Thread Lift (Non-Surgical Facial Lifting Threads): Who Is It For, How Long Does It Last, and What Are the Risks?

What is a thread lift and how does it work?

In a thread lift, medical threads are placed under the skin using a fine needle or cannula. Most threads used for aesthetic purposes today are made of materials that dissolve in the body over time and are also used as suture material in surgery. Among these, polydioxanone (PDO), poly-L-lactic acid (PLLA) and polycaprolactone (PCL) are the most frequently mentioned materials.

Threads are generally divided into two groups. Smooth (mono) threads are fine threads with no gripping projections on their surface; they are used mainly to support skin quality, and no lifting effect is expected. Barbed threads carry small barbs, hooks or cones. These projections grip the tissue and aim to create a mild upward pulling effect.

As the thread dissolves, the body's own connective tissue forms around it. This tissue response is thought to support the effect for a while longer; however, there is no strong evidence on how marked or how long-lasting this is.

What is it used for?

• Raising mild sagging in the cheek area somewhat
• Softening laxity that is starting to show along the jawline
• Slightly lifting the tail of the eyebrow (in selected people)
• Mild laxity of the neck
• Supporting skin texture with smooth threads (the effect is limited and variable)

How many threads are placed in which area, in which direction and of which type depends on the person's facial structure, skin thickness and degree of sagging. This decision is made after an examination and a doctor's assessment.

Who might it suit?

A thread lift may mainly be considered for adults with mild to moderate sagging, relatively good skin quality, good general health and realistic expectations. It can be discussed as an option for people who do not want surgery or for whom surgery is thought to be too early.

What matters is knowing from the start that the procedure does not replace surgery and that the result is temporary. Where there is pronounced sagging, very thick and heavy skin, or very thin and lax skin, the benefit of a thread lift usually remains limited.

Who is it not suitable for, and what should you watch out for?

• Pregnancy and breastfeeding
• Active infection, cold sores, an acne flare or an open wound in the treatment area
• A bleeding disorder or use of blood-thinning medicines (do not stop your medicine on your own; talk to your doctor)
• Uncontrolled diabetes, uncontrolled autoimmune disease or treatments that suppress the immune system
• A tendency to scar easily or to form raised scars (keloids)
• Previously placed filler or threads of unknown content, or non-dissolving filler or threads, in the same area
• Situations where surgery may be more suitable because of pronounced sagging
• Intense and persistent worry about your appearance (in this case it is better to talk and be assessed first)

Tell your doctor in full about all the medicines and herbal products you use and any previous procedures such as fillers, threads or surgery. Previous treatments can directly affect today's plan and risks.

Who should perform it, and where?

A thread lift should be performed by a doctor trained in this procedure who knows facial anatomy well, especially the course of nerves, blood vessels and salivary glands. Placing a thread at the wrong depth can lead to dimpling, visible threads or more serious injuries.

The procedure should be carried out in a licensed healthcare facility where sterile conditions are ensured. It is appropriate for the thread to be licensed as a medical device and original, for its packaging to be opened in front of you, and for the product information to be given to you in writing.

Preparing for the procedure

• At the examination, discuss your expectations, previous procedures and medical history.
• Get information in advance about medicines and supplements that may increase the risk of bruising; do not stop your prescribed medicines yourself.
• If you are planning dental treatment soon, decide on the timing together with your doctor.
• Do not schedule the procedure just before an important event; allow time for swelling, bruising and dimpling to settle.
• On the day of the procedure, your face should be clean and free of make-up.
• Read the consent form without rushing; ask questions, especially about possible side effects and what can be done if you are not satisfied with the result.

The procedure day, step by step

1. The doctor assesses your face in a sitting position; the thread entry points and pulling directions are marked on the skin. Photos are usually taken for the record.
2. The skin is cleaned with an antiseptic solution.
3. A local anaesthetic (numbing medicine) is applied to the entry points and along the line the thread will follow.
4. The thread is placed under the skin at the appropriate depth using the fine needle or cannula that carries it; the needle or cannula is then withdrawn.
5. With barbed threads, the tissue is gently guided upwards and checked by comparing the two sides of the face.
6. The ends of the thread left outside are cut; the entry points are closed or a small plaster may be applied.
7. Before you leave, the area is checked; you are given aftercare advice and information on how to reach the doctor if there is a problem.

After the procedure: the first 24 hours and the first week

Swelling, bruising, tightness and tenderness are expected in the first days. There may be a pulling sensation or pain when you open your mouth wide, chew or move your face. Your doctor will usually advise you not to open your mouth very wide for a while, to limit hard foods and not to massage your face.

Not sleeping face down and avoiding intense exercise, saunas and Turkish baths (hammam) for a while are also common recommendations. How long these periods last varies by doctor, the type of thread used and the area; follow the written instructions you are given.

Expected side effects

• Swelling and oedema
• Bruising
• Tightness, a pulling sensation and mild pain that increases especially with facial movements
• Small scabs or redness at the thread entry points
• Mild dimpling or puckering of the skin (often eases in the first days and weeks)
• A slight difference between the two sides of the face (often lessens as the swelling goes down)

These symptoms usually ease within a few days to two weeks. Steadily increasing pain, redness, warmth, discharge or fever, however, are outside the expected course and require you to contact your doctor.

Other possible problems

• Asymmetry: the two sides of the face look different. Sometimes this settles on its own; sometimes further intervention is needed.
• Dimpling or irregularity: a depression or puckering of the skin can form where the thread grips.
• The thread being palpable, visible or moving out of place: this is more likely especially in thin skin.
• The thread coming out: the end of a thread may appear at the entry point or skin surface; the thread may need to be removed.
• Infection: this can appear early or later on; sometimes antibiotic treatment and removal of the thread are needed.
• Inflammatory tissue reaction or granuloma: swellings, sometimes persistent, that the body forms in response to the thread material.
• Rare problems: injury to a nerve or salivary gland, hair loss along the thread line in the temple area.

Most of these conditions can be treated; however, the assessment should be made by a doctor. Do not try to pull or cut the thread yourself, or correct it by pressing on the area.

When are results seen, and how long do they last?

With a barbed thread lift, the effect is seen immediately. However, swelling and tightness in the first days can change the appearance; part of a lifting effect that looks exaggerated in the first week lessens as the tissue settles. It is usually necessary to wait a few weeks to assess the final appearance.

How long the effect lasts varies by thread type, material, the area treated, skin structure and the person's age. Sources generally mention periods measured in months; however, few strong studies have examined long-term results. For this reason, no firm promise should be made about how long the effect will last.

Realistic expectations: what a thread lift cannot do

• It does not provide a result to the degree or for the duration of a facelift operation.
• It does not on its own correct pronounced sagging, a heavy double chin or neck bands.
• It does not replace lost volume; different methods may be needed for volume loss.
• It does not on its own significantly change skin pigmentation, fine wrinkles or skin quality.
• It is not permanent; the effect fades over time and repeat treatment may be needed.
• It is not always possible for the result to be exactly equal on both sides.

Alternatives

This page is for general information only. The method that suits you can only be determined through an examination and a doctor's assessment.