Cat Eye Thread Lift Procedure | Empire Medical Training

Reopen your practice with a bang! Learn the new “Cat Eye Lift Procedure” and generate significant new revenue!
Ti Jo "TJ" Tsay, MD

Learn the new “Cat Eye Lift Procedure” and generate significant new revenue!

Welcome everyone again. My name is Melissa Alvarez. I'm the chief operating officer of empire medical training. As you may know, Dr. Cosentino normally joins me on these webinars but today he excused himself.

This is an amazing new procedure that we want to share with all of you. It is interesting how the different type of treatments that you can perform with PDO threads. This is something new for myself personally and I'm pretty interested in the new Cat Eye Lift procedure.
Our guest speaker today is Dr. TJ Tsay, he's going to share with all of us this about this new procedure that honestly sounds extremely amazing.

I want to congratulate you because I see you expanding more and more all about your different procedures and excited to hear about the new technique today. Thank you for the great introduction.

Before starting, I just wanting to explain why there's some markings on my face that we're doing that kind of a thread there. I don't have a model so I just marked some vectors and will explain the markings which is part of the procedure.

The presentation today is a potpourri of different things, we used the cat eye brow lift to get your attention but I'm going to talk about a lot of different things and try to condense a lot of different topics. I want to condense all of these topics in the next hour lecture as well as how to reopen your practice safely and then talking about the cat eye brow lift and a few other types of thread lifts. I call it show and tell, just some really cool products and procedures that I perform in my practice. Before we begin about opening the practice safely, I just wanted to take a moment about discussing, just changing our whole mindset, going into reopening the practice.
I don't know how this COVID crisis affects all of you, but of course it has and affected me as well and shut down my practice. Instead of bitching and complaining and griping about all the negative things, I think putting ourselves in a little bit of more positive mindset will help us give out positive vibes and feelings for patients and clients.

Just starting off the day, with a sense of gratitude, doing some breathing exercises and just kind of thinking about what it is that we're grateful for. I know that the restrictions with the COVID crisis affected me negatively, but I'm sure there's some way that it affected you positively - with me it's helped me to slow down. If you can immerse yourself in that. Positivity. I think that'll really bode well in terms of how you present and how you come across when we now start to reopen our practices to our patients.

The next topic is reopening the office safely. I received these pointers from a group of high level of practice owners that really have a wealth of knowledge and they are multi-million-dollar practices. We've shared our ideas on the little things that we're going to do to help reopen our practice and give our patients the perception or feeling that they're coming to a safe place. Now, maybe some of you have heard this on other webinars or in other discussion groups and some of them may be repetitive, but maybe if you will receive new thoughts and ideas from the presentation.

If you could just get one pearl out of this webinar that you could implement in your practice, then this whole webinar will be completely worth it. Number one, we're going to be screening our patients two to three days before their appointments – we will be assessing them for if they have symptoms.

Of course, if there's something symptomatic, I want them to reschedule. If they have fever, cough, shortness of breath, myalgias or something that's really specific for COVID 19 and in the early onset for COVID 19 they will be assessed. Any travel internationally or if they're presently sick just kindly ask that you reschedule for another date or that they get checked out with their primary care practice. We're going to enforce that all patients be required to wear a mask and I think this is going to be really important for reopening.
Government, cities and states have already required this from residents and it doesn't have to be an in M95 mask. If they just wear some sort of facial covering, I believe that will be suffice. Our practices acquired COVID 19 testing kits and we have the IgM and IgG antibody kits that are distributed through Henry Schein and FDA approved for the emergency use.

These tests take about 10 minutes to do, so we're going to test every single patient either in the parking lot or right when they come into the lobby. We are going to be testing every single one of our staff and if they're treating patients they should be proven negative and they're going to wear their protective equipment and coping status the testing kits on their name tag.

I think this will give the patients a little bit more security that our staff have been tested and we're going to test them every two weeks because you never know what they're going to do when they go home or grocery shop.

Let me go over the tests, the IgM antibody is for acute infection. If someone has fever, cough, shortness of breath, and they are positive for IgM then they have an acute infection and they should be sent home right away and contact their primary care doctor, but they should not be actively in your office.

