Thread Lift
A thread lift is a non-surgical procedure in which dissolvable PDO (polydioxanone) threads are placed under the skin to lift mildly sagging tissue and stimulate collagen. At Naficy Plastic Surgery in Bellevue, thread lifts are performed by our injectors, not by Dr. Naficy, and cost $1,500 per region — typically about four threads. Treatment takes under an hour with topical numbing, downtime is minimal, and results last roughly one year. We perform 100 to 125 thread treatments annually. Threads produce a few millimeters of lift, not the result of a facelift; patients with significant jowling or neck laxity are better served by surgery.
What is a thread lift?
A thread lift uses absorbable sutures placed in the deeper layers of the skin to accomplish two things at once. The threads themselves provide immediate mechanical lift by engaging and repositioning soft tissue. As they dissolve over the following months, they trigger a controlled healing response that lays down new collagen along the thread path.
The threads we use are made of polydioxanone (PDO), a material used in surgical suture for decades. PDO threads come in a range of sizes and configurations — smooth, twisted, and barbed — and our injectors select among them based on the region being treated and how much lift is needed. Threads dissolve completely. Nothing permanent is left behind.
This is a different procedure from the barbed permanent-suture "feather lifts" and APTOS lifts marketed in the mid-2000s, which used non-dissolving threads. Current PDO threads are absorbable and have a considerably better safety profile.
How much lift can a thread lift actually give you?
This is the question worth being direct about, because thread lifts are frequently oversold.
The American Society of Plastic Surgeons states that thread lifts generally lift the face by only a few millimeters, and that they are best suited to patients with mild to moderate laxity rather than severe sagging. That matches what we see. A thread lift will soften an early jowl or restore a little definition along the cheek. It will not reposition a heavy jawline, correct significant neck laxity, or produce anything approaching the change of a deep plane facelift.
If you are hoping threads will let you avoid surgery that you actually need, they will disappoint you. We would rather tell you that at consultation than after you have spent the money.
Who is a good candidate for a thread lift?
- Mild to moderate skin laxity, typically in the 30s to early 50s
- Early jowling, or slight descent of the cheek and midface
- Reasonable skin quality and thickness — thin, sun-damaged skin holds threads poorly
- Someone who wants a subtle change with minimal downtime
- Someone who understands the result is temporary and wants maintenance rather than correction
- Patients already receiving Sculptra, where threads and collagen stimulation work together
Who is not a good candidate?
We turn down a meaningful number of the people who ask about threads. You are unlikely to be a good candidate if:
- You have significant jowling or neck laxity. Threads cannot lift heavy tissue. A deep plane facelift is the appropriate operation, and threads will only delay it while costing you money.
- Your problem is volume loss rather than sagging. Hollowing in the temples, cheeks, or midface responds to filler, Sculptra, or fat grafting — not to lifting.
- You have very thin skin. Threads are more likely to be visible or palpable.
- You have heavy facial soft tissue. There is more weight than the threads can hold.
- You want a lasting result. At roughly a year, threads are among the shorter-lived aesthetic treatments we offer.
- You have an active skin infection in the treatment area, or a known sensitivity to PDO suture.
If any of these describe you, ask about a deep plane facelift, Sculptra, or facial fillers instead.
How is the procedure performed?
The treatment area is cleaned and marked, then numbed with topical anesthetic and small injections of local anesthetic at the entry points. Threads are introduced through a fine needle or cannula and advanced along the planned vector in the subcutaneous plane. Once positioned, gentle traction sets the lift, and the ends are trimmed below the skin surface. No incisions are made and no sutures need removal.
A single region typically takes 30 to 45 minutes and uses about four threads. Most patients drive themselves home afterward.
What is recovery like?
| Time after treatment | What to expect |
|---|---|
| First 24–48 hours | Tightness, mild swelling, and sometimes bruising at entry points. Sleep on your back with your head elevated. |
| Days 3–7 | Swelling settles. Avoid opening the mouth widely, chewing tough foods, and facial massage. |
| Weeks 1–2 | Most bruising resolves. Avoid facials, dental work, and strenuous exercise. |
| Weeks 2–4 | Threads secure in position. Any initial over-tightness relaxes and the contour settles. |
| Months 2–3 | Collagen response builds. This is when the final effect is visible. |
| Around 12 months | Lifting effect has largely faded. Retreatment can be scheduled if desired. |
How long do thread lift results last?
In our hands, about one year. The threads themselves dissolve within four to six months; the collagen they stimulate is what carries the result beyond that point. Some patients hold their result a little longer, some a little less, depending on skin quality, age, and how much laxity was present to begin with.
Because the effect is temporary, threads make most sense as maintenance — a way to hold a position — rather than as a one-time correction.
Why we often combine threads with Sculptra
Threads and Sculptra work by the same underlying mechanism: both stimulate your own collagen. Threads add a mechanical lift and lay collagen along a defined vector; Sculptra builds collagen diffusely across a broader area to restore structure and volume. Used together, they address lift and foundation at the same time, and the collagen response from each supports the other.
