Buccal fat pad thread lift: how to restore a sagging midface back to its place

Jowl thread lifting is a minimally invasive procedure that uses absorbable medical threads to lift and reposition tissues that have sagged downward from the deep layers of the inner cheeks. It is easiest to understand it as physically pulling and securing the sagged positions rather than cutting out or removing fat. The procedure typically takes 20 to 60 minutes, is performed under local anesthesia (combined with sleep anesthesia if necessary), and bruising and swelling usually subside within 1 to 2 weeks.

However, there is one thing we need to clarify. "Jowl (Simbu-bol)" is actually not a standard anatomical term found in medical textbooks. It is a name commonly used in the domestic beauty market. Anatomically, it is closer to a blanket term for several deep fat compartments, such as SOOF, deep medial cheek fat, and buccal fat pads. Therefore, even for the same "jowl concern," the underlying structural cause varies from person to person, and identifying that cause first is the very first step in determining the direction of the procedure.

🧭 Why and where do jowls sag?

Several structures are intertwined in mid-face sagging. As aging progresses, the retaining ligaments that hold facial tissues to the bone loosen, and the elasticity of the SMAS (superficial muscular aponeurotic system) that connects facial muscles also decreases. On top of this, deep fat such as the buccal fat pad sinks downward, causing the cheeks to sag.

For reference, the average volume of the buccal fat pad in adults is known to be around 9 to 10 mL, but individual differences are significant. When this fat sags and tissue support weakens, the results appear on the surface of the face. Typical examples include nasolabial folds, marionette lines, and jowls, which are sagged cheek fat under the jawline.

Therefore, jowl thread lifting targets these three main areas for improvement. Rather than just looking at surface wrinkles, it is an approach that repositions the underlying sunken tissue itself upward.

📌 Key Summary: Jowl sagging is a combined result of retaining ligament relaxation, decreased SMAS elasticity, and deep fat descent, manifesting as nasolabial folds, marionette lines, and jowls.

🧵 How do the types of threads differ? (PDO, PLLA, PCL)

The threads used for jowl thread lifting are sutures that are absorbed by the body. They are largely divided into three types, and the biggest difference is the absorption period.

All three materials dissolve and disappear in the body over time, and in the process of melting, they have a collagen regeneration effect that stimulates the production of collagen and elastin in the surrounding tissues. In other words, in addition to the immediate effect of the threads physically pulling, there is an additional process that supports skin elasticity in the long term. This collagen response is most active at around 3 months after the procedure.

It is difficult to say that a certain thread is "unconditionally the best." This is because the choice varies depending on skin thickness, degree of sagging, fat volume, and the desired maintenance period. The number of threads to insert also depends on your condition, so there is no need to obsess over the number itself.

📌 Key Summary: PDO, PLLA, and PCL have different absorption periods (6–8 months / 12–18 months / 18–24+ months) and commonly induce collagen regeneration.

⏳ How long do the effects last?

To be honest, jowl thread lifting is not semi-permanent. The duration of the effect is typically between 6 months and 2 years, with large variations depending on the type of thread, skin elasticity, fat volume, and lifestyle habits.

Also, please keep in mind that the appearance immediately after the procedure is not the final result. Since swelling remains, it is appropriate to make a final assessment about 2 to 4 weeks later after the swelling has stabilized. Even if it feels awkwardly tight for the first few days, it will naturally settle into place over time.

Since the maintenance period is temporary, you may consider repeated procedures, but it is best to carefully determine the number of procedures and intervals while assessing the tissue condition. This is because tissue reactions during repeated procedures can vary from person to person.

📌 Key Summary: The duration of results is generally 6 months to 2 years, and it is accurate to judge the final result 2 to 4 weeks after the procedure, once the swelling has gone down.

🩹 Recovery Process and Post-Procedure Care

One of the advantages of jowl thread lifting is that recovery is relatively quick. In most cases, it is possible to return to daily life the day after the procedure, and bruising and swelling generally ease within 1 to 2 weeks.

However, there are things to be careful of in the early stages when the threads are settling into the tissue. Please observe the following for 2 to 4 weeks after the procedure.

• Refrain from excessive facial expressions such as laughing widely or opening your mouth too wide

• Reduce chewing activities that require hard chewing on tough foods

• Avoid facial massages, saunas, and hot baths

• Postpone vigorous exercise for a while

Care during this period heavily influences the final results. Also, although rare, if you experience signs such as high fever, pus, severe redness, skin discoloration that turns pale or dark red, or exposed threads after the procedure, do not delay and immediately visit the clinic where you received the procedure.

📌 Key Summary: You can return to your daily routine the next day, but for 2 to 4 weeks post-procedure, care is needed to avoid excessive facial expressions, heavy chewing, saunas, and intense exercise.

⚖️ Who is thread lifting right for, and who needs other methods?

Here comes the most important premise. It is to first distinguish whether your jowl is the 'sagging type' or the 'excess fat type'. Thread lifting is a procedure that pulls tissue up, not a procedure that removes fat.

If you have a lot of fat, simply pulling up the sagged tissue may not produce the line you want. Conversely, if sagging is the primary cause, thread lifting is a good fit. This diagnosis is the core premise of selecting a procedure.

Here is a brief summary of other methods that are often compared.

Onlif prioritizes non-surgical procedures from a dermatological perspective. Thread lifting, ultrasound HIFU, and radiofrequency RF have different mechanisms, so when designed together, they often complement each other. In cases of very severe sagging, surgical methods may be discussed, but that is merely information based on the condition, and for most elasticity and sagging concerns, it is best to first explore ways to resolve them naturally with a combination of non-surgical procedures.