If someone has a positive IgG antibody test result, they have been exposed to it. I know a lot of friends and colleagues who've said back in February I got some weird cold and I got a bad flu and maybe I got. I don't know, so the IgG antibody will tell you if you've been exposed or if you had previous infection.

When we start reopening the economy, people that are IgG positive aren't going to show they've already developed the antibodies. Theoretically you cannot get the infection again, there's some argument about that, but in my personal belief I think if you have the IgG antibody, you are somewhat protected.

We spent last week removed, redecorating the office and we took out a bunch of chairs from the lobby waiting room. We removed the magazines, flyers, brochures, beverages and snacks or anything that's going to require a patient or client to touch something and then require us to touch it in return. It's kind of nice because the lobby now looks really open and clear and there's just one chair and we're not going to have more than one person in the lobby at a given time to enforce the social distancing. We're going to use a non-touch thermometer to measure the temperature for every staff when they come in in the morning. We're going to also use it to measure the temperatures of each patient when they come in and we've ordered an acrylic sneeze guard for the front office counter. The sneeze guard will be sitting on top of the counter and it's going to go 40 inches vertically. It's going to provide a barrier for the patient and the front office staff and there will be a little opening to use the credit card machine. I think there are a lot of practices I heard are purchasing this, it's fairly inexpensive and it's not in the thousands but a few hundred dollars.

Concerning social distancing, we are limiting the number of people in our office when we reopen. It's not going to be the same as we had a really busy practice before and would see 30 patients a day, but we're not going to have that anymore soon.
For the short time being, we're going to limit patients to half the volume and we're going to have someone in charge of flow so that patients don't cross their paths. We possibly could have two patients in the office at one time, but they will never cross paths because we're going to have someone in charge of flow and we're going to be having the patients check out in the treating room versus standing in line.

We're putting air filters with a HEPA and UBC filters and for every room, including the lobby and there's going to be left running all the time as well as continue to cleaning the areas. We have also added a COVID 19 consent, this consent is available through the American Society of Plastic Surgeons. It's a really thorough consent form and you want to revise it to fit your practice or your office, but it basically tells them that the patient has chosen to do an elective procedure. The COVID 19 risk exists out there and even though we're testing them there's still a chance that they can still get infected. We haven't seen how this may play out in court or legally but I think as a practice owner it gives me more of a peace of mind.

What are some popular procedures during or after we get out of the quarantine? While everyone is going to be wearing masks, patients are going to be focusing on areas that you can see such as the periocular region, the brow, or lashes. Either they're going to be focusing on these areas or the other alternative that patients are going to be more willing to do more aggressive procedures that require a longer downtime, like PDO thread lists or CO2 lasers, micro blading, or other invasive procedures.
The highlight of this talk is the cat eye, what this stems from is people that do makeup, especially the females that do makeup and even the makeup artists. They create an effect of the lateral canthus of the eye by using the eyeliner to draw or aligned to make their lateral canthus look like it's tilted and slanting upward.

It's a very exotic look and a lot of women are already doing this with their makeup, but the cat eye brow lift can be done using PDO Barb Threads. To lift the corner of the eye or lateral canthus of the eye, PDO Threads completely changes that lateral shape to a more lifted vertical and slanted look.

As you can see in these examples, these are all Cat Eye results using a makeup effect so you can see the effect that this is going to create. This has been around for a long, long time, right? If you look at the example on your screen and into her eyes, she's got that almond shaped eye and it almost seems like she has that cat eye effect. I think certain ethnicities look well or already have some of these features and so the reason that I drew these lines are because we're going to kind of show you how to do this thread procedure without actually doing it by the vectors on my face.

The requirements of this procedure are bi-directional pre-calculated barb threads. The thread is a barbed thread as opposed to a monofilament, smooth thread. The Barb threads are the type of threads that you want to do the lifting. Bi-directional means as opposed to a unidirectional barbed thread is where the thread has the barbs that are all facing one direction - that's unidirectional. The threads that I prefer are bi-directional, the Barbs on one side is facing one way and the other side of the thread the barbs are facing the other way.

They're actually facing each other, and so when you insert these into the face, one side of the threads are lifting and then the other side of the thread where the barbs are facing down are the anchoring. Anchoring means that once you pull the barbed thread up, the lifting part is lifting, but the anchoring is preventing the lifting part from falling back down.

