What is a thread lift, or non-surgical facelift?

A threadlift is a current facial rejuvenation technique used my many practitioners with the goal of performing a brief procedure and instantly restoring a more youthful appearing face or neck shape. While the procedure’s popularity has increased recently, the technique has been around for many years. A thread lift is performed in the office setting with the patient going home the same day.

The procedure involves making small tunnels underneath the skin and placing absorbable, barbed suture material, which are called “threads”. The barbs on the sutures then catch the soft tissue beneath the skin and can be used to tug on them to create the desired changes in facial shape. The suture materials currently used today are absorbable, and dissolve over time through an inflammatory absorption reaction. It is important to understand that a thread lift relies on creating tension and pull to get an effect. This is the exact opposite of today’s advanced facelift procedures which work by gentle, tension-free soft tissue repositioning underneath the skin.

Complications of the procedure include redness and swelling of the skin, dimpling and bunching of the skin, creation of scar tissue, visibility of the threads or thread extrusion, and hair loss. Scar tissue that is created from the slow absorption of the suture and the trauma of suture placement can also make the procedure difficult to reverse if the patient is not pleased with the results.

Who can perform a thread lift?

Thread lift procedures are becoming increasingly popular as recommended treatments by non-surgical providers within the facial cosmetics field. While the treatment is invasive because it is implanting a foreign material beneath the skin all throughout the face and neck, it is not considered a truly surgical procedure. There are several different branded names for the procedure. Most providers attend a training course or learn “on-the-job” prior to incorporating the treatment into their offerings.

Who is a good candidate for the thread lift procedure?

It is important for patients to understand that the thread lift procedure was never designed to be permanent. A recent study published in one of the most prominent plastic surgery journals found that there was an immediate improvement noted by most patients after the treatment (1). Within 6 months the results started to fade. By 1 year the results had worn off and were gone. This study confirmed other studies written about the procedure over the last 10 years or so (2,3).

Because of the relatively short life-span of the procedure, it is really best used for patients who want a quick, subtle refresh for a short period of time and do not have the time or financial freedom to pursue more long-lasting treatments for facial rejuvenation. 

A theoretical example of this is someone who has a social event coming up in a few weeks. The recovery period for a facelift would be prohibitive, but a thread lift could give the patient a nice “quick fix” for the event while realizing that the results are not long-lasting. Most “before and after” style photographs for patients to see online show the patient immediately after the procedure. This is done because this is when the contour change is most visible and the subtle swelling and inflammation from the procedure makes the face appear smoother and the rejuvenation effect seem stronger.

Conclusions

In summary, thread lift procedures, or non-surgical facelifts are not new. Recently, different suture designs and materials have been advertised heavily and the procedure is experiencing an increase in popularity. It’s risk profile is relatively low but not zero. Some papers have shown that up to 34% of patients may have some form of post-treatment complication. 

Thread lift may be good for patients looking for a rapid recovery and subtle change as long as they understand the results are not long lasting and may not be cost-effective over time if they choose to undergo the procedure repeatedly over time.

Bibliography

  1. Dario Bertossi, Giovanni Botti, Alessandro Gualdi, Piero Fundarò, Riccardo Nocini, Ali Pirayesh, Berend van der Lei; Effectiveness, Longevity, and Complications of Facelift by Barbed Suture Insertion, Aesthetic Surgery Journal, Volume 39, Issue 3, 15 February 2019, Pages 241–247, https://doi.org/10.1093/asj/sjy042
  2. Abraham, Rima F., Robert J. DeFatta, and Edwin F. Williams. “Thread-lift for facial rejuvenation: assessment of long-term results.” Archives of facial plastic surgery 11.3 (2009): 178-183. https://jamanetwork.com/journals/jamafacialplasticsurgery/fullarticle/407369
  3. Obourn, Chelsea A., and Edwin F. Williams. “A Decade of Thread-Lifting—What Have We Learned Over the Last 10 Years?.” JAMA facial plastic surgery 20.5 (2018): 349-350. https://jamanetwork.com/journals/jamafacialplasticsurgery/article-abstract/2688163

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