach for minimally invasive NLF correction when guided by anatomical principles.