Thread Lift: Does it really work? From thread types to side effects

What is Thread Lifting, and Why is Everyone Getting It?

Thread lifting is a non-surgical lifting procedure that physically pulls up sagging tissue by inserting medical-grade absorbable threads under the skin, while simultaneously stimulating collagen production as the threads dissolve. In other words, you can think of it as two mechanisms working together: pulling force and collagen.

Immediately after the procedure, you can see the lifting effect right away because the threads hold and pull the tissue. On the other hand, for the feeling of improved elasticity, you need to wait a bit longer. It usually develops gradually over 4 to 12 weeks. The procedure takes about 30 to 60 minutes, and most people return to their daily lives within 1 to 3 days.

For reference, the market is also growing rapidly. The global aesthetic thread lifting market is expected to grow from approximately $153.63 million in 2026 at a CAGR of 10.49% to reach approximately $253.14 million by 2031. In South Korea, demand from young people is rising, with those in their 20s and 30s making up as much as 46% of the market.

📌 Key Summary: Thread lifting works through two mechanisms: 'physical traction + collagen stimulation', and its effects have both immediate and gradual aspects.

🧵 Thread Materials and Shapes: What's the Difference?

Threads are largely categorized by two factors: what they are made of (material) and what they look like (shape). These two factors determine the duration of the effect and the strength of the lift.

Materials: PDO, PLLA, PCL

There are three main materials used for absorbable threads.

PDO is widely used for beginners. If you want a longer-lasting, stronger collagen effect, you might consider PLLA or PCL. However, since PLLA is relatively rigid, some individuals may experience a foreign-body sensation.

Shapes: Mono, Cog, and Cone Threads

• Mono Threads: Smooth threads without barbs. Instead of lifting, they aim to improve skin elasticity and fine wrinkles.

• Cog Threads: These have barbs that directly catch and pull sagging tissue. They are the key to immediate lifting.

• Cone Threads: These feature cone-shaped structures that provide 360-degree support to the tissue for a powerful lift.

The immediate lifting traction comes from the barbs of the cog threads catching on the subcutaneous fat layer or fibrous tissue. The number of threads used typically ranges from 4 to 20, depending on the area and the degree of sagging.

To be honest, the result depends far more on the insertion layer, direction, tension, and the anatomical expertise of the practitioner than on the type of thread. Good hands come before good threads.

📌 Key Summary: While the material (PDO, PLLA, PCL) determines duration and the shape (mono, cog, cone) determines lifting strength, the most critical variable is the practitioner's skill.

⏳ How Long Do the Effects Last, and When Should You Get It Again?

The duration of the effect typically ranges from 6 to 24 months, depending on the material and individual differences. You can expect around 1 year for PDO and nearly 2 years for PCL.

Here is a common misconception: "Once the threads dissolve, won't everything sag back to how it was?" Not completely. Because collagen is produced during the micro-inflammation and fibrosis process triggered as the threads break down, a certain level of elasticity remains even after the threads are fully absorbed.

You might also wonder about the timing for a touch-up. Clinical recommendations suggest that getting a repeat procedure when about 50% of the effect remains (typically 1 to 1.5 years after the initial procedure) helps maintain a more natural look. In other words, cumulative maintenance is better than waiting until the effect is completely gone.

Also, the rumor that "getting frequent thread lifts makes your skin sag more" is mostly a misconception. When repeated at appropriate intervals, it actually helps consistently stimulate collagen production. However, excessive repetition is a different story, which we will discuss later.

📌 Key Summary: The effects last 6 to 24 months; repeating the procedure when about 50% of the effect remains is recommended; and some collagen benefits persist even after the threads dissolve.

🆚 How Does It Differ from Ultherapy, Fillers, and Facelifts?

There are so many types of lifting procedures that it can be confusing. The key is that each has its own area of expertise.

A surgical facelift lasts for 5 to 10+ years, but it comes with the burden of surgery. Thread lifts last shorter, about 1 to 2 years, but offer a quick recovery. If the sagging is severe, a thread lift cannot fully replace a surgical facelift. Please keep this in mind.

For cases involving both volume loss and midface sagging, such as nasolabial folds, combining a thread lift with fillers is highly effective. If you use Botox together for the masseter muscle or trapezius, it creates a contouring synergy. Some also combine it with Ultherapy or Thermage.

As a note: if you have a lot of facial fat, the lifting traction of the threads may not hold well. In such cases, it is more practical to first consider alternatives like fat dissolving injections, contouring injections, or radiofrequency treatments.

