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Trends and Evolution of Thread Lifting

“Gone were the days where patients would shun cosmetic and aesthetic procedures. Thread lift procedures today are known for their ability to deliver results comparable to surgical procedures, albeit semi-permanent.

A very common and highly sought after procedure in the fields of medical aesthetics – both by practitioners and patients alike, threads continue to gain traction in the medical field for its ability to lift, refresh and rejuvenate the skin.

This has also led to an increase in the number of studies being conducted in recent years, with most, if not all, drawing the same conclusion – thread lifting is safe and patients now are not only favouring the procedure, but also actively seeking effective and innovative non-surgical approaches in aesthetic and cosmetic procedures.”

“Evolution of Thread Lifting

Introduced in the late 1990s, PDO threads were initially designed mainly to lift ptotic facial tissues; but over the years, variations of the original design such as mono, screw/tornado, and cog were developed and used. These variations involved the placement of threads along a planned trajectory and these threads are then pulled to lift the skin, secured and trimmed at the entry point.

At its initial stage, thread lifting was viewed with a degree of suspicion amongst some medical aesthetic practitioners due to the high incidence of post-operative complications. However, as technology and techniques continue to advance, new suture and variations have become increasingly available, and if one were to review the available literatures regarding threads, it should be noted that although early data showed inconsistent results and early relapses, recent findings have provided clear evidences of the effectiveness and safety of thread lift.

Today, new devices, thread variations, materials, designs and techniques are continuously being developed and the indications for each technique are further refined, thereby resulting in significantly lower incidences of complications in the initial stages. In fact, the evolution of thread lifting has progressed so much that aside from the popularly known PDO threads, the market has now availed new threads such as PLLA and PCL, PLACL.

In the last 3-5 years, a growing trend shows that patients today are actively seeking non-surgical procedures, including thread lifts. This proves that when performed correctly with the right threads and techniques, previous thread lifting associated complications can be greatly reduced, minimised and prevented.”


“Polydioxanone (PDO): Most commonly used for stitching suture in surgeries, the effects of polydioxanone (PDO) threads can last between 6 to 12 months. With the threads complete dissolved and absorbed by the by skin after 6 months, it helps to stimulate the production and synthesis of collagen in the skin for up to 12 months.

The functions of PDO has been known to cause changes in the dermis and many studies have shown that it is effective in improving pores and fine wrinkles. Furthermore, it is able to foster collagen formation in the dermal matrix to increase thickness of the papillary dermis.

PDO threads can also induce tissue changes by placing them into the subcutaneous layer, as PMN cells, including eosinophile, are gathered making granulation tissues around the thread after insertion. It has been observed in some studies that there is an abundant of newly made collagenous connective tissue in the formed granulation tissues.

Some studies have also shown that these newly made collagenous connective tissues converge into the pre-existing fibrous connective tissue creating a “merging effect”. Through this effect, it causes an inflammatory reaction to the surrounding area where the thread is inserted, and by effect of mechanotransduction, it will spread as waves to the surrounding tissues.

In the granulation tissues newly made near the threads, fibroblast and myofibroblasts have also been reportedly observed. This shows that PDO threads can effectively improve the elasticity of the skin in the area of the procedure and by the effect of myofibroblasts, tighten the skin.

Lastly, fat cells have also been observed to have denatured by the granulation tissues in the area of treatment, proving that PDO threads, if used correctly, can be very effective in face shaping, contouring and rejuvenation procedures.”


“Polycaprolactone (PCL): Although not as commonly used or as popular as the PDO and PLLA, polucaprolactone (PCL) threads is one that can last up to more than 2 years. This is because, the chemical bonds and structure in PCL are stronger and more complex, hence it takes a much longer time to be dissolved completely. The slower rate of degradation of the PCL threads also makes it ideal to be inserted to the surrounding tissues over an extended time; achieving a longer lasting result. PCL is also known to be very potent at stimulating collagen production as compared to PDO or PLLA. Once dissolved, the material breaks down into nontoxic ordinary substances and even after the thread has dissolved, collagen production can last for up to one year.”


