Sir, a 58-year-old woman presented for prosthodontic treatment. Her medical history revealed only previous breast and head and neck cancers.

Extraoral and intraoral examination revealed no unusual findings apart from her partially edentulous state and extensive restorations but, in the course of investigation, multiple unusual linear radio-opacities were evident over a wide area on pantomography (Fig. 1). On further questioning the patient revealed she had undergone 'gold thread therapy' for facial 'rejuvenation'.

Figure 1
figure 1

Pantomography revealed multiple unusual linear radio-opacities

Full size image

It is recognised that some 'cosmetic' procedures can be demonstrated radiographically1,2 but we are unaware of other reports on gold thread.

The technique (Gold Filament, Gold Lift; Remaillage; Gold Reinforcement; Gold Silk) involves the implantation of a 99.99% pure gold thread of diameter 0.1 mm to 0.5 mm into the sub-dermal skin, the concept being that gold promotes angiogenesis, as the immediate area surrounding the thread is richer in blood vessels, and the mast cells numbers around the gold thread increase over time,3 which, it is suggested, may result in skin 'rejuvenation'. The latest Gold Thread Implantation™ is performed with 0.1 mm gold thread and purportedly requires no anaesthesia, and is associated with no pain, no haemorrhage, and no scars – and lasts 8-15 years.4 It is occasionally used in chronic diseases (eg sinusitis, arthritis, rheumatism)5 and in acupuncture.

The evidence base for any therapeutic efficacy, however, is slender.6