I was 13 years old when my mother first gave me the skin care talk. In our family bathroom, she introduced me to the concept of “cleanse, tone, moisturize, sunscreen.” (I grew up in sunny Australia, so I learned the importance of sun protection at a young age.) It’s safe to say, that very simple routine has been significantly expanded over the years as my needs have changed — my skin care lineup today is much more intensive. But as I enter my mid-40s, I realize that no amount of topical peptides or luxurious creams are really going to move the needle on collagen depletion, bone loss, or skin laxity. I’ve dabbled with baby Botox and small amounts of filler injections here and there over the years (which I still love), but now I’m seeking out treatments that help my own body generate and rebuild collagen to provide structure and support from within, versus just filling the depleted areas.
I first heard about thread lifts from Vanessa Lee, RN, a world-renowned medical aesthetic provider and founder of The Things We Do in Los Angeles. She was one of the first to really popularize thread lifts in the states and is now a well-known trainer and educator of the procedure. We met at an event where she spoke on a panel I was moderating, and I have been a devoted fan and client ever since. I’ve long admired her natural approach to skin care and aesthetics, and her commitment to educating her followers on both. Yes, she has an A-list clientele (Kourtney Kardashian among them), but her work speaks for itself. When I decided that I was ready to try thread lifts, she was the person I trusted to do the procedure.
What Is A Thread Lift?
Polydioxanone or PDO threads are most commonly used in aesthetic treatments and are made of a synthetic biodegradable polymer. “We have been using PDO sutures for decades in surgery,” says Lee. “They are technically barbed sutures that help hold the tissues. They dissolve and are absorbed over time, and your own collagen takes its place, so it is considered a type of biostimulator.” She notes that PDO is the “most biocompatible”, which means it will cause the least amount of inflammation and reaction when used typically.
How Do Threads Work?
First, a deep assessment is done on what areas of the brow, mid-face, and jawline need to be lifted. Lee says she will draw on her patients to create a facial map, including vectors of where the threads will go. After being cleaned off with alcohol and chlorhexidine, a surgical-grade skin cleaner, the doctor or injector will numb you with lidocaine injection, then do a second round of “tumescent numbing,” where the tracks of the threads will be placed.
“Threads then enter the tissues in the lateral aspect of the face and are moved towards the center of the face, still within the cannula they come in,” says Lee. “Once in the right plane and vector, the cannula is gently pulled out and the thread stays in place in the tissues.” From here, the threads are lifted and the skin tissues “grasp” onto the barbs of the threads and lift with it. It’s then secured in place and the tails of the sutures are cut. Afterwards, they are officially closed and your skin is ready to heal.
Where Can You Get Threads?
Thread lifts can be done in the brows, the mid-face to lift heavy folds instead of filling them, and can also lift the jowls and tighten the jawline.
What’s The Benefits Of Threads Vs. Filler?
Thread lifts are great for helping with mild to moderate laxity of the skin and to help lift the tissues without adding volume. “Usually, if someone wants a nonsurgical treatment for jowls, a provider will try to use dermal filler to volumize surrounding tissues and disguise the jowl,” Lee says. “Threads displace the jowl higher and hold it away from the jawline without adding any volume to the face.”
What Are The Potential Risks Or Side Effects Of Threads?
Like with any procedure, there can be side effects. Lee says the most common for lifting threads is bruising at the entry sites and soreness. “Complications at our office are extremely rare when it comes to threads, but adverse events that can happen are infection and dimpling in the tissues,” she says. “Infections can be avoided by your provider properly and thoroughly cleansing the entry sites and anywhere on the face they may be touching, as well as making sure that for 48 hours, the patient avoids submerging in bodies of water and avoiding touching the entry sites with hands that are unclean. Dimpling or puckering can be avoided by the provider by being in the correct depth — being too superficial [when doing threads] causes dimpling. Also, choosing clients with skin that is too thin can cause dimpling, regardless of depth.”
If you experience a little pucker, Lee notes it usually goes away within days. Deeper puckering that lasts more than a couple of weeks is concerning and should have an radiofrequency treatment done where the puckering occurs; PRFM (platelet-rich fibrin matrix) injections help as well.
Threads have been stigmatized by some plastic surgeons for “not working as advertised” and causing scar tissue that could impact a facelift later on — but Lee says this is only if they aren’t done correctly. “If the provider is forcing their way through tissue in the wrong depths, using low-quality threads, and doing the treatment more than once a year, then yes, you can end up with scar tissue that can make a facelift more difficult,” Lee says. But she notes that she knows many plastic surgeons who have been doubtful of fillers in the past have come around, even becoming trained in doing threads themselves after learning a better technique.
Who Is A Good Candidate For Threads?
Lee says that threads are for the person who is not ready for a surgical procedure (like a facelift) and wants to address skin laxity without adding volume to the face. Also, the best candidates are those who doesn’t have thin, crepey skin and have mild to moderate laxity of the skin tissue.