It is a really different concept, the pre-calculated barbs mean that the barbed thread is already attached to a blunt tip cannula because it's less traumatic, less bruising, less hematoma. The type of barbed threads that I like to use are Mint Threads. I am a speaker and trainer for them so I like the mint brand. The threads are much more grippier and the barbs are not cut into the thread and the barbs are actually molded while being one of the thickest threads on the market.

In general, you could use any bi-directional pre-formulated barbed threads, you're going to need scissors to cut the threads, Lido with epinephrine, and you're going to need 29G-38mm barbed threads.

I drew out the vectors, these two vectors here on the tail of the brow and the side of the eye here. They're pulling in an upper lateral direction and it's going to change the shape of the lateral canthus. We use a PDO, pre-calculated thread and is a bi-directional bar thread. Traditionally with a brow list people make an entry point up top and the hairline and they go down and pull it up. I have it completely different way and is a lot more effective and gives me more consistent results every single time.

I go in reverse and you can only do this because it's a bi-directional bared thread. Once you draw it in your vectors these are going to be your entry points. You're going to insert in the entry points and you can anesthetize in path of the track of the vectors going upward. The vector design is very important, if you look at these two vectors right here, these are the vectors that I use for a traditional lateral third lift.

There are two threads that I'm going to use, two threads that are traveling parallel to each other and going straight vertical. Once you anesthetize these two areas, you want to anesthetize the inherent track, then what you do is you make an entry hole and take an 18 gauge needle and make a little porthole. Basically, you are making a little stab incision with an 18G needle, be sure it's not bleeding and then those two entry holes are going to be where you place the cannula.

We enter with a cannula, it's bi-directional so if you insert in this way so you're going to have a section of the barbed thread that's going to do the lifting and then at the distal end around the temple area in your hairline. This way you're going to have an area of the thread that's doing the anchoring, meaning it's anchored up here so that the thread doesn't fall back down.

It's completely different method of doing the Brow Lift and many people do this as it gives me more consistent results and a more dramatic effect. Once you enter into the two port holes, you're going to insert the tip of the cannular into the skin at a 30 to 45 degree angle.

Once into the subcutaneous tissue, you're going to flatten it and run it parallel to your skull and push it all the way into the hairline. You want to get it as much as you can into the hairline, you don't have to go all the way back to the occiput and you don't have to even get it into the hub.

Once you place the thread in there, you're in the subcutaneous plane so it's really good. Basically, the majority of the time with the barb threads you're going to be in the subcutaneous plane.

Once you have the thread placed there, you're going to twist the cannula and put pressure and you're going to pull the cannula out. After pulling the cannula out, you're going to have a portion of the thread that's sticking out of the skin here and we're going to grab a hold of that and you're going to pull it. Notice the Brown is going to lift like you've never seen it and it is incredible. This technique gives way more of a lift than you'd ever get with any toxins or putting fillers there and finally you are going to lift the brow like so until you get the desired effect you want.

Finally, you're going to go with a scissor and basically clip it right at the entry of the skin and the barbed threads is going to be buried underneath the skin and you can repeat for the second vector. For the cat eyebrow lift, there are two vectors; one at the corner of the eyebrow and one just above the lateral canthus angled vertical and angling upward. You're going to cut both threads and then afterwards I put smooth threads that are perpendicular to the Barb threads. And I put five smooth threads per side, the smooth threads. Why do I do that? I think it adds extra reinforcement. The smooth red stimulate collagen.

When you're putting the smooth threads there, the colonies growing around the tissue is growing around the Barb threads and it helps reinforce the Barb thread effect. The smooth threads cause some skin tightening and there is a little bit of lifting though not dramatic.

By putting the smooth threads in a perpendicular direction to the barb thread you're getting a lifting perpendicular to the placement of the smooth threads. I hope that was helpful. and again, these two vectors going straight up and are the vectors that I use for the traditional lateral brow.

What is a Cadillac Brow Lift? It's the same concept where you make two entry holes right here at the base of the brow and then you make an entry point here. You place the thread here at the entry point and you push it all the way into the scalp. I've done this live in power presentations before, so you can see the way that I did it there.
Once into the skin, you lift up the barbed thread and you cut the thread and leave it there and then you put the smooth threads there - it's the same technique.

