Types of Thread Lifts: A Clear Summary by Material and Shape

Thread lifting threads are largely divided into two axes: **material (what they are made of)** and shape (how they act on tissues in terms of form). Materials range from absorbable (PDO, PLLA, PCL) to non-absorbable, and shapes vary from smooth mono threads to cog threads with barbs, spiral screw threads, and cone threads with cones. If you are looking into this because you are concerned about sagging, understanding just these two axes will make the conversation in the consulting room much clearer.

First of all, the outcome is not determined by the type of thread alone. Even with the same thread, the results vary greatly depending on which layer it is placed in, and with what direction and tension it is anchored. Therefore, we hope you read the following content from the perspective of 'understanding the thread that fits my concerns' rather than 'choosing a better thread.'

🧵 What are thread lifting threads?

Thread lifting is a procedure that inserts specially processed threads into facial skin and soft tissue to pull up sagging areas and, at the same time, induce collagen production. Two principles work together.

The first is physical traction by barbs, and the second is collagenesis, where new collagen and elastin are created through a foreign body reaction that occurs as the threads are absorbed into the body. Because of this second mechanism, the elasticity improvement effect remains for a while even after the threads are completely dissolved.

The placement of the thread is also important. The layer directly related to the lifting effect is the facial fascia layer, commonly called SMAS (Superficial Muscular Aponeurotic System), and the depth at which the threads are placed determines how natural the results will be.

📌 Key Summary: Thread lifting works through two mechanisms: 'physical traction' and 'collagen regeneration,' and the insertion layer and direction of the threads greatly influence the results.

🔬 Classification by Material — Differences between PDO, PLLA, and PCL

Most threads used for cosmetic purposes today are absorbable threads that slowly dissolve in the body. They are more widely preferred than non-absorbable ones due to their safety and collagen-inducing effects. For absorbable materials, the longer the absorption period, the longer the effect tends to last, and the order is PDO < PLLA < PCL.

Here is a common misconception: the absorption period and the duration of the effect are not the same. For example, PDO is mostly absorbed within about 6 to 8 months, but thanks to the collagen created during that time, the effect continues for about 6 to 12 months. There are also materials like PLGA where the ingredients are mixed to adjust the characteristics.

Conversely, non-absorbable threads (polypropylene, gold threads, etc.) do not decompose in the body. Although they seem to have the advantage of being permanent, they are difficult to remove if an infection or foreign body reaction occurs, and as the surrounding skin ages over time, they may not blend in well, leading to unnatural results. Therefore, they are only used restrictively in the cosmetic field today.

📌 Key Summary: Absorbable threads are the mainstream, lasting longer in the order of PDO < PLLA < PCL, and the point when the threads dissolve is different from the point when the effect disappears.

🪡 Classification by Shape — Mono, Screw, Cog, and Cone Threads

Even with the same material, different shapes serve completely different roles. This is actually the most confusing part of thread lifting.

Mono Thread

These are smooth threads without barbs. Multiple strands are inserted closely to target skin elasticity, texture improvement, and collagen induction. Although the direct lifting effect is weak, it is a great choice if you are concerned about fine wrinkles or skin texture.

Screw/Twist Thread

With a spiral twisted structure, they provide stronger tissue stimulation than mono threads, so they are used for mild volume support and elasticity improvement. They are also called tornado or hurricane threads.

Cog Thread

These are full-fledged lifting threads with barbs (cogs/barbs) on the surface to physically hook and pull the tissue. They are the main players when pulling up sagging cheeks, jawlines, or nasolabial folds. The structure is divided into uni-directional, bi-directional, and 360-degree cogs, each with different anchoring methods.

There are also two ways to make the barbs. Cutting types slice into the thread to create cogs, while **molded cogs** attach cogs through extrusion and molding. Generally, molded cogs are considered relatively advantageous for maintaining tensile strength.

Cone Thread

These feature cone-shaped cones that support a wider surface of tissue. This shape is used to leverage anchoring power in areas that require support, such as the midface. Spring-type volume threads that support sunken cheek or under-eye volume can also be understood as an extension of this category.

📌 Key Summary: Mono and screw threads are mainly for elasticity and texture improvement, while cog and cone threads are primarily for lifting to directly pull up sagging tissue, dividing their purposes.

🎯 Which Thread Fits My Concerns?

Usually, more than one type of thread is used. In most cases, multiple threads are designed together to fit the purpose.

• I want to lift sagging cheeks and jawline → Focus on cog threads, and reinforce support with cone threads if necessary

• I am concerned about skin texture, fine wrinkles, and elasticity → Insert mono threads closely

• I want to address sunken cheeks and nasolabial volume together → Consider volume-type shapes or combine with fillers

However, if there is severe skin sagging and excessive loose skin, thread lifting alone has clear limitations. In such cases, surgical facelifts are often compared as an alternative, but it is proper to first check whether there is room for improvement without incisions. Onlif prioritizes natural improvement by combining thread lifting with non-surgical skin procedures such as ultrasound HIFU and high-frequency RF. We use different procedures with distinct roles depending on the goal, such as fillers filling in lacking volume and threads holding sagging areas.