This is why Onlif says, "We do not change you." Rather than artificially changing the shape, we clear away the sagging and loss of elasticity that obscure your natural expression. Therefore, we do not overdo it, nor do we rush to judge the results. Our practice of assigning doctors who are best at what they do in each field is also a choice that stems from this philosophy.

📌 Key Summary: The key is to distinguish beforehand whether you have the sagging type or excess fat type, and Onlif prioritizes a combination of non-surgical treatments such as thread lifting, HIFU, and RF.

💰 How much does it cost?

The cost varies widely depending on the type of thread, the scope of the procedure, and the number of threads inserted. In Korea, it starts at about 100,000 KRW per thread for Mint threads, and ranges from hundreds of thousands to millions of KRW depending on the area and type of thread.

For reference, in the US market, thread lifting for the jowl area is reported to be about $2,500 to $3,500 for partial treatments, and over $4,000 for comprehensive treatments. The global aesthetic thread market size is also projected to grow from approximately $157.1 billion in 2025 to approximately $282.3 billion by 2034, indicating steady demand in this field.

However, rather than deciding based on price alone, whether the plan is tailored to your condition comes first. Even for the same cost, results vary depending on what diagnosis is made, which threads are used, and how they are placed.

📌 Key Summary: In Korea, prices start from around 100,000 KRW per thread and range up to hundreds of thousands or millions of KRW depending on the area and type of thread; a design based on diagnosis takes priority over price.

❓ Frequently Asked Questions

How is jowl thread lifting different from buccal fat removal?

Thread lifting is a minimally invasive procedure that pulls sagged tissue with threads to reposition it, while buccal fat removal is a surgery that directly removes fat. The fundamental difference is that it is a method of lifting upward rather than removing fat. Therefore, the approach differs depending on whether you have the sagging type or the excess fat type.

How long do the effects last? Is it semi-permanent?

It is not semi-permanent. It typically lasts between 6 months and 2 years, and varies greatly depending on the thread type, skin elasticity, fat volume, and lifestyle habits. The collagen response induced as the threads are absorbed also helps maintain elasticity.

How do I know if my jowl is the sagging type or the excess fat type?

We distinguish whether sagging is the main cause or if there is a high volume of fat through visual inspection, palpation, and facial structure evaluation. Since this diagnosis is a prerequisite for choosing a procedure, it is more accurate to confirm through an in-person consultation rather than self-judgment.

When will the swelling and bruising go down, and when can I return to daily life?

Bruising and swelling generally subside within 1 to 2 weeks, and most people can return to daily life starting the day after the procedure. However, judging the final result is appropriate after 2 to 4 weeks when the swelling has stabilized.

Which thread among PDO, PLLA, and PCL is most suitable for jowls?

Their absorption periods differ, being approximately 6–8 months, 12–18 months, and 18–24 months or more, respectively. Rather than one being absolutely superior, they are chosen according to skin thickness, degree of sagging, and desired maintenance period, and multiple threads are sometimes combined.

Is it okay to get thread lifting repeatedly?

Since the maintenance period is temporary, you may consider repeating it, but it is best to carefully determine the number of procedures and intervals while looking at the tissue condition. Because tissue reactions during repeated procedures can vary from person to person, it is safe to plan through a consultation.

Can I receive it together with ultrasound HIFU or RF?

Since thread lifting, HIFU, and RF work in different ways, they are often designed to complement each other. The order and interval vary depending on skin condition, so if you plan to proceed with them together, it is best to coordinate the schedule during the consultation stage.

Can I get a thread lift if I currently have fillers or Botox?

In general, they can be performed in tandem, but if they overlap with the previously treated areas, coordination considering the tissue condition is necessary. If you inform us in advance during the consultation about what procedures you received and where, a safer design can be made.

Conclusion

Jowl thread lifting is a procedure that pulls up the sagged mid-face to clearly define your impression. However, its start always begins with accurately knowing what type of jowl you have and which structures have sagged.

Even if it seems like the same concern, the cause varies from person to person. We recommend confirming an accurate diagnosis and a design tailored to you through an in-person consultation. Gangnam Onlif Clinic aims to naturally lift away the sagging and loss of elasticity that obscure your natural beauty, rather than changing your shape.

Jowl Thread Lifting, Things to Check Before Choosing a Clinic

Even for the same procedure, the results and recovery process vary depending on where, by whom, and how it is performed.

Asking these items directly during the consultation will help you make a decision.

• Is it a place that performs that procedure frequently? — Every clinic has different procedures they focus on. Check if it is a place that regularly performs jowl thread lifting.

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

• Do they explain the breakdown of the cost? — Rather than just hearing the total amount, you must hear explanations of what products are used, how much, and in what areas to make a proper judgment.

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

• Do they explain adverse reactions and the recovery process first? — It is better to make a decision at a place that informs you of possible adverse reactions and coping methods together, rather than a consultation that only talks about expected changes.

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

This is how Onlif Clinic performs jowl thread lifting

• We divide responsibilities — With the belief that a single doctor cannot handle every procedure, Onlif divides medical treatments among doctors responsible for each field.

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

• We guide you through the costs 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 balance of the entire face — We view the face through three axes: texture, balance, and signals of youth, and plan in a direction that clears away the parts obscuring your natural impression rather than changing your shape.

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

• We look at the progress together after the procedure — If verification is needed during the recovery period, we guide you on re-visiting and contact methods.

If you are considering a jowl thread lift, it is best to first check what is possible and what is difficult in your current state.

An accurate diagnosis and treatment plan can only be determined through an in-person medical examination. Please check through a consultation at Gangnam Onlif Clinic.