Minimally Invasive · Suture Suspension · Facial Lifting

Thread Lifting

How this page was made
This page was written with AI assistance and reviewed against the sources listed under References below. It is general information only, not medical advice. See our full disclaimer for how SHEA creates and reviews treatment information.
01

What it is

Thread lifting is a minimally invasive procedure in which sutures are placed beneath the skin to reposition facial tissue. Modern techniques commonly use absorbable sutures, including polydioxanone (PDO) and other absorbable materials.

The procedure is intended to create a lifting effect without surgical facelift incisions. Available research supports visible short-term improvement in appropriately selected patients, but the degree and durability of improvement vary, and current evidence does not support treating thread lifting as equivalent to a surgical facelift.

02

Why people consider it

  • They are considering a minimally invasive treatment for mild facial sagging or changes in facial contour
  • They want a lifting procedure without undergoing a surgical facelift
  • They are willing to consider a more limited result in exchange for a less invasive procedure
03

What the experience is like

Threads are inserted beneath the skin along selected treatment paths. The number of threads, suture design, material, placement technique, and areas treated vary according to the product and treatment plan.

Swelling, bruising, skin dimpling, numbness or tingling, and awareness of the thread beneath the skin are among the complications reported in clinical studies. Many reported reactions are temporary, but some complications can require additional treatment.

04

Limitations & considerations

  • A 2021 meta-analysis of 26 studies estimated pooled complication rates of 35% for swelling, 10% for skin dimpling, 6% for paresthesia, 4% for visible or palpable threads, 2% for infection, and 2% for thread extrusion
  • The studies included different thread materials, techniques, patient groups, and follow-up periods, so pooled complication figures should not be treated as exact predictions for an individual procedure
  • Absorbable threads had lower pooled rates of paresthesia and thread extrusion than nonabsorbable threads in the 2021 meta-analysis
  • Short-term aesthetic improvement has been reported with modern absorbable thread techniques, but long-term durability remains uncertain
  • Different thread products and techniques should not be assumed to have identical effectiveness, complication rates, or durability
  • No specific degree of lift or duration of result can be guaranteed
Evidence note
A 2019 literature review found that older nonabsorbable barbed-suture techniques had higher revision and complication rates, while newer absorbable techniques appeared to have fewer adverse events. The authors concluded that long-term efficacy remained unclear.
A 2021 systematic review and meta-analysis included 26 studies and produced pooled estimates for complications including swelling, skin dimpling, paresthesia, visible or palpable threads, infection, and thread extrusion. The authors also found that long-term satisfaction was lower than satisfaction measured shortly after treatment.
A newer systematic review of absorbable facial thread lifts included 12 studies involving 818 patients. Measures of aesthetic improvement generally improved immediately after treatment, while the longest follow-up among the included studies was two years. The authors concluded that thread lifting can produce immediate improvement in appropriately selected patients and that dangerous complications appear uncommon, but long-term efficacy data remain lacking.
Smaller product-specific studies should be interpreted more narrowly. A Korean retrospective review of 31 PDO thread-lifting procedures reported favorable physician-rated outcomes but had no control group. A separate study of 100 patients evaluated the Silhouette InstaLift suspension system; its findings apply to that specific product and should not automatically be transferred to the PDO and other thread systems used by different clinics.

References

Peer-reviewed literature.

1. Tong LX, Rieder EA. Thread-lifts: a double-edged suture? A comprehensive review of the literature. Dermatologic Surgery, 2019;45(7):931–940.
Peer-reviewed · Comprehensive literature review
2. Niu Z, Zhang K, Yao W, et al. A meta-analysis and systematic review of the incidences of complications following facial thread-lifting. Aesthetic Plastic Surgery, 2021;45(5):2148–2158.
Peer-reviewed · Systematic review & meta-analysis · 26 studies
3. Update on Absorbable Facial Thread Lifts. Dermatologic Surgery. Published online 2024.
Peer-reviewed · Systematic review · 12 studies · n=818
4. Suh DH, Jang HW, Lee SJ, et al. Outcomes of polydioxanone knotless thread lifting for facial rejuvenation. Dermatologic Surgery, 2015;41(6):720–725.
Peer-reviewed · Retrospective review · n=31 · PDO-specific
5. Ogilvie MP, Few JW, Tomur SS, et al. Rejuvenating the face: an analysis of 100 absorbable suture suspension patients. Aesthetic Surgery Journal, 2018;38(6):654–663.
Peer-reviewed · n=100 · Silhouette InstaLift-specific · Manufacturer relationship disclosed
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