PCL thread lifting: An honest summary of its effects and limitations

PCL thread lifting is a non-surgical lifting procedure that inserts threads made of a biodegradable polymer called Polycaprolactone under the skin to pull up sagging tissue. The core mechanism consists of two parts: immediate lifting, where the cog and barb protrusions on the surface of the thread physically hook and pull the tissue, and delayed neocollagenesis, where the skin produces new collagen while the thread slowly degrades. The overlap of these two processes maintains the lifting effect.

The maintenance period is usually guided as 1 to 2 years. Among absorbable threads, PCL has the slowest degradation rate, so it tends to last longer than PDO or PLLA. However, this is an average story, and there are large deviations depending on the degree of sagging, age, skin condition, and procedure method. Rather than "how many threads were inserted," I wanted to tell you first that which layer, in what direction, and with what tension the design was made dictates the results much more.

🧬 What exactly is the material PCL?

PCL is a synthetic biodegradable polyester-based polymer. It slowly degrades through a hydrolysis process by moisture in the body. Although it sounds like an unfamiliar name, it is a material that has been approved by the US FDA for medical sutures and drug delivery systems and has been used for decades, so its foundation for safety is well established.

As a product sharing the same PCL component, there is the Ellansé filler. It contains about 30% PCL and utilizes the same collagen induction principle as thread lifting. Although the form is different—whether it is a thread or a filler—what the material does inside the skin is similar.

One thing to point out. There is a common explanation circulating that it "degrades into water and carbon dioxide," but this is an expression closer to PDO. The actual degradation pathway of PCL is slightly different, and the fact that the degradation progresses slowly, resulting in a long maintenance period, well demonstrates the characteristics of this material.

📌 Key Summary: PCL is a biodegradable material with a history of FDA approval, and because its degradation is slow, it has a long maintenance period among absorbable threads.

⚖️ How is it different from PDO and PLLA?

Absorbable thread lifting materials are largely divided into three pillars: PDO, PLLA, and PCL. Each has distinct characteristics, so it is difficult to say that one is unconditionally superior.

PCL is the slowest to degrade among the three materials, so its effect lasts long, but the cost is higher than PDO. Therefore, the standard for choice is not simply "a better material," but where your degree of sagging, budget, and desired maintenance period lie.

Let's clear up one misunderstanding here. The 'period during which the thread degrades' and the 'period during which you experience the lifting effect' are different. Just because the thread has dissolved does not mean the effect disappears on that day. It is known that the collagen induced during the degradation process remains, continuing to improve elasticity for a certain period even after the thread has completely disappeared.

📌 Key Summary: PCL lasts longer than PDO and PLLA, but is more expensive. Material selection should be tailored to sagging, budget, and desired maintenance period.

🔧 How is the thread lift performed?

The procedure involves inserting the threads into the dermis and subcutaneous layer of the skin using a special needle called a cannula. Into which layer and in which direction this cannula is inserted determines the result. This is why, even with the same PCL thread, the results can be completely different if the design of the procedure is different.

The procedure time is reported to be roughly between 15 and 60 minutes, depending on the area and the number of threads. The figures vary slightly from source to source, so you can understand that it is not a "fixed time" but rather flexible depending on the design.

The target areas are mainly the middle and lower face, such as the cheeks and jawline, but depending on the design, it can also cover a wide range up to the eyebrow, forehead line, and neck. At Onlif, too, thread lifting is approached in a way that refines the sagging texture without altering the face's natural shape.

📌 Key Summary: The thread is inserted with a cannula, and the design of the insertion layer, direction, and tension has a greater impact on the result than the material itself.

📉 Are there cases where thread lifting does not work?

Let me be honest. Thread lifting cannot solve all types of sagging. If the skin is severely sagging, if there is an excess of loose skin itself, or if there is a large amount of fat, there are clear limits to using only threads.

In the deep layers of the face, there is a structure called the SMAS (Superficial Muscular Aponeurotic System). For very severe sagging, surgical methods that address this layer may be more appropriate. This is why incisional surgeries like a facelift are mentioned as a point of comparison.

However, this does not mean surgery is always the answer. If the sagging is mild to moderate, you can certainly aim for improvement by using non-surgical procedures such as thread lifting, ultrasound HIFU, and radiofrequency RF, either alone or in combination. It is also common to combine these by building a foundation of elasticity with energy-based devices and pulling up the texture with threads. Which direction is right can only be determined by directly assessing the pattern of sagging and the skin condition.

📌 Key Summary: While threads alone have limits for severe sagging and excess skin, mild to moderate cases can be fully addressed through a combination of thread lifting and HIFU/RF.

⚠️ Side Effects and Post-Procedure Precautions

Typical reactions that may occur include bruising, swelling, asymmetry, dimpling, feeling the thread, inflammation, and infection. Most of these subside within a few days to two weeks, but if they persist for a long time, it is correct to visit the clinic to check rather than leave them alone.

Here, the characteristic of PCL becomes a double-edged sword. Since it is a material with a long maintenance period, if it is incorrectly inserted or over-corrected, issues like discomfort or dimpling can also persist for a long time. Therefore, a restrained design that does not insert excessively from the beginning is important. The effect is not proportional to the number of threads.

In particular, there is one warning sign to watch out for. If the skin in the treated area turns white or is accompanied by severe pain, it could be a blood flow anomaly, so you must contact the clinic where you received the treatment immediately.

Let's also organize things to keep in mind before and after the procedure.

