The original threads were simple, single lengths of thread folded in two and mounted on a needle. These are still used, primarily to improve skin tone and quality. These are known as “mono” threads and form the mainstay of a treatment to restore the balance between the lower and upper face. They improve the tone of skin in the lower face thereby reducing the heaviness of the appearance.

There is an ever-increasing range of different shapes, sizes, formulations and presentations of threads designed to add volume to the face such as the nose to mouth area, cheeks and chin.

Threads are an interesting alternative to fillers and may well be more commonly used in the future. Further developments in this area is PDO powder being used as a collagen stimulator – threads have gone full circle to become an injectable filler!!


The treatment can be a bit more invasive than a filler and there can be some swelling afterwards. A numbing injection is used at the insertion points of the threads. The passage of the thread through the tissues feels strange and smarts a bit for a few minutes, then subsides. Once the treatment has finished you might feel a bit tender and fatigued. The overwhelming sensation is one of tightness, which is reassuring. For the next week there can be momentary stabbing sensations associated with the threads settling in.

There can be some bruises which will last up to a week.


Threads are not surgery so any excess skin or tissue is not cut out. The spare skin forms a small fold which smooths itself out within a few days. The “gathering” normally shows at the ear or other insertion site. Skin has an amazing capacity to shrink or stretch to the given length, so by shortening the skin by threading it rapidly adjusts to its new dimensions.

When do I see results?

Although there Is an immediate lift, the face can relax a bit after the treatment. Over the next three months the results pick up again as the body creates new collagen, using the thread as a matrix.

How long do the results last?

In general the results last for up to a year.

What place can threads play? Are they essential for lifting the face?

The main cause of facial sagging and looking tired is volume loss. Sagging due to skin laxity is a much later occurrence. However additional ageing due to smoking, sun exposure, sudden or excessive weight gain or weight loss, severe illness or medication can render the skin lax and make threads a more attractive option in a younger person.

  • Threads can offer an alternative to volumizing fillers for those who do not want any more volume.
  • Volume and lift are a fine balance that can be achieved by combining threads with fillers.
  • Ideally the volume should be corrected prior to using threads.

As our understanding of threads increases (and the media stops looking for hype) we appreciate that threads can provide the lift not achieved by fillers. There is no such thing as a lunch time lift – what we need to be thinking about is a regular programme of fillers, threads, skin care and toxin to maintain our faces as we strive for a long, healthy life looking good.

Ideal candidates

The best candidates for threading are those with good quality tissues, toned skin with little excess fat deposits. These people tend to be younger with tighter faces in the first place, which seems contrary. Heavy jowls in less than perfect tissues are not always easy to life. Soft, loose tissues do not hold onto the thread mechanism so well.

To overcome this we can use more threads, or perform two treatments about 4 weeks apart to really “rev up” the collagen making process. Treatments that stimulate tissue activity such as microneedling, peeling, Profilho, Juvederm Volite can be used to improve tissue tone prior to threading.

Choosing your thread

The first question should be “am I suitable for a thread treatment” and then “which thread should I chose?”. As a general rule PDO threads are easier to insert, less invasive and achieve a more generalised result. They work well on the cheek and jowl area. Silhouette is a more substantial thread system, is more invasive but can be more effective on the jawline, cheeks and the neck.