Facial Thread Lift

What Is a Facial Thread Lift?

A facial thread lift uses medical threads placed under the skin to support soft tissue that has dropped, lifting it upwards. It usually does not require a surgical incision, and no skin is removed. This sets it apart from a surgical facelift: the two are not lighter and heavier versions of the same procedure, but two separate approaches that work on different scales.

In the technique described in research, threads with small barbs on their surface are placed along set lines, and in this way the face’s superficial layer of muscle and connective tissue (SMAS, the superficial musculoaponeurotic system) is moved upwards. Under the skin, the thread acts like a support structure: it grips the tissue and mechanically repositions tissue that has sagged. In other words, the thread does not add volume; it changes the position of existing tissue.

It is worth knowing that the scientific evidence supporting thread lifts is still limited, and many studies in this field have methodological weaknesses. On the other hand, when performed by a doctor with a good knowledge of facial anatomy, it is considered a relatively low-risk procedure; it can be planned on its own or combined with fillers, muscle-relaxing injections or surgical methods.

The name “thread lift” describes a family of methods, not a single technique. At this clinic, the name is used as a general term covering lifting treatments performed with threads; the French thread lift is one of the techniques within these methods. You can find details specific to areas such as the mid-face, jawline, brows, outer corner of the eye, neck, nose and upper lip on the relevant pages.

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Thread Types: Material and Surface Structure

Two key features distinguish lifting threads from one another: whether the material dissolves in the body over time, and whether the thread’s surface has barbs that help it grip the tissue. Over time, preference has shifted from non-absorbable threads towards absorbable threads, that is, threads that dissolve over time. Studies show that material and surface structure are associated with how often side effects are reported.

Absorbable threads are made from materials such as polydioxanone (PDO), poly-L-lactic acid (PLLA) and polycaprolactone (PCL), or from blends of these. In studies on the mid-face and lower face, the most frequently studied material is polydioxanone, followed by a blend of poly-L-lactic acid and polycaprolactone. This blend has long been used as an absorbable surgical suture; its compatibility with the body (biocompatibility) and the way it breaks down in the body are well described.

The second distinction is surface structure. Lifting is mostly discussed in terms of barbed threads (described in English-language sources as “barbed” or “cog” threads); smooth threads and threads with cones (small cone-shaped projections) are also used alongside them. A review comparing different absorbable threads reported more complications with barbed threads than with smooth or cone threads. More complications were also seen with threads placed without being anchored at a fixed point than with anchored threads.

The picture is different for permanent, or non-absorbable, threads. Early studies with these threads reported high rates of revision (a corrective procedure) and complications; techniques developed with absorbable threads were seen to cause fewer adverse effects. In a meta-analysis combining data from many studies, absorbable threads were associated with a significantly lower risk than non-absorbable threads for two problems: altered sensation (3.1% vs 11.7%) and thread extrusion, where a thread works its way out through the skin (1.6% vs 7.6%).

According to researchers who compared the materials from a technical and mechanical perspective, looking only at how long a thread stays in the body is not enough when choosing a thread; other factors should be considered as well. This clinic uses dissolvable threads (PLLA/PDO). Which thread is used in which area is decided at the consultation.

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How Does the Thread Work in the Tissue?

Two separate effects of the thread are described: the mechanical repositioning it provides by gripping the tissue, and the tissue response that develops around the thread over time. The first is what does the lifting; evidence on how much the second contributes in the human face, and for how long, is limited. This distinction explains why the effect you see on the day of the procedure may not be the same as the effect that remains weeks later.

The mechanical effect comes from the barbs gripping the tissue under the skin; the thread carries the sagging tissue along the line it follows. According to a review of the anatomical landmarks of the face, correctly redirecting the fat compartments helps address age-related changes. Engaging the ligaments that hold the tissue in place (retaining ligaments) is very important for a sustainable lift that does not distort the tissue. In short, the result depends not only on the thread itself but also on which layer it is placed in and in which direction.

The clearest data on the tissue response come from animal studies. In a study on rat skin aged with ultraviolet light, polydioxanone, poly-L-lactic acid and polycaprolactone threads all increased collagen density in the dermis (the middle layer of the skin); polycaprolactone was found to be more effective than the other two. However, this is a rat back-skin model; its results cannot be directly applied to the human face, to the lift a thread will provide or to how long the effect lasts.

A small randomised trial in humans (a trial in which participants are randomly assigned to groups) makes this distinction concrete. In this trial of twenty-two people, three or six polydioxanone threads were placed in each half of the face; no significant difference was found between the two groups in tissue displacement, volume change or satisfaction. The improvement in volume and tissue displacement seen in the early period had decreased by day 60. The researchers state that studies with longer follow-up are needed to understand how much collagen stimulation contributes to a lasting effect.

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Mid-Face and Cheeks

The mid-face is reported to be one of the areas where thread lifts are most often performed. The main finding discussed in this area is cheek tissue moving downwards. However, changes in the mid-face can be caused not only by sagging but also by volume loss; the two are told apart at the consultation. A pilot study of thread lifting in the mid-face also noted that volume remains the main target in this area.