• Before the procedure: You must consult with your prescribing physician before deciding whether to stop anticoagulants and antiplatelet agents such as aspirin, warfarin, clopidogrel, and NOACs. Please also inform us in advance about health functional foods like Omega-3, ginkgo biloba extract, and high-dose vitamin E, as they may be related to bleeding risks.

• 1–2 weeks after the procedure: Refrain from saunas, intense exercise, drinking alcohol, and strong facial massages.

• Sleeping posture: Avoid sleeping on your stomach, and it is better to sleep flat on your back if possible.

📌 Key Summary: Bruising, swelling, and dimpling usually resolve within a few weeks, but if the skin turns white or there is severe pain, you must visit the clinic immediately.

🤔 Won't it sag more once I get it?

This is a concern I hear often: "Won't it sag even more than before once the threads dissolve?" To give you the conclusion first, because new collagen is generated, results like sagging more than before the procedure are not common.

However, since aging continues, it is a natural flow that elasticity decreases again over time. Therefore, rather than being "done in one go," thread lifting is closer to a procedure where you establish a rhythm of care tailored to your age and skin changes. It is reasonable to decide on the timing of re-treatment or combination with other procedures after assessing the condition.

📌 Key Summary: Thanks to neocollagenesis, it does not sag more than before the procedure, but since aging itself progresses, a long-term management perspective is required.

❓ Frequently Asked Questions (FAQ)

How long does the effect of PCL thread lifting last?

Generally, it is guided as 1 to 2 years. Among absorbable threads, PCL is on the slowest-degrading side, so its maintenance period is longer than PDO (approx. 6–8 months) or PLLA (approx. 12–18 months). However, there are large individual variations and differences depending on the procedure method.

Does the lifting effect disappear immediately when the thread dissolves?

No. Because new collagen is generated while the thread is degrading, it is known that the improvement in elasticity continues for a certain period even after the thread has completely disappeared. It is helpful to understand the 'thread degradation period' and the 'experienced effect period' separately.

Does inserting more threads improve the effect?

No, it does not. Excessive insertion can actually cause dimpling, asymmetry, and unnaturalness. Designing the appropriate number and direction suited to the facial structure is key, and the effect is not proportional to the number of threads.

I got dimpling after the procedure; when will it disappear?

Most dimples subside within a few days to a few weeks. However, since PCL is a long-lasting material, it can persist for a long time if inserted incorrectly. If it does not improve over time, it is recommended to visit the clinic where you received the treatment for an evaluation.

Can I receive ultrasound or radiofrequency lifting together after the procedure?

It is common to combine them. A combination where you build the foundation of elasticity with energy-based procedures and pull up the texture with threads is possible. However, because the appropriate interval and order vary depending on the skin condition, it is best to make a plan after consultation.

Can I still receive the procedure if I am taking medication?

Anticoagulants and antiplatelet agents (aspirin, warfarin, etc.) can increase the risk of bleeding, so you must consult with your prescribing physician about whether to stop them. For safety, it is also important to inform us in advance about blood pressure and diabetes medications.

Can I receive the procedure while pregnant or breastfeeding?

Generally, procedures are often not recommended during pregnancy or breastfeeding. For safety, you must inform us of your status in advance and make a decision through consultation.

What should I do if my skin turns white after the procedure?

It could be a warning sign indicating a blood flow anomaly. If accompanied by severe pain, contact the clinic where you received the treatment immediately to take measures. It is crucial not to wait on your own.

Good things to check before choosing a clinic for PCL thread lifting

Even for the same procedure, the results and recovery process vary depending on where, by whom, and how it is done. Asking the following items directly during your consultation will help you make a judgment.

• Is it a place that performs that procedure frequently? — Different clinics specialize in different procedures. Check if it is a place that regularly performs PCL thread lifting.

• Can I verify the products and equipment used? — Ask if you can verify the product name and authenticity (whether it is an import-approved product and if there is an unboxing verification process) during the consultation.

• Do they explain the breakdown of the cost? — Rather than just hearing the total amount, you can make a better judgment if you hear an explanation of what product is used, how much, and on which area.

• Do they design looking at the whole face? — Even for the same procedure, the location and amount of insertion vary depending on the face shape, skin condition, and left-right asymmetry.

• Do they explain adverse reactions and the recovery process first? — Rather than a consultation that only talks about expected changes, a place that also informs you of possible adverse reactions and how to cope with them is better for making a judgment.

• Is there a follow-up check path after the procedure? — Check if the timing for checking progress, how to contact them if there is an issue, and the criteria for a return visit are established.

Onlif Clinic performs PCL thread lifting like this

• We divide responsibilities — Believing that a single doctor should not handle every procedure, Onlif divides medical treatments among doctors responsible for each specific field.

• We check products and equipment together during consultation — We guide you through the products used and the unboxing verification process during the consultation process.

• Costs are guided along with the configuration after diagnosis — Since the area, volume, and scope differ for each person, we explain what costs what together.

• We design looking at the overall balance of the face — We view the face through three pillars: texture, balance, and signals of youth, and we plan in a direction that cleans up the parts obscuring your natural impression rather than altering your shape.

• We tell you about adverse reactions and the recovery process first — Along with the expected changes, we guide you through individual differences, possible adverse reactions, and coping methods before the procedure.

• We monitor progress together after the procedure — If checks are needed during the recovery period, we provide guidance on return visits and communication channels.

If you are considering PCL thread lifting, it is best to first check what is possible and what is difficult in your current state. Accurate diagnosis and procedure planning can only be determined through an in-person medical evaluation. Find out through a consultation at Gangnam Onlif Clinic.