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 inside the cheeks. It is easily understood as a method of physically pulling and fixing the sagged position rather than cutting out or removing fat. The procedure usually 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 to clarify. 'Jowl' (Simbu-bol) is not actually a standard anatomical term found in medical textbooks. It is a term commonly used in the domestic beauty market. Anatomically, it is closer to a lump sum expression of several deep fat compartments such as SOOF, deep medial cheek fat, and buccal fat pad. Therefore, even for the same 'jowl concern', the structural cause varies from person to person, and identifying the cause first is the first step in deciding the direction of the procedure.

🧭 Why and Where Do Jowls Sag?

The sagging of the midface involves several structures. 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 the facial muscles also decreases. Aggravated by this, deep fat like 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 facial surface. Typical examples are the nasolabial folds, marionette lines, and jowls, which are sagged cheek fat below the jawline.

Therefore, jowl thread lifting targets these three main areas for improvement. Instead of just looking at wrinkles on the surface, it is an approach that repositions the sunken tissue underneath upward.

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

🧵 What is the Difference Between Thread Types? (PDO, PLLA, PCL)

The threads used for jowl thread lifting are absorbable sutures that dissolve in 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 during the dissolving process, 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 physical lifting effect of the threads, there is an additional long-term support for skin elasticity. This collagen response is most active about 3 months after the procedure.

It is difficult to say that a certain thread is 'unconditionally good.' This is because the choice varies depending on skin thickness, degree of sagging, amount of fat, and 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 or more), and commonly induce collagen regeneration.

⏳ How Long Does the Effect Last?

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

Also, please remember that the appearance immediately after the procedure is not the final result. Since swelling remains, it is appropriate to make a final judgment 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, repeat procedures are often considered, but it is highly recommended to carefully determine the number of procedures and intervals while observing the condition of the tissues. This is because tissue reactions during repeated procedures can vary from person to person.

📌 Key Summary: The maintenance period is generally 6 months to 2 years, and the final result is most accurately judged 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. Most people can return to daily life the day after the procedure, and bruising and swelling are generally alleviated within 1 to 2 weeks.

However, in the early stages when the threads are settling into the tissues, caution is required. Please follow the guidelines below for 2 to 4 weeks after the procedure:

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

• Reduce chewing activities that require hard chewing of tough foods

• Avoid facial massages, saunas, and hot baths

• Postpone strenuous exercise for a while

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

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

⚖️ Who is Thread Lifting Right For vs. Who Needs Other Methods?

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

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

A brief summary of other methods that are often compared is as follows:

Onlif prioritizes non-surgical procedures from a dermatological perspective. Thread lifting and ultrasound HIFU / High-Frequency RF have different mechanisms, so when designed together, they often complement each other. In cases of very severe sagging, surgical methods might be discussed, but that is only information based on the condition, and for most elasticity and sagging concerns, it is best to first look into a natural solution through a combination of non-surgical procedures.

This is why Onlif says,