This study followed six people with mild to moderate sagging in the mid-face. After lifting with absorbable threads, the measured volume changes remained significant compared with baseline at about one year of follow-up. However, this is a very small series that compares results only with the same people’s measurements before the procedure; it should not be read as a promise of how long the effect will last. A systematic review comparing absorbable threads, meanwhile, reported that swelling and bruising were more often associated with mid-face treatments.

Mid-face anatomy, thread directions and how volume loss is distinguished from sagging in this area are explained in detail on the Mid-Face Thread Lift page. The general picture can be summed up as follows: in the mid-face, the thread lifts tissue that has dropped; it does not replace lost volume.

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Jawline and Lower Face

The jawline is also reported to be one of the areas where thread lifting is most often performed. The concern here is a jawline that has lost definition, with jowls forming along it. The bone structure of the chin and fat build-up under the chin are separate issues and are assessed separately at the consultation.

In a pilot study of eight people with mild to moderate sagging along the jawline, lifting was performed with polylactic acid and polycaprolactone threads. Surface distances from the small projection in front of the ear to points on the line below the corner of the mouth and on the jowl improved significantly compared with baseline, both immediately after the procedure and at a mean follow-up of 8.16 months. However, this too is a very small series that compares results only with measurements taken before the procedure; it does not show how the method performs in this area over the long term.

The anatomical structures that need care in this area are described separately in the Facial Anatomy and Safety section below. Lifting techniques specific to the jawline, how they relate to the chin and the area under the chin, and the difference between filler and a thread lift in this area are covered on the Lower Face & Jawline Thread Lift page. In short: the thread lifts sagging tissue along the jawline; it does not change bone structure or fat tissue.

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Brows, Eye Area and Neck

The brows and neck are also among the areas where thread lifts are often performed. A change in brow position is considered one of the early signs of facial ageing; in the neck, the concern is laxity.

In a series of 38 women with mild to moderate brow drooping, or no drooping, scale scores based on the patients’ own assessments were higher than baseline at six and twelve months after brow lifting with barbed threads, and no serious complications were seen. This series had no comparison group, and all the patients came from a single institution; the rise in scores at twelve months was reported to be more marked in younger women.

Treatments aimed at the outer corner of the eye and the tail of the brow, known in everyday language as “fox eyes” or “cat eyes”, also belong to this family. These names come from an aesthetic trend; this page does not recommend any particular eye shape as a goal. Treatments for the brows, outer corner of the eye, neck, nose and upper lip are described on the relevant pages, together with their own levels of evidence.

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What Does the Evidence Show?

Studies report a measurable improvement immediately after a thread lift. Long-term evidence on how long the effect lasts, however, is limited, and publications in this field state this clearly. The findings below do not reflect a result specific to you; they reflect the current state of the scientific evidence.

A 2025 systematic review of absorbable threads in the mid-face and lower face assessed twelve studies covering a total of 818 patients. In all the studies, scores on aesthetic improvement and wrinkle scales improved immediately after the procedure. The longest follow-up was two years, and complications were mild. The review concluded that, in a suitable patient, threads are effective immediately and the risk of dangerous complications is low, but long-term effectiveness data are lacking.

Two older reviews are more cautious. In a 2018 systematic review, the lifting effect was maintained for only a very limited time in all but two of the twelve studies examined; the two studies reporting positive results were supported by thread manufacturers. Another review, from 2021, screened 192 publications and examined twenty clinical and two experimental studies; it concluded that, although the method looks promising, no new evidence had been added to support its use.

Patient satisfaction points the same way. In a meta-analysis combining twenty-six studies, the satisfaction rate was 98% immediately after the procedure but had fallen to 88% at six months. The researchers recommend discussing with patients, before the procedure, that the rejuvenating effect of a thread lift may not be maintained in the long term. For this reason, this page does not give duration or longevity figures for any type of thread.

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Limits of This Treatment

A facial thread lift is not a substitute for a surgical facelift. According to a review of lifting with barbed threads, the maximum degree of correction that can be achieved, how long the results last and the consequences of a thread remaining in the tissue for a long time are not yet clear. The review therefore concluded that, for now, the method should not be adopted as an alternative to a surgical facelift.

The second limit relates to the type of finding in the face. The thread lifts tissue; it does not remove excess skin and does not replace lost volume. The area-specific studies described above were carried out in people with mild to moderate sagging; these data cannot be applied to faces with advanced sagging and marked excess skin. In such cases, surgical options are assessed by the relevant specialty.

The third limit relates to age. In a meta-analysis combining twenty-six studies, patients over 50 had a significantly higher risk of skin dimpling (16% vs 5.6%) and infection (5.9% vs 0.7%) than younger patients. In a multicentre study of 2,000 procedures with polydioxanone threads, older age and the number of threads used were identified as independent predictors of complications (factors linked to risk even when other factors are taken into account). In another multicentre study of 1,500 patients, the same factors were found to be independent predictors of patients returning because of an unsatisfactory result.

