Facial threading, also called a thread lift, can be a cost-effective, beneficial procedure —as long as you've appropriately managed your expectations. While a thread lift isn't a replacement for a surgical face-lift by any means, the right patient can get a lot out of it, experts say.
Thread lifts have actually been around since the 1990s, but the materials and techniques used in the procedure have evolved over time, Dr. Alan Matarasso, spokesperson for the American Society of Plastic Surgeons,tells TODAY.com.
Originally billed as the "lunchtime lift," facial threading can provide some rejuvenating effects, Dr. Ivona Percec, associate director of cosmetic surgery at Penn Medicine, tells TODAY.com.
But the term"is really a misnomer because they don't provide that much lift in reality," she says. "It's temporary. They do not replace a face-lift." When the public realized that the actual effects didn't always match up with the marketing hype, thread lifts fell out of favor, Percec explains.
Over the last decade, though, patients have started to gravitate to thread lifts again —with a better understanding of what to expect, says Matarasso, who is also a clinical professor of surgery at the Zucker School of Medicine at Hofstra/Northwell. And, in "appropriately selected patients," facial threading could result in exactly what they're after, he says.
What is a thread lift?
A thread lift is a minimally invasive procedure performed in-office. During the procedure, surgeons place small surgical threads under the skin, which are designed to catch and hold the tissue to provide a subtle tightening and lifting effect, Matarasso explains.
Thread lifts also provide a secondary benefit: As the threads dissolve and the tissue heals, the skin produces collagen in the area, which adds volume, Percec says. Together, the effects of a thread lift typically last one to two years.
On the spectrum of rejuvenation options, thread lifts sit somewhere in between fillers (which are non-surgical but only last for a few months) and a face-lift, which comes with all the costs, risks and more permanent benefits of a surgical procedure.
What is a PDO thread lift?
There are a few different types of suture materials that surgeons can use during a thread lift. One type of thread that they might use is made of polydioxanone (PDO).
PDO is "an absorbable compound that's used to make sutures," Matarasso explains. It's used in sutures that surgeons use every day in other procedures, like tummy tucks and breast lifts, he says. But, the specific PDO threads used in facial threading have barbs or cones on the ends to help grab onto the tissue.
Other thread types you might come across include PLA (poly L-lactic acid) and PCA (polycaprolactone).
Some of the threads are thicker or thinner than, and some have different design features, like the cones or barbs, to help them catch onto the skin, Percec explains. And, because they're all made of slightly different materials, "as they dissolve, they cause a controlled inflammatory reaction slightly different from one another," which is what builds collagen, she says.
In the big picture, one isn't necessarily better than the other, Matarasso says, and "the distinction (between thread types) is not so important for the consumer." The type of thread an individual surgeon might use in a particular procedure often comes down to just their personal preference and experience, he adds.
Thread lift recovery
A thread lift takes between 30 minutes and an hour to perform in the office, the experts say, and typically patients can go back to their normal life right afterward.
There is no downtime "in the sense that you can't go public," Percec says. But patients should expect some bruising and healing for a few days, and they will need to avoid exercise for a few weeks.
Thread lift side effects
"There's always a risk of bruising and infection, but it's very low. It's lower than the risk you would have with surgery," Matarasso explains. Some patients may end up with skin irregularities, like bumps or asymmetry, if one side of the face ends up looking fuller than the other, he adds.
The biggest potential complication of facial threading is puckering, which can form as a result of the pressure the threads put on surrounding skin, he says. In some cases, that goes away on its own and there are things surgeons can do preventively or afterward to resolve the issue. "Sometimes it's just a matter of massaging and dislodging the suture from underneath," Matarasso explains.
How long does a PDO threat lift last?
You'll notice the effects of the thread lift "basically immediately," Matarasso says. "You sort of see it as you're doing it."
The effects you'll get from those sutures dissolving will develop over a period of months, he explains. "And both benefits will last somewhere between one and two years typically."
The different types of threads can produce benefits that last for slightly different lengths of time, Percec adds. For instance, PCA threads "don't last in the tissue as long but the effect of collagen formation lasts longer," she says. And with PDO threads, "the threads themselves last a reasonable amount of time, but they don't produce collagen for as long."
How much is a thread lift?
It can be challenging to determine exactly how much a thread lift will cost as the price depends on the provider and the specific procedure, but the experts shared some helpful guidance.
In general, know that surgeons charge by the thread, which typically cost hundreds of dollars each. When working on the lower part of the face, from the cheekbone to the jawline, surgeons often use three or four threads per side, Matarasso explains.
And a provider might also charge a premium for working in a more complex or risky area, like around the nose, Percec says, even though they'll need fewer threads compared to an area like the brow.
Ultimately, patients should expect to pay at least $5,000 for a thread lift, she says. For larger areas, Matarasso says you could be spending $8,000 or more.
For comparison, hyaluronic fillers typically cost between $700 and $1,000 per syringe (most people need more than one) and need to be repeated every six months or so to maintain their effects, Percec explains. And a surgical face-lift can cost at least $20,000 when all fees (including anesthesia) are accounted for, she says. But the effects will last upwards of eight to 12 years, Matarasso says.
"It's more painful to pay for surgery because it's a bigger upfront cost," he explains. "But over time, you're going to probably spend more on most minimally-invasive or non-surgical procedures than you would on surgery."
Talking to a knowledgeable, board-certified surgeon will help you weigh these various factors and figure out what the right option is for your unique situation.
How to know if a thread lift is right for you:
First, remember that a thread lift is not a substitute for a surgical face-lift. “It’s nowhere near what a face-lift does," Matarasso emphasizes. "And it shouldn’t be misconstrued because otherwise, people are going to be disappointed.”
A thread lift is ideal for somebody who “needs a subtle improvement, which is not permanent,” Percec says. That would be someone “who could use a little bit of lifting, a little bit of volume that lasts, on average, for two years.” But you shouldn't get a thread lift solely for the volume-boosting, effects Matarasso notes, because "we have easier ways of doing that," like fillers.
In general, the right candidate tends to be someone on the younger side, maybe in their early 40s, who isn't ready for a surgical face-lift but is beginning to notice some sagging jowls, she adds. (However, if you have a lot of loose skin, a thread lift won't address that, the experts say.)
Facial threading can also be helpful for people who could benefit from a face-lift but, for whatever reason, aren't medically cleared to undergo the procedure, Matarasso says.
But thread lifts aren't just for people who aren't ready or right for surgery, the experts say. In fact, some of the best candidates are those who've had a surgical face-lift and just need a minor tune-up later on.
However, having had prior surgery can make a patient's anatomy more complicated when it comes time for a thread lift, Matarasso says, which underscores the importance of finding a provider you trust and can see consistently. If your surgeon thinks a face-lift might be in your future, they can help you plan ahead when considering a thread lift, Percec adds.
In past decades, all providers could really offer was a full surgical face-lift, Matarasso says, so minimally invasive options like thread lifts give them another great middle-of-the-road option for people who aren't ready for or can't get surgery. But whether or not facial threading is right for you depends on your anatomy, your budget and your overall goals.
