Multiple Thread Lifts created scar tissue to 'hold' the skin up, but the underlying layer still droops! Can I have a facelift?

I've had multiple procedures (thread lifts), but the results are so short-lived - it's frustrating! The scar tissue created under the skin has had the affect of 'propping' my skin up; however, I appreciate that thread lifts cannot address the SMAS layer & any fat that has travelled down. If I don't have much excess skin to trim, but would like a lift of the SMAS layer & fat, am I still a good candidate for a facelift?

Doctor Answers 9

Facelifts address different tissue layers

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Hi.  Yes you are a candidate for a facelift even if you don't have lots of excess skin, but do have sagging of the SMAS and/or excess fat.  There are different types of facelifts designed to address the different layers of tissues and different areas of volume loss.  As you have experienced, the minimally invasive techiques have the shortcomings of minimal results over time.  Be sure to consult with an ABPS certified PS to review the types of lifts, pros and cons.  Good luck!

Short answer, yes.

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The short answer to this question is yes. Thread lifts were popular for a few years and I have performed numerous facelifts on individuals who previously had a thread lift with no issues at all. If I encounter the threads, we simply remove them at the time of surgery and the deep plane facelift that we perform takes the tension off the skin so they no longer provide any benefit.

Edwin F. Williams, III, MD
Latham Facial Plastic Surgeon

Thread lifts

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Thread lifts are minor procedures targeted towards.A.  Surgeons who do not want to spend the time, energy, and effort to do an actual surgery, B. Patients who fall for the hype of a "quick-pick-me-up"I have revised face lifts in patients who have failed to tell me that they have had the threads placed in their face.  I agree with Dr. Romo.  The scar tissue developed is unpredictable, and since the sutures are permanent, there is a theoretical possibility of them becoming infected or coated with a biofilm if the face is opened up and the threads are exposed to the outside environment.

Raghu Athre, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 94 reviews

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Facelift after Threadlift

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Thank you for your question!  Unfortunately the thread lift does not last very long, and most often does not give the result a facelift can give.  While a thread can temporarily lift the facial skin, there is no anchoring of the deeper tissues to hold the lift.  I would discuss your threadlifting procedure with a board certified facial plastic or general plastic surgeon who specializes in facelifts.  While you would need to have an in-person consultation and physical exam, I believe that you could have a traditional facelift after having a thread lift with good results.  I hope that this helps!-David Gilpin 

David Gilpin, MD
Nashville Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Thread lift results

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while I do think there is a role for thread lifts in some patients, it is very limited and the results are subtle and short lived. Fortunately, the results with face lifting are very reliable and often dramatic, in a good way. Results often last years and the recovery may not be as difficult as most people think. Previous thread lifting does not get in the way of a facelift

Ben Lee, MD - Account Suspended
Denver Plastic Surgeon

Thread face lifts

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The major problem with thread facelifts is that the threads are at different and varied levels in your facial soft tissues and this has caused scarring at these different levels. This could easily mean that the facial nerves are incorporated in the scar tissue and any open facelift surgery could actually injure these nerves. I'm surprised that thread facelifts are being performed by any honest surgeon. If you are going to have actual surgery on your face, you need to be sure they have a lot of experience in facial surgery.

Thomas Romo, III, MD, FACS
Manhattan Facial Plastic Surgeon
4.8 out of 5 stars 58 reviews

Poor Results from Thread Lift

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Thank you for your question.
Unfortunately, what you are experiencing is rather common with thread lifts.  While some patients do get a good result, often the results don't last long, or there are visible contour deformities which are distressing to patients.  I recommend consulting with a board certified plastic surgeon who will be able to assess you.  In all likelihood, you can still have a facelift that addresses the SMAS layer and achieve an excellent result.  The threads, if they are "in the way" can often be removed without too much difficulty.  Best of luck!

Dr. Michael Epstein
MAE Plastic Surgery
Northbrook, IL


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I've done many facelifts for patients disappointed after a thread lift as well as any and all of the other non-invasive "mini lifts".  The threads sometimes cause a small issue because they are sometimes in the same plane of tissue as my facelift.  However, they are quite easily removed and the results are generally unaffected by the "old" threads.

R. Scott Yarish, MD
Houston Plastic Surgeon
4.4 out of 5 stars 42 reviews

Multiple Thread Lifts created scar tissue to 'hold' the skin up, but the underlying layer still droops! Can I have a facelift?

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 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts on women in their late twenties and early thirties.  Non smiling photos of your face from the front and side would help in the evaluation as to whether, or not you are a good candidate for a facelift at this time.  Regardless of the times performed nay suspension technique (threads, sutures) would not have lasting elevating effects to the underlying SMAS layers as in a proper SMAS facelift as described below.Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.  If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed. My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

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