📌 Key Summary: Thread lifting is excellent for moderate sagging and contour definition, while surgical facelifts are more suitable for severe sagging, fillers for volume, and HIFU for elasticity.

⚠️ Side Effects and Pre-/Post-Procedure Precautions

Let's start with common, temporary symptoms. Bruising, swelling, dimpling (skin puckering), and a pulling sensation are common and mostly resolve within 1 to 2 weeks, with dimpling resolving within 2 to 4 weeks. Local anesthesia is typically used to minimize pain.

On the other hand, you should not ignore signs like these:

• Persistent, severe pain

• Fever, pus, or exposed threads

• Skin color changes or abnormal sensations

If these occur, they could indicate an emergency, so seek medical attention immediately.

Before the procedure, you should adjust medications or supplements that increase the risk of bleeding. You must consult with your healthcare provider regarding aspirin, anticoagulants, high-dose Vitamin E, omega-3s, etc.

For 1 to 2 weeks after the procedure, it is best to avoid strong massages, facial bone massages, saunas, vigorous exercise, drinking, and smoking. Using sun protection and staying well-hydrated also helps maintain the results.

However, this procedure is not recommended for everyone. Caution is advised for individuals with a keloid constitution, compromised immunity, uncontrolled diabetes, those who are pregnant or breastfeeding, or those taking anticoagulants. Diabetes or smoking can also decrease collagen production itself.

Repeated procedures are not always better. Doing it too frequently increases the risk of fibrosis, adhesions, thread residue, and infection. The key is proper intervals. While absorbable threads generally do not pose major issues for MRI scans, it is safer to inform the imaging staff about the procedure beforehand.

Lastly, let's clear up some common myths: "There are no side effects because it is a dissolving thread", "It is permanent", "It completely replaces a surgical facelift"—all three of these are false.

📌 Key Summary: Most bruising and dimpling resolve naturally, but fever, pus, or exposed threads require prompt medical care, and caution is needed for those with keloids or low immunity.

🙋 Frequently Asked Questions (FAQ)

How does thread lifting work?

It combines immediate effects, where barbed threads physically lift sagging tissue, with gradual effects, where the dissolving threads stimulate collagen production. This is why it feels different immediately after the procedure compared to several weeks later.

Which thread is right for me among PDO, PLLA, and PCL?

PDO is highly versatile and gentle, making it a common choice for beginners. PLLA is considered if you want stronger collagen stimulation, while PCL is chosen for the longest-lasting results (18 to 24+ months). It is best to determine the final choice with a practitioner after assessing your degree of sagging and skin condition.

Can I see the results immediately after the procedure?

The lift from physical traction is visible immediately. However, elasticity improvement from collagen regeneration typically appears gradually over 4 to 12 weeks.

How long do the effects last? Will my skin sag back once the threads dissolve?

They last 6 to 24 months, depending on the material and individual differences. Even after the threads dissolve, elasticity benefits persist for a certain period thanks to the newly formed collagen, so your skin does not return completely to its original starting point.

How long do bruising and swelling last after the procedure?

They generally improve within 1 to 2 weeks. Even if dimpling (skin puckering) occurs, most cases resolve naturally within 2 to 4 weeks, so there is no need to worry excessively.

When is the best time to get a repeat procedure?

For a more natural look, it is recommended to get a repeat procedure when about 50% of the effect remains, which is usually around 1 to 1.5 years after the initial treatment. However, avoid overly frequent sessions, as adjusting the interval is key to preventing the risk of fibrosis and adhesions.

If I have a lot of facial fat, will the procedure still be effective?

If you have a large amount of facial fat, it is difficult for the threads' lifting force to hold. In this case, it is more practical to first consider or combine treatments like fat-dissolving injections, contouring injections, or radiofrequency.

My skin has severe sagging. Can a thread lift deliver the same results as a facelift?

It is difficult. For severe sagging, a surgical facelift that addresses the SMAS layer is more suitable and provides longer-lasting results (over 5 to 10 years). Thread lifts are best suited for moderate sagging and contour definition.

Can I get fillers and Botox on the same day as my thread lift?

Yes, they can be combined and can even create a synergistic effect—such as adding fillers for nasolabial folds and Botox for the masseter or trapezius. However, the order of treatment and whether to perform them simultaneously should be determined by a healthcare provider.

Are there any medications I should stop taking before the procedure?

You should consult with your healthcare provider beforehand to manage medications or supplements that increase bleeding risks, such as aspirin, anticoagulants, high-dose Vitamin E, and omega-3s.

Will the threads interfere with an MRI scan?

Absorbable threads generally do not cause major issues. However, for safety, it is best to inform the technician of your procedure prior to the scan.