“I also think it’s important to remind people considering threads that it is not a facelift,” Lee says. “Facelifts can lift by centimeters and we can only lift by millimeters with threads — and it is not permanent!”
How Long Do Threads Last?
Threads will last several weeks in the skin before dissolving, and the results last one to two years.
The Cost
The cost for a thread lift varies, but expect to spend at least $1,000 minimum if you are treating your neck, jawline or face at a reputable provider. At The Things We Do, thread lifts range from $2200 to $3800 depending on which areas are addressed.
My Experience Getting Threads
This isn’t my first rodeo when it comes to thread lifts. I had an upper face thread lift in 2020, followed by a brow thread lift in 2022 (both administered by Lee), and was so happy with the results that I went back in July. This time, I really wanted to pre-treat my nasolabial folds, jowls, and neck, where I have been noticing a general downward trend. After an initial consult to express my concerns, Lee recommended mid-face threads to lift, smooth, and tighten those areas. What I love about thread lifts is how quick (it takes about an hour), painless, and effective they are.
The first thing anyone asks me about threads is “But does it hurt?” I know it’s hard to believe they don’t when you see the videos of Lee inserting needles down my cheeks to insert the threads and then pulling them to create the lift effect, but if you look closer, in many of them I am smiling or talking freely as it’s happening. I cannot feel a thing. This is because Lee is an expert at anesthesia.
After she marked the track from my hairline down to my cheek, she then filled that track with lidocaine before going in with the threads, so the entire procedure is completely pain-free. That said, it is definitely a strange sensation. Even though I was fully numb, I could feel the threads being inserted. I have thick skin, so there is often an initial push needed to get through it, and then Lee slowly inches it down through the tissue via a cannula. Once she gets to her destination, then she removes the cannula, leaving the threads in the tissue and the ends sticking out the side of your face. It’s pretty funny!
Then this is where the “lift” happens. Lee gently pulls on the threads so the barbs lift the tissue and then she secures them in place — this is the only time you will hear any sound throughout the procedure because it makes a clicking noise. It hasn’t ever bothered me because Lee always lets me know what to expect in advance, so nothing is ever a surprise. After that, those ends or “tails” as Lee calls them are cut and closed. During the healing process, that area where the threads were inserted does feel numb to the touch, but the feeling comes back over time; I generally avoid touching that area and brushing my hair post-treatment. Since this is my third time having threads, I knew what to expect but that didn’t mean I was any less nervous. (In fact, I might have been a little more nervous this time around because I knew what was going to happen!) But I knew I was in the safest and most experienced hands and I never experienced any pain throughout the process. Also, the actual procedure is really quick. While the entire appointment is around an hour from start to finish, the actual procedure is really quick — 15 minutes for each side of the face, max.
Post-Threads Aftercare
For the next five days, I was generally pretty uncomfortable, and my face was very sensitive to the touch, but in terms of pain, I only needed some Tylenol for the tension and to help me sleep. I didn’t have a ton of bruising either, but there was definitely noticeable swelling around my temples. “This isn’t a lunchtime Botox treatment,” Lee says. “It is a skin-lifting procedure, so there is definitely more soreness.”
I also didn’t wash my hair for those five days because I didn’t want to touch or disturb the injection points in my hairline — they weren’t painful at all, it just felt weird to. Lee gave me one of her soft spa headbands to wrap around my head, which I wore all day and night to provide additional comfort, support, and protection during the healing process. I took some gentle painkillers before bed, and was told to lie on my back for the next few nights to ensure the threads weren’t disrupted. As a side sleeper, this was probably the hardest part for me. I didn’t exercise or do any strenuous activity for the first five days either and was instructed to do only very light movement (walking) and stretching for the week following.
I kept my skin care routine really simple after the thread lift because you don’t want to touch your face too much. I used the iSClinical Cleansing Complex, Pro Heal Serum, Hydra-Cool Serum, and Moisture Emulsion, as well as the Cosmedix Purity Balance Exfoliating Prep Toner to keep my skin clean and clear. I finished with Cosmedix Peptide Rich Defense 50+ because you should always apply sunscreen, even when indoors.
My Takeaway
This is my third time doing threads, so you know I am a fan of the treatment. While the procedure itself doesn’t hurt, the downtime and sleeping on your side are something to consider. It was about two weeks before I could touch my face with some pressure, but all up, the healing process probably took about a month before I felt completely back to normal.
Now, a couple of months later, I am really starting to see the results. My cheeks are visibly sculpted, my jawline is nicely chiseled, my neck is lifted, and overall, my skin is tighter and plumper, thanks to the new collagen that is being created over time. There is definitely a noticeable rejuvenation and an overall freshness to my appearance that is hard to pinpoint as a viewer. It’s very understated, which I love. I am truly so happy with my results.