I don't have any financial relationships with any of the following, but I would like to just talk about some really cool medical devices that I've been using lately. One of them is the called the Agnes-RF from Clearskin Institute and is a really cool device. I first saw this back in I believe 2017, it was at the Aesthetic Show and they had a really small little booth. I just walked up and was just curious - it's a focus, monopolar radio frequency device using one, two, three needles.

I know a lot of people have radiofrequency devices and they think this is like their devices. It's completely different, I have a fractional radio frequency, multiple needles, called Secret. This device is considered more focused radiofrequency - basically it is a modified Bovie and it destroys the sebaceous glands. It destroys comedones and they have a 3-needle tip that goes down to four millimeters to the subcutaneous tissue for coagulation of fat. It's semi- insulated so when you insert it into the tissue the part that's insulated is totally protecting the epidermis, whereas the tip of the needle is acts like a Bovie, coagulates and burns and destroys the fat.

During the procedure there's no pain and it's absolutely incredible. There's even a 5mm single pen needle that you put it under the eye for the fat pads and you can shrink the fat pads without having to put in fillers. You've seen these cases where someone presents with a large fat pad and the only thing you can do is put some fillers in there to help cover that. Now you can combine fillers with the Agnes treatment and reduce that fat pad significantly. There's even a three-needle tip that goes down to the SMAS layer it's used for facial tightening and face lifting result, I think is better way better than Ultherapy. You've got immediate lifting, no more than one treatment is needed with the Agnes and there is a lot less swelling compared to Kybella. I definitely get way better results per session than with Kybella.

Another really cool product that I've been playing around with for the past a year and a half to two years is called Renuva. This product is an off the shelf alternative to fat transfer - it's an allograph that is an adipose matrix containing growth factors. Their company, MTF, is a nonprofit organization. They would get tissue donors and process it.

Renuva comes in a powder, you pre-mix it and you want to place it in somewhere that fat naturally exists. You want to inject renewal where there normally is fat in it and it just makes the fat grow.

The analogy is this, if you've heard of Sculptra you inject stimulate your body to produce its own collagen. It's a college and stimulating filler where Renuva is a fat stimulating filler. It's a really interesting product that, um, again, you would only use in places that you have fat.

This renewable fat filler is used for facial atrophy, facial rejuvenation, or nasal labial fold. Replace and improve their fat pads and practitioners have used it in the hands, I use a lot for people that have had liposuction which after liposuction they can sometimes get irregularities or dimpling.

There are some providers that actually have used Renuva in combining with Sculptra and calling it Nuva Sculpt. It's a renewed Sculptra combination and practices been using that for rejuvenation for both fat as well as stimulating your own collagen so that there are long lasting results. Some even say the results with the Renuva are permanent but there are no long-term studies.

That is concludes my presentation, I talked about a lot of different items and I hope you just took away one or two pearls and that this webinar was just completely worth it for you.

Are you ready to reopen your practice and start generating new revenue?

Empire Medical Training is your source for valuable Procedure training and insight into learning new procedures and growing your practice.

Join us this Tuesday May 5 at 2:00 PM EST with Dr Cosentino, president of Empire Medical Training and Dr. TJ TSAY, “Celebrity” Aesthetic Physician from affluent Newport Beach, California who will train you on (4) Four great new procedures you can immediately implement into your practice when you decide to resume.

As quarantine restrictions begin to lessen, Practitioners will continue to maintain a safe environment and practice setting while performing new procedures. Now is the time to learn the new “Cat Eye Thread Lift Procedure". This 20 minute in office procedure is not only replacing cosmetic surgery but is becoming akin to botox treatments as the most sought after non surgical cosmetic procedure (Thread lift procedures)

The Cat Eye Thread Lift is a technique using PDO threads where the practitioner inserts the thread beneath the skin adjacent to the temporal area and lateral eyebrow. It does much more than just producing an eyebrow lift The Cats Eye Lift is becoming a major trend on social media (i.e. Kendall Jenner and other celebrities) and Millennials specifically are eager to have this procedure and enjoy the dramatic results achieved.

