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!