Fillers Vs Thread Lift

I'm in my 30's. I would like the nasolabial folds and mouth corners lifted as they are drooping.. (FYI, I've lost 20 pounds in 2 months). Do you think fillers can fix my problem? or I need a thread lift?

Doctor Answers 9

Lift and fill

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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

Spokane Dermatologic Surgeon
4.9 out of 5 stars 121 reviews

Address a sagging face during weight loss

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First congratulations on the weight loss. Unfortunately, just looking at your mid and lower face from the front makes it impossible to recommend the best procedures for you.  We evaluate patients from all sides to see where volume is lacking and need to get our hands on the skin to see where there is the possibility of movement.  In general, fillers to provide support for the areas that have lost volume followed by a skin tightening procedure like Thermage or Ulthera and a silhouette instalift to physically hold the skin up and back would be useful for this problem.  There are caveates.  If you anticipate losing more weight quicklly, you may want to wait until youve reached your goal to determine if this combination of noninvasive and minimally invasive procedures will provide enough improvement or if you would do better with a surgical lift.  That's why in cases where a patient is in the process of losing a lot of weight quickly, I'll frequently recommend starting with a skin tightening procedure like Therrmage or Ulthera.  The skin tightening is seen over 3 to 6 months so less sagging is seen as you lose more weight..  During that time, filler can be used to turn your frown upside down and fill out the upper face and sides where you likely have lost more.  When you reach your goal is the best time for the suture lift or surgery.

I hope that answers your question.  Best wishes.

Heidi A. Waldorf, MD
New York Dermatologist
5.0 out of 5 stars 10 reviews

Filler & Thread Lift! Perfect Combo!

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I would suggest getting both filler & thread lift, The filler brings up those nasolabial folds and fills those hollow spaces in the cheek area that we have lost with age. Down closer to the jawline the thread lift does an amazing job pulling up those lines that the filler can not get to! The Thread lift is highly suggested for clients who have dropping in that area and last up to 12 months! PDO Thread lift has 0 downtime and is non-invasive lunchtime procedure! I hope this helps you with your journey!:)

Chaitali Nangrani, MD
The Woodlands Family Physician
4.2 out of 5 stars 25 reviews

How to improve droopy face | Fill and lift approach

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Dear hanna,

Thank you for your question. 

There is heavyness on both your nasoabial folds and slight heaviness in your mouth corners.

It is best to utilise a 2 step approach.

Step 1: Fillers to your nasolabial fold and mouth corners to provide volume, structure and support.

Step 2: Thread lift to reposition the overlying tissue.

As Dr Chestnut has said, thread lift received mixed reviews in the past, because in those days, we used permanent sutures and the technique was still relatively new.

The trend now is for absorbable sutures, of which we have PDO and PLLA.

Threadlift is a minimally invasive treatment, and it appeals to people because of this fact. 

After a threadlift procedure, it is best to wait for swelling to settle, which takes up to a month, before doing any further work.

Skin irregularities may occur but these resolve with time as the threads are completely dissolvable.

Daniel Chang, MBBS
Singapore Physician

Treatment of nasolabial folds

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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.

Combined approach

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A combined approach of fillers, thread lift, and laser therapy would be optimal for you to see the best results.

Dr. Elkeeb

Laila Elkeeb, MD, FAAD
Corona Del Mar Dermatologic Surgeon

Fillers or Threads

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Bravo on losing weight! It's likely that you need volume replacement due to weight loss that may be sufficient and would be a good foundation. After which threads can be added if necessary to achieve the results you desire. As always, I recommend going to an experienced injector and experienced cosmetic surgeon who has worked with treads. 


Andre Berger

Andre Berger, MD
Beverly Hills Physician
5.0 out of 5 stars 13 reviews

Fillers Vs Thread Lift

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Fillers will improve, not the threading! Be very careful. Remember fillers last from a few months to a year depending on which type you use. And you will need at least 2 to 3 syringes. 

Fillers vs. lift surgery

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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.

Aaron Stone, MD
Los Angeles Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.