Do I need fillers or a thread lift?

Thread lifting has a long history with both very beautiful results and happy patients mixed with poor results and dissatisfaction. Most of the latter stems from the use of permanent sutures and poor technique.
Most modern thread lifting utilizes absorbable sutures, which have many major benefits. These threads not only lift and support, but provide volume as they go away, creating a lift and fill effect. The risk of dimpling, an issue with the old thread lifts, is zero here as these are not providing a permanent pull. 
These modern thread lifts are best thought of like a filler. They will do their job for a year or two and then will need to be touched up, but the results in the meantime are beautiful.
Choosing your physician wisely here is key, as knowledge of normal facelift anatomy, tissue movement and technique is a highly valuable skill when placing these absorbable lifting threads.
To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
Cameron Chesnut#realself500 Physician

Thank you for your question and photo. Lifting the midface would have a very positive effect on both your nasolabial folds and the downturned corners of your mouth. This might be best achieved with a thread lift. The latest threads offer very good results with minimal side effects and can last 6-12 months for most patients. The procedure does not require anesthesia and the threads can be strategically placed to produce very natural results. As the threads dissolve over time, collagen levels in the skin increase to prolong the improvement. You might also consider some injectables with your thread lift to further enhance your results. Neuromodulators like Botox work on lines that are the result of repeated facial expressions, while dermal fillers restore volume to key areas to smooth away wrinkles from the inside out. I encourage you to schedule a consultation with an experienced, board-certified facial plastic surgeon who can assess you in person and create a customized treatment plan that meets your needs and goals best.

Thank you for sharing your question and posting your photo. Both options are usually good, but an in person examination by and experienced oculofacial surgeon would be best to determine exactly what would work for you. Often, a combination approach is an excellent choice. From your photo, it looks like you could benefit from both options. Good luck!

There have been a few different types of thread lifts over the years.   I have never performed it and suspected it was useless.   The results of unhappy patients I’ve seen   have pretty much convinced me if this.   Go on line and see if you find any truly worthwhile before and after pictures.   You can try fillers but they end up being expensive over the long haul.   Many people like them but they really add up over time.

Thank you for your question. Looking at your photo it is not easy to assess, which of the two treatments would give better results. Novathread is one of the many FDA approved lifting threads in the USA, and it has achieved a significant market share in this country. They are a brand of polyioxanone (PDO) thread with barbs along its length that can achieve temporary lifting of the soft tissues of the face. It has been suggested that collagen building up along the course of the threads provides longevity even after the threads have dissolved.I usually use the combination of the two, filler and Novathread as the best option for skin tightening and lift after the weight loss. 

Thread lifts with reabsorbable sutures have several problems - The first, and most important concern is that if an early recurrence of the facial deformity in loss of the lift occurs, sometimes this is one-sided. Additionally there are problems with palpable sutures and injury to nerves and unevenness. There has been a lot of improvement in the thread lift technology over the past 10 years and it continues to improve however, currently I do not feel that they are the best option for our patients. Better options for moderate improvement that is long-lasting for the nasolabial folds and lower face may include; Long-lasting fillers like Bellafill Cosmetic or Sculptra, minimally-invasive ProfoundRF (deep radionfrequency + microneedling) which induces your body to build up new collagen and elastin for facial structure and improved elasticity. Face and/ or neck lift remain a good option for some patients. Hope this helps! 

Thank you for your question and for sharing your photo.  Both fillers and Instalift can help address your concern.  Both will result in a nice a softening of the nasolabial folds and can provide an even stronger result when used together.  If you plan on both, then I would recommend doing the Silhouette Instalift first as this will help recruit some of the laxity away from the nasolabial folds.  If you are happy with the results, then you are done.  If you decide you want further softening, then a dermal filler can be used.  Best of luck.

The photo you posted shows fairly deep nasolabial folds, early marionette lines down from the corners of the mouth and early jowling. The best option for the nasolabial folds is a filler. You need to decide which filler after consulting with the doctor you choose to do the procedure. The jowling is a bit too early in the process to warrant a major operation in my opinion though some surgeons would want to do it. You could try some of the non-invasive skin tightening procedures. I would recommend against doing a threadlift which is the placement of barbed sutures to lift the facial soft tissues. These initially looked good but then the barbs would split along the length of the suture and the suture would break on the upper part. The lower ends would then migrate under the skin like a snake and then pop through the skin in areas far from where they were initially placed. That is why the FDA took those threads off the market.

Some surgeons would recommend placing a filler in the concave area of the jowl. I personally do not think that gives patients a more youthful natural look so I do not do that.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Hello!
The laxity that you are noticing around your mouth can be targeted with both fillers and threads. Fillers add volume to areas that have lost support, whereas threads suspend descending tissues. I suggest doing both to achieve the best results.
With Love & Gratitude,Jordan Jacobs, RN, CANSOwner/CEOAesthetic Injector

A variety of options can be used to address the problem you are experiencing including PDO threads. CoolSculpting to reduce fat if there are. In order to tighten and firm your skin, I would suggest combining Secret RF with Fraxel. Botox and fillers are also wonderful options when appropriate. Please contact a qualified provider or a board-certified physician with extensive experience in these procedures.