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Home Substance Science & Innovation

Treatment Insights: The Thread Lift

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By Ricky Allen and Bronwyn Watt

Dreaming of a natural-looking facelift that doesn’t require a scalpel? Here’s a brief outline on why threading is now a popular alternative to surgery.

The thread lift — a minimally invasive alternative to cosmetic surgery — has been around since the 1990s but is gaining both momentum and popularity thanks to advances in technology that mean better results and lower risk. Here are some key points to know if you’re considering this clinical treatment option.

Insight One: Facial threads do more than just lift.

When threads first appeared in clinics three decades ago, they were much thicker than they are now, had to be inserted much deeper under the skin, and often broke before doing their job. Nowadays, technology has advanced to the point where materials are more effective and better tolerated by the skin. For example, Dr Cosima Karlburger, a thread lift expert and founder of Dr Cosima Medispa in Sydney, only uses threads that can be placed very close to the skin’s surface under local anaesthetic, giving her more control and safety.

Insight Two: Thread materials have been used in surgery sutures for decades.

Doctors use three main of threads: polylactic acid (PLA), polycaprolactone (PCA) and polydioxanone (PDO). The latter has been around the longest and is the most used. PDO threads are absorbed into your body over six months and work by triggering fibroblasts to produce more collagen in the area. There are three types of PDO threads: mono (smooth without barbs, to tighten the skin and provide a small lift), cog (with barbs to hook into the skin to lift and support) and screw threads (one or two intertwined threads to help restore volume to sunken areas).

Insight Three: Mono threads stimulate collagen and elastin.

Mono threads are inserted just under the skin to stimulate collagen and elastin, therefore strengthening the skin and improving its texture and general appearance. Mono threads offer very natural-looking aesthetic results and dissolve in a few months, but their rejuvenating effect can last anywhere between one to two years.

Insight Four: Good skin preparation can enhance results.

Dr Cosima often will treat a patient’s face with the Thermage system, then insert the threads several weeks later when the skin is smooth and plumped. This, she says, gives longer-lasting lift results. Most of her thread lift patients are in their thirties or forties. When older patients present, she will first thicken their skin with other treatments, such as injectables, then follow up with threads anywhere from several weeks to several months later.

Insight Five: Downtime is surprisingly minimal given the results.

When the threads are first inserted, the area may look a little tight. There may also be slight bruising as the body takes a few days to allow the skin to react. Then the skin loosens and looks totally natural while the threads do their work.


References: Journal of Dermatology and Cosmetology 2017;1(4):86-88. Wong V, Rafiq N, Kalyan R, et al. Hanging by a Thread: Choosing the Right Thread for the Right Patient.

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