This combination is a particular strength of our practice. Galderma has ranked us, year after year, as the #1 single-location Sculptra provider in Washington State and among the top 10 providers nationwide, so our injectors are unusually experienced at planning collagen-based treatment across a whole face rather than treating one area in isolation.
Threads can also be combined with hyaluronic acid fillers or neuromodulators in the same visit. Your injector will sequence them appropriately.
Thread lift compared with other options
| PDO thread lift | HA filler | Sculptra | Deep plane facelift | |
|---|---|---|---|---|
| How it works | Mechanical lift plus collagen along the thread | Adds volume directly | Stimulates diffuse collagen | Surgically repositions deep tissue |
| Amount of lift | A few millimeters | Indirect, through volume | Indirect, through structure | Substantial and definitive |
| Best for | Mild laxity, early jowling | Volume loss, contour | Global collagen loss | Moderate to severe laxity |
| Duration | About 1 year | 6–18 months | 2+ years | 10+ years |
| Downtime | Minimal | Minimal | Minimal | 2–3 weeks |
| Anesthesia | Topical and local | Topical | Topical | General or IV sedation |
What are the risks of a thread lift?
Thread lifts are low-risk compared with surgery, and because no incisions are made there is essentially no risk of scarring. The complications that do occur are usually minor and self-limited:
- Visible or palpable threads. Reported in roughly 1–5% of cases, more likely in thin skin.
- Dimpling or puckering at entry points or along the thread. Usually resolves on its own or with gentle massage.
- Bruising and swelling — common, and expected for several days.
- Asymmetry, which may need a further thread to correct.
- Thread migration or extrusion — uncommon with absorbable threads.
- Infection — rare, and treated with antibiotics.
- Under-correction. The most common disappointment is not a complication at all, but a patient who needed a facelift and hoped threads would substitute.
How much does a thread lift cost?
$1,500 per region, which typically includes about four threads. The number of regions depends on your anatomy and goals; many patients treat one or two.
Thread lifts are cosmetic and are not covered by insurance. See our pricing and purchasing terms and financing options.
Who performs thread lifts at our practice?
Thread lifts are performed by our injectors rather than by Dr. Naficy. Most of our injection team is trained and experienced in thread placement. We perform 100 to 125 thread treatments a year.
Two members of our injection team hold national trainer appointments — one as an Allergan National Trainer and one as a Galderma GAIN Trainer — and our injectors work inside a surgical facial plastic surgery practice. That matters for a treatment like this: the same team that places your threads can tell you honestly when threads are the wrong answer and a surgical consultation with Dr. Naficy is the right one. Individual credentials are listed in our staff biographies.
Frequently asked questions
Is a thread lift painful?
Most patients describe pressure and tugging rather than pain. Topical anesthetic and local anesthetic at the entry points make the procedure well tolerated. Some tenderness for a few days afterward is normal.
How soon will I see results?
There is an immediate lift from the threads themselves, though it is partly obscured by early swelling. The settled result appears over two to four weeks, and the collagen contribution continues building for two to three months.
Can a thread lift replace a facelift?
No. A thread lift produces a few millimeters of lift lasting about a year. A deep plane facelift repositions the deeper tissues of the face and lasts a decade or more. They are not substitutes for one another, and we will tell you plainly at consultation which one your anatomy calls for.
What happens when the threads dissolve?
The threads are absorbed by your body over four to six months without leaving scar tissue. The collagen laid down along the thread path persists beyond that, which is why the visible result outlasts the threads themselves.
Can I have a facelift later if I have had threads?
Yes. Absorbable PDO threads dissolve completely and do not complicate later surgery. This is unlike permanent fillers, which can make dissection more difficult.
How many threads will I need?
Typically about four per region. Your injector will assess this at consultation.
Can threads be combined with Sculptra or filler?
Yes, and combining threads with Sculptra is a particularly effective pairing because both stimulate collagen. Fillers and neuromodulators can also be performed in the same visit.
Is there any downtime?
Minimal. Most people return to work the next day. You should avoid strenuous exercise, facials, dental work, and wide mouth opening for about two weeks.
What if I do not like the result?
Because the threads absorb, any result is temporary and will resolve. Asymmetry or under-correction can usually be addressed by adding a thread.
Are thread lifts FDA-cleared?
Yes. PDO threads are FDA-cleared for soft tissue approximation and, for certain products, for midface and brow lifting. Only PDO and PLLA/PGA thread types are cleared for use in the United States.
How often can I repeat treatment?
Most patients who continue with threads repeat annually, as the previous threads have fully absorbed by that point.
Will the threads be visible under my skin?
Usually not, but visible or palpable threads occur in roughly 1–5% of cases and are more likely in thin skin. Placement depth is chosen to minimize this.
Before and after photos
View our before and after photo gallery.
Next steps
The most useful thing a consultation does for a thread lift is tell you whether you are a candidate at all. If your laxity is beyond what threads can address, we will say so and discuss the alternatives.
Schedule a consultation or ask us a question.
Medically reviewed by Sam Naficy, MD, FACS, board-certified facial plastic surgeon and medical director, Naficy Plastic Surgery & Rejuvenation Center, Bellevue, Washington.
