In our office this procedure is done until local anesthesia. There is almost no discomfort during the procedure. This is often surprising to patients but has a lot to do with a person's anatomy and proper technique. The threads are generally placed in the subcutaneous plane (below the dermis where most of the pain nerve fibers are!) so there is little discomfort. And if the procedure is performed by an experienced surgeon, with a good understanding of the tissues, the chances are greatly improved for very little discomfort in my opinion.There can be some swelling/brusing after the procedure and some pain that is generally easily treated with Tylenol. In our office we recommend Arnica and ice as well as a number of other methods to help decrease the incidence of bruising, swelling, and post procedure pain.If this is something you are considering I would recommend a consultation with a Board Certified Plastic Surgeon who is experienced with threading techniques.I hope this helps!