As we age, our skin loses elasticity and becomes more fragile. The skin stops producing natural oils, key hydration molecules such as hyaluronic acid, and collagen.  Exposure to UV light speeds the process of aging because it breaks down the connective tissue in our skin. The loss of volume and strength in our skin means that it is no longer able to support the tissues beneath it. This causes it to become lax and gravity pulls the skin downward, which leads to sagging jowls and cheeks.

The procedures to correct cosmetic concerns stemming from facial laxity range from subtle to more dramatic. Laser resurfacing and soft tissue fillers can help impart a more youthful and refreshed appearance, but they do not eliminate excessive or sagging skin.

A facelift surgery will tighten the underlying muscles and tissues, but healing times can take considerable time. For those interested in correcting the appearance of loose skin due to aging, but who are not willing or able to undergo facelift surgery, a thread lift can bridge the gap between resurfacing and surgery.

What is a thread lift?

A thread lift is a minimally invasive procedure where absorbable sutures made of polydioxanone (PDO) are inserted into the skin via a hypodermic needle or blunt cannula. It can lift and tighten the face where the barbed sutures are placed. It also induces a selective inflammatory response, which in turn, stimulates the production of collagen. This is the body’s natural response to foreign objects present in the dermis, and it occurs when the sutures are placed.

Patients who have a thread lift will experience progressive improvement, as the new collagen thickens, strengthens, and hydrates the skin. Skin will appear less wrinkled and have improved elasticity. Between four to six months after insertion, the sutures will be fully absorbed in the skin and replaced with new collagen.

Depending on the patient’s aesthetic goals and age, different types of threads may be used in the procedure. The two primary types of threads are barbed threads and straight/twist threads. The former is typically used when increased lifting is necessary to achieve desired results, while a combination of straight/twist threads are used to stimulate mild collagen production.

What makes PDO thread different/better?

Since thread lifts are noninvasive, they have fewer risks and less downtime than facelift surgery. They are sometimes referred to as a “lunchtime lift” because the process is usually completed in less than an hour. Patients are given local anesthesia, rather than general anesthesia, and have a reduced recovery time. Since it does not require general anesthesia, it is safer for people who have conditions such as high blood pressure, type two diabetes, or cardiovascular disease.

Polydioxanone, used in the monofilament sutures or PDO threads, is one of the safest materials that can be inserted into the skin. In fact, polydioxanone is the type of suture used in cardiac surgeries.

Other types of threads

The other two types of materials used in threads are poly-l-lactic acid (PLLA) and polycaprolactone (PCL). PLLA threads cause less inflammatory response than PDO, while delivering similar or better results. PLLA threads dissolve after 12 to 18 months, while PDO threads dissolve by six months.

PCL threads are not as commonly used or popular as PDO and PLLA threads, since they take two or three years to be dissolved. The slower degradation can lead to longer lasting results; however, since they are more inflexible than PDO threads, there is a greater risk of inflammation, discomfort, and other side effects.

What can PDO thread treat?

Popular treatment areas are the neckline, premature sagging of the neck skin, the forehead and eyebrows, and under the eyes. In recent years, the use of threads has progressed to rejuvenating skin on the arms, thighs, abdomen, and buttocks.

Since PDO threads commonly lift the skin by only a few millimeters, it is a good option for patients who desire natural-looking results for firmer skin. The ideal candidate for a thread lift has mild to moderate signs of skin laxity, and is usually in their late 30’s to early 50’s.

How long do the results last?

A thread lift can last one to three years, and additional treatments can extend the results even further. While it doesn’t have the long-term results of a traditional facelift (which can last up to a decade), the convenience, cost, and low risk of complications make it a good option for many people. Since it is low risk, patients that are happy with the results of their initial treatment are typically able to have another thread lift once the initial sutures are absorbed by the body.