Threads

Threads

What’s New in Aesthetic Plastic Surgery: Non-Surgical Thread Lifting

Non-surgical thread lifting is among the most advanced techniques in aesthetic plastic surgery for both the face and body.

Thread lifting provides a youthful, fresh, and firm appearance to the face without a scalpel, especially when the facial oval begins to lose definition.

Threads are fully absorbable, requiring no incisions or sutures. This results in lifting, rejuvenation, contour improvement, and smooth, flawless skin.

Types of Threads and Application Sites

There are two main types of threads: PDO threads and COG threads.

PDO Threads (Polydioxanone)
These are extremely fine, absorbable sutures, even thinner than a human hair. When inserted into the face or body, their action is threefold:

  • They trigger a “foreign body” reaction, stimulating new collagen synthesis.
  • They stimulate elastin fibers and hyaluronic acid production for a youthful skin appearance.

COG Threads
COG threads are thicker and feature small barbs along their surface. These barbs immediately lift the tissue upon insertion into the facial skin. COG threads are typically not used for the body.

Thread Application Procedure

PDO Threads
A topical anesthetic cream is applied one hour before treatment, followed by gentle antisepsis. Threads are inserted into the target area using fine needles. Placement depth can involve the dermis or subcutaneous fat. The procedure typically takes 10–30 minutes, depending on the number of threads.

COG Threads
The process is similar to PDO threads, but local anesthesia may be applied at entry points and along the path of the threads.

Application Sites

PDO Threads can be used on the face for: eyebrow lifting, nasolabial folds, glabellar lines, cheeks, marionette lines, smoker’s lines, and overall facial contour.
On the neck: to improve laxity, reduce double chin, and refine contours.
Also applicable to: abdomen, buttocks, and lower limbs.

COG Threads are usually applied to the face, 2–5 per side, mainly to lift the facial oval and deep nasolabial folds.

Post-Treatment Expectations – Threads

PDO thread results are not immediately visible. Mild swelling may occur but typically subsides in a few days. By approximately day 15, the body’s reaction begins with collagen formation, peaking at 3–5 months. Visible results last 12–16 months. The skin becomes thicker, with improved tone, elasticity, and reduced fine lines.

PDO threads are fully biodegradable; within 12 weeks they are absorbed, leaving a network of collagen, elastin, and hyaluronic acid.

COG threads provide immediate lifting. Their absorption period is longer, around 5–6 months, but results can last 18 months or more.

Contraindications
Threads should not be used in:

  • Active acne
  • Active herpes labialis or dermal herpes
  • Any active skin disease in the treatment area
  • Recent anticoagulant medication (past 5 days)
  • Pregnancy or breastfeeding
  • Autoimmune disorders
  • Uncontrolled diabetes

Post-Treatment Care

  • Avoid activities that may worsen inflammation: sauna, hot baths, alcohol consumption on the treatment day.
  • Ice packs may be applied to the treated area for up to 10 minutes, up to 5 times daily for 3–4 days.
  • Apply antibiotic cream as prescribed for 48 hours.
  • Limit facial movements for 24 hours; avoid exaggerated expressions.
  • Avoid makeup for 48 hours.
  • Pat dry after washing; do not rub the face.
  • Oral painkillers may be used; avoid NSAIDs for 2 weeks. Mild inflammation is desirable for optimal results.
  • Use a higher pillow on the first night to reduce swelling.
  • Avoid pressure on the face, especially on the cheeks.
  • Limit strenuous activities for 24 hours; normal activities may resume after 2–3 days.

References

  1. Wanitphakdeedecha, R., et al. (2021). Absorbable Barbed Threads for Lower Facial Soft-Tissue Repositioning: Prospective Evaluator-Blinded Study. Dermatologic Surgery.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC8322220
  2. Su, D., et al. (2024). Experimental investigation of biostimulatory effects after PDO thread insertion compared to PGLA and nylon threads. Journal of Cosmetic Dermatology.
    https://onlinelibrary.wiley.com/doi/10.1111/jocd.15966
  3. Hong, G. W., et al. (2025). Post-Procedural Considerations and Thread Types for Facial Thread Lifting: U-shaped vs I-shaped.
    https://www.mdpi.com/2075-1729/15/1/85