The Instructors

Ti Jo "TJ" Tsay, MD
Chief Medical Officer - Empire Medical Training

Dr. Tsay, renowned “Celebrity” Aesthetic Physician will teach you the protocols, guidelines, and specific methods to perform the technique. Durin the livestream webinar, Dr. Tsay will also share procedure videos where you can watch the procedure being performed correctly by the nations leading Aesthetic Physicians. These are interactive webinars where you can ask questions and be in direct contact with the Physician instructor.

Dr. Tsay is the founder and medical director of AGELESS MD, one of the most desired destinations for discriminating women and men seeking to defy the laws of gravity and eliminate wrinkles, lines and other telltale signs of aging. His practice has a global following and is the go-to Southern California medical spa for aesthetic medicine and noninvasive cosmetic procedures.

Where else can you receive this level of education and training?

What makes this series so different and so special is the invited guests who represent the faculty and core of the practice building webinar series.

Empire will interview a new guest every week including renowned Physicians and Industry Experts to help practitioners expand their practices in the areas of:

Anti-Aging and Regenerative Medicine
Aesthetics, Cosmetic Dermatology
Pain Management
Practice Management
Legal and Compliance
Business and Marketing
Social Media

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Livestream Late Registration Fee: Virtual Empire Members enjoy VIP registration benefits. However, if a virtual member registers after their designated registration window, a late registration fee of $50 will be requested and charged.

Seminar Rules and Safety: Empire has implemented strict rules regarding the handling of needles, sharps, biohazards, and the protocols involving various procedures. These rules will be announced prior to each hands-on training session, you are familiar with same. Additionally, you will be required to view a video presentation prior to your arrival at the seminar pertaining to handling of needles and other matters. Registrants may access this video after registration on the “member’s portal”. Non-members will receive a link to access the same.

If a participant is acting in a manner that may cause detriment to others in attendance or is otherwise deemed to be disruptive or not following the instructors’ instructions or guidelines, the participant may be asked to leave the training program without being entitled to a refund. The designated instructor and his support team will serve as the final authority in this matter. This is a rare event! However, it is important for you to understand that our first objective is the care and safety of the Empire personnel and participants at our training programs. If these terms and conditions seem to you to be either unreasonable or extreme, we respectfully request that you think twice before registering for any hands-on training course. We thank you in advance for your cooperation and attention to the seriousness by which Empire takes its training.
Hands-on Training: Empire has trained over 100,000 health care professionals, safely and effectively over the past 22 years. This is due in part to our strict guidelines and protocols regarding hands on training. By participating in an Empire event, you agree to follow the supervision and direction of the Empire Physician instructors at all times during the training.

Prerequisite Training: Prior to participating in ANY Facial Aesthetics hands on workshop, all non-core medical professionals (other than Plastic Surgeons and Dermatologists) are urged to complete EITHER the LIVE FACIAL CADAVER COURSE* or the ON-DEMAND VIDEO FACIAL CADAVER COURSE*, which will satisfy the requirement. The Video ON Demand program can be viewed at any time from your “MyMembersPortal.com . If you have already completed an AMA approved advanced facial cadaver workshop in Aesthetics, then you may submit your certificate as proof of completion and will not need to take this course.

This requirement will help ensure that graduates are learning safe technique and will help reduce the chances of having dangerous patient complications.

There is a FEE associated with these programs that is in addition to and separate from a membership FEE. This fee is significantly discounted for Members. The Facial Cadaver training fees are posted on the Facial Cadaver landing page or you may speak with an Empire representative.

Graduates will receive a Certificate indicating their completion of the Advanced Facial Cadaver Course and a written statement on each Certificate earned in Aesthetics. Certificates should be submitted to your malpractice carrier.

Attendees who are unwilling to participate in either the Video on Demand or the live Program may attend courses, however, must sign a digital waiver indicating that you have been offered and urged to participate in the training, and explained the importance of receiving the training as relates to patient safety and complication avoidance, but have chosen not to participate in the training and will accept any liability that may result from not receiving this training.

