Which one is better: PDO threads or Silhouette Lift for sagging neck and jowls? (Photo)

Unfortunately, based on these photos, you can not expect much improvement from any kind of tread lift. Major problem in your case are fat deposits in the neck and along jawline, that can be shaped and reduced only by means of face/neck or neck lift. Only on the basis of in person evaluation, an experienced, board certified plastic surgeon with good reputation in face/neck lifts, would be able to discuss which of the two procedure is better for you. Good luck.

With significant neck sagging you would need a facelift / neck lift with muscle tightening (platysmaplasty). At the same time, I would recommend lasers (Fraxel, CO2, Halo, or Erbium) and microneedling RF (Fractora, Morpheus8, PiXel8, Intensif) to improve the crepey skin and wrinkles. Overall, the neck can be treated with a combination approach:

1. Microneedling and laser treatments for texture
2. Botox, Dysport, Xeomin or Jeuveau to help platysmal bands
3. Intensif, Fractora, PiXel8, or Morpheus8 microneedling RF for crepey skin and lifting
4. Injectable fillers like Belotero, Restylane Silk, Versa, and Juvederm Volbella to improve lines and folds
5. Face/neck lifting if sagging is prominent or premature, with or without platysmaplasty (muscle tightening)
6. Renuvion (J-Plasma), ThermiRF, and InMode FaceTite/AccuTite for internal tightening
7. Ultherapy and Thermage for external tightening
8. Regular Venus Legacy, Exilis Ultra, or InMode Forma treatments with facials to maintain tightness
9. PDO NovaThreads or Silhouette InstaLift cone threads for lifting and long-term collagen production

See an expert for a formal evaluation and to develop a personalized treatment plan based on your individual situation and goals. Best, Dr. Emer"

Great question. Trying non surgical face lift like rejuvenation options is quite challenging. The "Gold Standard" is surgery.... These non surgical options are very limited in longevity, with the costs approaching that of a mini surgical face/neck lift. If you desire short term effects/results in limited basis both the Silhouette Lift sutures and the PDO threading are the options . But must included the Y-Lift injection of HA fillers option also. As to which is better. That is the magic question? I have used all three options and combinations of them. All in all surgery still best! I prefer a combination of Y-Lift filler facelift with PDO threading with a side burn 1 inch incision to obtain 1 or 2 deeper SMAS sutures. Fees all range in same areas from $3,000-$8,000 depending upon # of threads/sutures/syringes used. Also most of the non surgical options are under local anesthesia with PO sedation or IV sedation. While mini FL/NL w SMAS usually IV sedation or light general anesthesia. And to be complete must also add in fat grafting - nano, milli, macro grafts. So you see there are no short cuts to facial rejuvenation options. But which one works best for you depends upon so many factors. See a few consultations. And remember the cheaper options are the shorter lasting ones...