Thread lifts have been around for decades, during which their popularity has waxed and waned. But they’re currently on an uptick, thanks to a resurgence of interest in this nonsurgical, minimally invasive procedure. The cosmetic threads market pulled in more than $121M in 2022—and is projected to increase to more than $215M by 2030. Credit new and improved thread materials coupled with more advanced techniques that have helped mitigate many of the issues associated with earlier iterations. Thread lifts now come in a variety of shapes and sizes and are being used on both the face and body. But they’ve always been—and still remain—somewhat controversial, with experts split as to exactly how effective and reliable they are. At the end of the day, there’s no denying that there are some notable disadvantages to a thread lift. Here, doctors explain exactly what to consider before undergoing the procedure in order to ensure the best possible results as well as what can be done if a thread lift goes wrong.
What is a thread lift?
Simply put, it’s the use of multiple sutures (the threads) that are inserted under the skin and used to either lift and reposition sagging skin and/or to stimulate collagen, explains Dr. Jessie Cheung, a board-certified dermatologist in Willowbrook, Illinois. The sutures can be made of different materials: polydioxanone (PDO), poly-L-lactic acid (PLLA), or a blend of poly-L-lactic acid and polyglycolic acid (PGA), adds New York City board-certified dermatologist Dr. Ariel Ostad. All are FDA approved and dissolvable, meaning they gradually break down and are absorbed by your body over time.
What are the benefits of a thread lift?
“Thread lifts are popular because they’re marketed as a noninvasive way to lift tissue,” says Dr. Babak Azizzadeh, a board-certified facial plastic surgeon in Beverly Hills, California. And indeed, they are quick and easy, typically taking less than an hour and requiring only small amounts of local anesthesia. It’s instant gratification with minimal to no downtime, notes Dr. Cheung. And in the right candidate (more on this caveat in a moment), the results can be impressive.
What are the disadvantages of a thread lift?
While thread lifts are often positioned as a direct substitute for a facelift, the results are hardly equivalent. “The aging process is multifactorial and consists of so much more than just sagging skin. Things such as volume loss, sagging fat, and bone loss also have to be addressed, and thread lifts are only repositioning the skin,” says Dr. Azizzadeh. They can’t do anything to the underlying structures the way a surgical facelift can, he adds. Not to mention that a thread lift won’t actually remove any skin. This is why they’re not a great choice for those with severe laxity; a thread lift can reposition the skin incrementally, but there’s no cutting or removal, says Dr. Cheung. Finally, the results aren’t permanent. According to Dr. Cheung, the lifting effects last about nine months, while collagen-stimulating benefits last for about a year and a half.
What can go wrong with a thread lift?
Extrusion (where a thread pokes out of the skin) and dimpling are two of the most common issues. The former is caused by improper placement; dimpling or visible lumps and bumps occur when a thread is placed in an area without enough other threads around it, explains Dr. Cheung. Thread migration is also possible, though this is more likely to occur in threads that do not have an anchoring cone or barb that hooks into the tissue, says Dr. Ostad. (The majority of those used for lifting purposes do.) However, this can happen even with barbed threads that are thicker: “These are often used when there’s more skin that needs to be lifted. However, they’re not as soft and pliable as thinner threads—and as such, don’t conform as well to the contours of the face, so our daily muscle movements start to dislodge them,” he explains.
Asymmetry is also possible, again, due to improper placement or the wrong number of threads being used on both sides of the face. Nerve damage as well as damage to the parotid glands (the salivary glands located in front of the ears) are potential problems as well. Because thread lifts are performed blind, there’s always a risk that the barbed hook can go through a nerve or the gland if the suture isn’t inserted in the correct spots, Dr. Azizzadeh points out. Finally, a risk of infection is always possible, although the experts we spoke with agree that this is the least likely pitfall. (While the permanent threads that were used years ago would often trigger inflammation and infection, the dissolvable ones of today are unlikely to cause such issues.)
How to fix a thread lift gone wrong
The good news: “The disadvantage of thread lifts being nonpermanent becomes the advantage here,” says Dr. Cheung. Point being, if you’re not happy with the results of your thread lift or if there is an issue, it ultimately will resolve itself as the threads dissolve. The majority of the time—particularly in instances such as extrusion, migration, or puckering—providers simply cut the problematic threads and wait for them to dissolve on their own, she says. “If it’s a serious problem, they can be removed. However, removal, particularly of barbed threads, can be a bit more complicated,” Dr. Azizzadeh notes. To address asymmetry, threads can be either added or removed.
How to get the best results from a thread lift
The golden rule for all cosmetic procedures certainly applies here: Make sure to choose a provider who is experienced and well versed in the technique. “Many people simply follow a standard diagram for thread placement, but a cookie-cutter approach doesn’t work here,” cautions Dr. Cheung. Everyone’s face is different, and you really need someone who understands the underlying facial anatomy in order to give you the best possible results, she adds. That being said, while you definitely do want to see someone who performs a lot of thread lifts, they should also be familiar with—and be willing to suggest—other forms of facial rejuvenation. “Ask your doctor if they ever perform or refer potential thread lift candidates for facelifts,” says Dr. Azizzadeh.
To that point, it’s important to remember that not everyone is a good candidate. “Thread lifts are great for those with very early signs of aging who are dealing primarily with minimal laxity,” says Dr. Ostad, adding that you also have to be okay with the results not being permanent and always keep your expectations in check.
Finally, keep in mind that while thread lift results do vary greatly based on the individual, where the procedure is performed also plays a role. Dr. Ostad says they work especially well to target laxity around the neck and jaw as well as to address marionette and laugh lines. On the flip side, “Brow thread lifts aren’t always as effective because there isn’t that much soft tissue for the threads to latch on to. It’s mostly thin skin and a large muscle in the forehead,” he explains. Dr. Cheung adds that the nose is another trickier area, with a high potential for asymmetry.