Physician Supervision: During all training programs, the Empire physician instructor (“Instructor”) will have the final authority as to whether an attendee may perform a procedure on a patient and, the instructor will also decide if the attendee has successfully demonstrated a basic level of competency to receive the graduation certificate. Their decision will be based on many factors, including but not limited to, patient safety, participant safety, participant licensure or lack thereof, legal guidelines, and participant competence as evaluated by the Instructor. If the Instructor believes the participant has not demonstrated sufficient skills while practicing on training models (inanimate), the instructor will offer additional training to the participant, AT NO ADDITIONAL CHARGE TO THE PARTICIPANT*. The additional training may be in the form of a repeat seminar OR a One on One preceptorship with an Instructor at Empire’s Centers of Excellence. This latter option is an integral part of Empire Medical Training’s Wow Refund Policy.
*Reduced fee applies to Thread Lift Training (speak with an Empire representative for details).

Seminars/Membership Terms & Conditions: Empire memberships cannot be transferred to other individuals during the term of the membership. This includes Diamond, Platinum, and Office Memberships. Office Memberships cannot be transferred after completion and attendance by individuals to any one program. Any request for changes to the various memberships would need to be made prior to members' first attendance at an Empire program and is at the sole discretion of Empire.

Video and Photography during all Events: All training programs are photographed and recorded for various reasons including, but not limited to, providing educational videos to participants, for video testimonials, for marketing purposes, and for business purposes related to education. All participants, guests, exhibitors, and visitors to the training programs understand that they may be photographed or videotaped for broadcast or exhibition in any medium, and that Empire may use the edited or finished product for any legitimate use. Upon entering such Empire training programs, you give Empire the unqualified right to take and use such pictures and/or recordings as well as giving Empire the perpetual right to use your likeness, image or photograph (collectively herein referred to as “photo”) without compensation or payment or any type. You agree to waive and forever release and discharge Empire from and against any and all claims or actions arising from the use of your photo.

Important Disclaimer: Enrollment in a training program does not guarantee that the enrolled licensed healthcare professional is competent to perform a procedure and the participant will hold Empire and affiliated entities, together with their respective shareholders, members, directors, managers, officers, employees, agents and affiliates (collectively, "Indemnities") harmless from any losses, liabilities, negative results or outcomes whatsoever that a patient may suffer from an attendee’s action or procedure. Furthermore, it is the responsibility of the licensed healthcare professional to understand and adhere to all the laws and guidelines of the state in which they practice medicine or otherwise perform healthcare services. Indemnitees may not in any way be blamed or held liable for violations committed by an attendee. Attendees must also understand the scope of what their professional license allows or disallows in regards to the newly learned procedure.

SPECIAL PRICING WITH MERZ AESTHETICS: As an additional benefit to your membership (all levels, i.e., Platinum, Diamond, Pain), members may enroll in the "My Merz Select ("MMS") program, at no charge and with no prior purchase history, and be upgraded to Premier Plus Pricing. This discount program is available to appropriately licensed medical accounts (other than dental healthcare providers, who are not eligible for discounts and rebates amounts, MMS levels or eligibility criteria). Empire Members must contact Merz Aesthetics directly to enroll in the program and to be provided with Merz terms and conditions. Merz Aesthetics reserves the right to unilaterally modify the terms and conditions of the program, including without limitation to adjust its list prices, product inclusions, discount and rebates amounts, MMS levels or eligibility criteria, and further reserves the right to suspend or terminate this program or MMS at any time. This information does not constitute a formal agreement between an Empire Member and MERZ.

Vendor Disclosure: I understand that the companies listed in this directory are vendors or exhibitors with Empire.
Empire does not endorse or recommend specific sponsors or exhibitors listed in this directory. All medical advice, treatment and/or products and services given by those listed in this directory should be taken at your own discretion.

All information, including names, contact information, descriptions and website links, in this directory is provided to Empire by third parties. We assume no responsibility for the information provided by third parties or the content of other Internet sites to which we provide links.

I understand that at no time is Empire making any representation or warranty regarding any sponsor's or member's products or services, nor will Empire be liable for the sponsor's products or services.

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Empire Wow Refund Guarantee® and all trademarks, whether expressly written or implied, are strictly protected by copyright and trademark laws.

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The American Academy of Procedural Medicine offers Board Certification Pathways for Physicians in Aesthetics, Anti-Aging, and Pain Management. Call today to find out how to get your Certification Plaque FREE.

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