X-TOSIS is one of several mini-invasive face-lift methods using special threads with cogs. It is called ‘X-TOSIS’ because a thread is placed crossing against the upward pulling direction, and it looks like the shape of ‘X’.

Typical design of X-TOSIS is shown. A long thread is inserted as A-B-C, and another long thread is inserted as D-B-E, crossing the first thread at B point. After that, the triangle plane made up of D-B-E is lifted up by pulling the first thread in the A-C direction.


Actual pictures of before and immediately after the operation are shown below. The threads are inserted along the hairline or the outline of a chin, therefore, thread and needle marks cannot be recognized even right after the operation.



X-TOSIS can be designed variously depending on the person’s way of sagging. Several applied examples are shown below.

A thread inserted as B-A-C is pulled by the D-A-E thread crossed at A point.

A long thread inserted as A-B-C-D is pulled in the directions of E-B-E and F-C-F.

Threads are placed as A-B-C, D-E-F, and G-H-I, and they are pulled up by another thread placed in the side of hair to the opposite direction, with B, E, and H as crossing points.

In X-TOSIS operations, the state of being pulled up is the strongest just after the operation, ‘Reversion’ occurs slowly taking approximately one month, and then it becomes stable.

Compared to the state before the operation (picture: above), you can see that the face is pulled up strongly immediately after the operation. ‘Reversion’ occurs after about a month, but it does not completely ‘reverse,’ and it becomes stable at some point (picture: middle). You can see the state is maintained after a year (picture: below). This patient added an Aptos thread on each side of the face after a year.

If you cannot see the subtle changes clearly only by plane pictures, please put the cursor on the picture below.

This is another patient. You can see the difference between the state before the operation (picture: above) and the state after a year (picture: middle). After a year, she further added a pair of X-TOSIS threads. In this way, X-TOSIS and Aptos can be added each time when you care about the sags. No scars are left and there is little downtime.

X-tosis is a very satisfying operation. Different from Aptos, its design is a stereotype, so that operator’s designing skill does not influence much. Please adapt this method to the range of services at your clinics.