“Poly-L-Lactic Acid (PLLA): Another material often chosen for surgical sutures is the Poly-L-Lactic Acid (PLLA). The PLLA has been observed to be even more effective at simulating collagen production than PDO. This material has a lifetime of two years or more, and once dissolved, the PLLA breaks down into harmless ordinary substances like lactate, glucose, carbon dioxide and water.

Some times used an alternative to fillers and botulinum toxin, PLLA can function as a volumizer and is able to stimulate the production of collagen and effectively lifts pull up sagging skin.
P(LA/CL) [Poly(L-Lactide-co-co-caprolactone)]is flexible and hardness materials. Lactide have high tensile strength, Caprolactone have elasticity.”


“P(LA/CL) [Poly(L-Lactide-co-co-caprolactone)]is flexible and hardness materials. Lactide have high tensile strength, Caprolactone have elasticity.
PLACL is an innovative lifting thread that maximizes the advantages by supplementing the shortcomings of PLLA and PCL.
The unnatural feeling of PLLA’s stiffness has been improved, and the outstanding stability of PLLA (100% biodegradation by microorganisms) and the strength of the thread that maintains more than 80% of the effect after six months of the procedure have been maximized.
PCL material have a character of flexible and soft, while compensating for the shortcomings that easily deform after insertion in the skin, maximizing the effect of very high tensile strength and elasticity (force that can withstand without cracking when pulling materials) compared to PDO and PLLA, so that they can be lasted for a longer period.
PLACL, made by mixing PLLA and PCL materials, has a more stable and excellent lifting effect without deformation of the product after skin insertion, and the volume effect through collagen synthesis is valid for 2-3 years.”

Side Effect

A thread lift is considered a low-risk procedure, but there are side effects and a risk of complications.

After a thread lift, it’s not uncommon to experience the following:

slight pain at the site of the thread injection
There’s a 15 to 20 percent chance of complications, including dimpling. Possible complications are minor and can easily be corrected.

Complications to look out for include:

allergic reaction to ingredients in the threading material
bleeding as a result of the procedure building up behind your skin
visible dimpling or pulling where the threads have been inserted
migration or unintended “movement” of the threads that result in skin that looks lumpy or bulges
pain under your skin as a result of the thread being too “tight” or awkwardly placed
infection at the site of the procedure
Of all the risks of a thread lift, infection is the one to watch out for most carefully. Call your doctor right away if you notice:

green, black, brown, or red discharge at the site of your procedure
swelling for more than 48 hours
persistent headaches


Cautions after the procedure

1. Please refrain from washing, wetting the treated area after your procedure.
2. Please do not touch strongly to treated areas.
3. Recommend to lie upright for 3~5days, raise your head with a pollow.
4. Avoid the act of opening the mouth wide (dental treatment, excessive facial expression cahnge) for 1month.
5. Please do not plan any facial treatments and massage for next 4 weeks.
7. Please refrain from drinking too much and smoking.

Benefits of thread lifting

“Thread lift vs facelift
A thread lift won’t give you the same dramatic results as a surgical facelift. If you’re considering investing in this procedure, it’s important to have realistic expectations.

A thread lift is also not permanent. A facelift can’t stop the process of aging completely, but the results last many years. The subtle results of a thread lift usually last around 2 years.

To make the results last longer, you may need dermal fillers or other therapies that cost additional time and money.

On the other hand, the risks of complications with facelift surgery are much higher. If you don’t like the results of a facelift, there’s not much you can do except have another invasive procedure. If you don’t like the result of a thread lift, you can simply wait for the threads to dissolve.

A thread lift is less expensive than a facelift. You can go right back to work after having it done, and the recovery is minimal.

If you’re noticing signs of aging in your jawline or under your eyes, a thread lift is a low-risk way to see how a more permanent procedure might look.”