📌 Key Summary: Threads are designed in combination depending on the purpose. The more severe the sagging, the more important a combination of non-surgical procedures and a specialist's diagnosis becomes over thread alone.

⚠️ Side Effects and Post-Procedure Care

Just because they are absorbable threads does not mean they are free from side effects. Typical examples include bruising, swelling, asymmetry, thread protrusion, infection, and the dimple phenomenon, where the skin becomes sunken and puckered after a cog thread procedure. Dimples are directly related to the skill of the practitioner, so where you receive the treatment is actually very important.

The recovery flow is generally as follows:

• Swelling: Approx. 3 to 7 days

• Bruising: Approx. 1 to 2 weeks

• Tightness/Foreign body sensation: Relieved within approx. 1 to 4 weeks

The procedure time is about 20 to 40 minutes depending on the area and the number of threads. It is safe to avoid strong massages, saunas, intense exercise, drinking, and sleeping face down for at least 2 weeks to a month after the procedure. Sleeping with your upper body slightly elevated in a correct posture also helps the threads settle into place.

Checking whether the product is genuine, i.e., checking if it is a product approved by the Ministry of Food and Drug Safety (MFDS), is also a useful practical tip.

📌 Key Summary: Absorbable threads can also have side effects such as dimples, bruising, and swelling. Lifestyle management for 2 weeks to 1 month post-procedure and verifying genuine products (MFDS approved) are important.

❓ Frequently Asked Questions (FAQ)

Which thread lasts the longest among PDO, PLLA, and PCL?

Based on the absorption period, PCL (approx. 18 to 24 months or more) is the longest, followed by PLLA (approx. 12 to 18 months), and PDO (approx. 6 to 8 months). However, lasting longer does not necessarily mean it is better; choosing the right one for the area and purpose is the priority.

Does the lifting effect disappear as soon as the thread dissolves?

No. Collagen newly generated during the absorption of the thread supports skin elasticity for some time. Therefore, the completion of thread absorption is not immediately the end of the effect.

What is the difference between cog threads and mono threads?

Cog threads are for lifting, using barbs to hook tissue and directly pull up sagging areas, while mono threads are smooth threads without barbs aimed at improving elasticity, skin texture, and inducing collagen. The two are often used together.

Is thread lifting effective even for severe sagging?

If there is excessive loose skin and severe sagging, there are limitations with threads alone. In this case, it is best to first diagnose whether there is room for improvement through a combination of non-surgical procedures, and depending on the degree, surgical methods may be compared.

What should I do if dimples occur after thread lifting?

Mild dimples that appear early on often ease as swelling goes down, but if they persist, you must check the cause at the clinic where you received the procedure. Dimples are closely related to insertion direction and tension, so a follow-up consultation is safer than self-judgment.

Can I get thread lifting if I already have fillers?

Generally, they can be combined. Threads hold sagging while fillers fill volume, so they serve different roles. However, the procedure area and timing differ depending on individual conditions, so it is recommended to consult with a specialist on the sequence.

Knowing the types of threads is only the beginning. Even with the same thread, the results vary depending on which layer it is placed in, and with what direction and tension. Therefore, an accurate diagnosis that considers your skin thickness, fat volume, and degree of sagging must come first. Gangnam Onlif Clinic operates in a way where specialized doctors in each field handle the procedures they do best, aiming to restore your natural texture rather than altering your face. We encourage you to confirm details through a consultation with a specialist.

Things to Check Before Choosing a Clinic for Thread Lifting

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

Asking the following questions during your consultation will help you make a decision.

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

• Can I verify the products and equipment used? — Ask if you can confirm the product name and whether it is genuine (if it is an imported approved product, or 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 need to hear an explanation of what product, how much, and on which area it is being used to make a judgment.

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

• Do they explain adverse reactions and the recovery process first? — A place that informs you of possible adverse reactions and how to cope with them is better for making a decision than a consultation that only speaks of 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 criteria for re-visiting are established.

This is how Onlif Clinic performs thread lifting

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

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

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

• We design by looking at the overall facial balance — We view the face through three axes: texture, balance, and signs of youth, and make plans to clean up parts that overshadow your natural impression rather than changing your features.

• 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 countermeasures before the procedure.

• We review the progress together after the procedure — If verification is needed during the recovery period, we provide guidance on re-visiting and communication channels.

If you are considering thread lifting, 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 consultation. Find out through a consultation at Gangnam Onlif Clinic.