Medical Journal

The authors report the histopathologic and ultrastructural features of gold threads, which were implanted in the cheek subcutis of a 77-year-old woman 10 years ago. These particles did not give rise to any adverse reactions and were fortuitously discovered by the surgeon during a facelift. Histopathology showed a nonpolarizing exogenous material consisting of black oval structures surrounded by a capsule of fibrosis and by a discrete inflammatory reaction with a few giant cells. In some cases, only a long fibrous tract surrounded by a moderate mononucleate infiltrate was observed. The wires were characterized with scanning electron microscopy, and X-ray microanalysis revealed a specific peak at 2.2 keV representative of gold that was absent in the control skin sample. As this value is specific for gold, it confirms the presence of the metal in the patient’s skin. The histopathologic appearance of gold threads is particularly distinctive and easily recognizable by ermatopathologists.

A 48-year-old patient reported pain in her face and neck. Within 10 years she had undergone three ‘‘golden thread lift’’ suspension procedures, the last one 2 years previously. Skull radiographs showed complete fragmentation of all the implants into small pieces, and a total loss of their vector orientation.

The idea of the thread under the skin goes back more than half a century. For a face that was getting tired and relaxed, even in young patients, the only solution was the facelift, heavy and disproportionate act for early lesions.

Augmentation material used in plastic surgery such as facelift procedures can be radiopaque and thus become visible on extra- and intraoral radiographs. These objects may obscure anatomical structures and mask critical findings, therefore leading to potential misinterpretation of otherwise successful images. The present report describes a case in which the radiographic intra- and extraoral data are partly masked by a superimposed radiopaque mesh, which was suspected to originate from a facelift procedure. A gold thread lift was confirmed by the plastic surgeon.