Fourth: more threads do not mean a better result. In a small randomised trial, placing six threads instead of three in each half of the face did not significantly change the lasting lift or satisfaction. These limits do not mean that the treatment should be avoided; they show where to set your expectations. Your doctor assesses you; the decision is yours.

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Facial Anatomy and Safety

The thread is passed close to blood vessels, nerves and salivary gland structures in the face, so knowledge of anatomy is the main factor that determines safety. Carefully tracking the facial blood vessels is necessary to reduce the risk of bleeding and bruising. Knowing the course of the facial nerve is necessary to reduce the risk of nerve damage that can cause facial weakness or paralysis.

According to a review of complications, serious problems such as infection, granuloma (a small cluster of inflammatory tissue that the body forms in reaction to foreign material), thread migration (the thread moving out of position), nerve damage and injury to the parotid gland are rare; however, when they do occur, they are markedly difficult to treat. Common problems, on the other hand, are mostly linked to unsuitable technique or anatomical factors. Planning before the procedure, correct thread placement and planning tailored to the individual are important in reducing the risk of these problems.

The parotid is the large salivary gland located in front of the ear and at the side of the lower face. In a series reporting eight patients with a puncture of the parotid gland and one patient with an injury to the gland’s duct after a thread lift, the main findings were tenderness and swelling; some patients had no symptoms. The duct injury caused severe swelling and pain. Although the severity and duration of symptoms differed, the cases improved with non-surgical (conservative) treatment. These are reports at the level of individual cases; the fact that they are rare does not mean the risk can be ignored.

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Known Risks

The most frequently reported effects after a thread lift are swelling, bruising and pain; these are mostly temporary. Late findings that may be of greater medical importance include skin dimpling, a thread that is visible or palpable (can be felt by touch), and thread migration. Thread extrusion, infection and altered sensation have also been reported. Nerve and salivary gland injuries are rarely reported.

A 2026 meta-analysis of twenty-six studies covering 2,827 patients reported rates of 34% for swelling, 26% for bruising, 10% for a visible or palpable thread and 7% for skin dimpling. The researchers classify swelling, pain and bruising seen in the first four weeks as early complications, and a visible thread, dimpling and thread migration lasting longer than four weeks as late complications. They also note that the late findings may be the ones of greater medical importance.

Rates vary markedly from study to study; in the same meta-analysis, the variation between studies was found to be high. Another meta-analysis, from 2021, gives these pooled rates: swelling 35%, dimpling 10%, altered sensation 6%, a visible or palpable thread 4%, infection 2% and thread extrusion 2%.

A systematic review covering 14,222 patients, which looked at face and neck treatments together, found that the most frequently reported finding was asymmetry (a difference in appearance between the two halves of the face). In this review, serious side effects were rare and consisted of altered sensation, hair loss, and blood vessel and gland injuries. Most findings resolved on their own; however, contour irregularities, blood vessel and gland injuries, infection and inflammatory responses are exceptions to this generalisation.

In the multicentre study of 2,000 procedures with polydioxanone threads, the overall complication rate was 12.4%; the most common findings were skin puckering (6.35%), asymmetry (2.9%) and pain (1.75%). In a series of 190 patients who sought care for complications after thread lifts performed at other institutions, the most common problems, in order, were skin dimpling, contour irregularity, a visible thread and thread extrusion. The researchers point to insufficient knowledge of facial anatomy and treatment by inexperienced practitioners as the main causes.

Infection is rare but can be serious. In one case in which an abscess developed along the path of the threads after polydioxanone thread treatment, the threads had to be removed surgically after antibiotic treatment; because the threads were brittle, more than one incision was made. Before the procedure, you will be asked about blood thinners, antiplatelet medicines (which stop blood platelets from clumping together) and supplements that can affect bleeding. Do not stop any prescribed medicine on your own. If needed, the procedure is planned or postponed after consulting the relevant doctor.

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Combining with Fillers and Other Treatments

A thread lift is often considered not on its own but as part of a plan with other treatments. This is because different findings respond to different methods: the thread lifts tissue that has shifted, filler replaces lost volume, and muscle-relaxing injections target lines caused by facial expressions.

In a study of 111,948 facial thread lift procedures performed over five years at more than a hundred clinics belonging to a cosmetic surgery group in Japan, more than 60% of patients had additional treatments alongside the threads, such as fillers or botulinum toxin. The most common combination was polydioxanone and polycaprolactone threads used together. The same study also reported that patient age rose over time and that the use of non-absorbable threads increased.

A review on the combined use of fillers, threads and botulinum toxin offers guidance on the key anatomical landmarks where these treatments are performed on the face and on the timing between them. However, these recommendations are based on expert experience; they are not a controlled comparison showing that combined use is better than individual treatments. Which treatment is considered, and in what order, is decided at the consultation.

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