Thread Lift

Dr. Godley: It is important to understand what a thread lift is designed to achieve. It does not provide the same degree or longevity of correction as a surgical facelift. For an appropriate candidate, however, it can offer a refreshed and lifted appearance while preserving their natural features. Many of my patients want a noticeable improvement with significantly less downtime than surgery. They want to look refreshed and still look like themselves. The key is matching the treatment to the patient’s anatomy and expectations. If someone has significant excess skin or wants a greater degree of correction we need to discuss whether surgery would better meet their goals.

Dr. Godley: The threads gradually dissolve but the collagen they stimulate can continue supporting the skin beyond that point. This collagen-related support may continue for 12–24 months, although the visible lifting effect and duration of results vary.

Maintenance treatments may help sustain the improvement. Depending on the patient, we may also consider complementary treatments such as biostimulatory fillers like Radiesse, Sculptra or PRF as part of an ongoing treatment plan.

Dr. Godley: Yes, a previous thread lift does not necessarily automatically rule out a surgical facelift. Threads can be an option for patients who wish to defer surgery while leaving open the possibility of considering it later. My surgical colleagues have recommended allowing around a year between a thread lift and a subsequent facelift. However, the surgeon needs to determine the appropriate timing based on the threads used, their placement and the patient’s tissue response. An experienced facial surgeon can assess these changes and plan the procedure accordingly. It is important to share your full treatment history when discussing surgery.

For more on recovery, results and common misconceptions, read our 7 Thread Lift Myths You Shouldn’t Believe.

Dr. Godley: We all like immediate gratification but patients need to allow time for healing after a thread lift. Swelling can occur from inserting the cannula, administering local anaesthetic and the tissue’s response to the procedure. In my practice, I describe the more noticeable swelling during the first week to ten days as “macro swelling.” Less visible swelling beneath the surface, which I call “micro swelling,” can persist for two to four weeks on average. These are approximate timelines, and recovery varies between patients. That early swelling can make it difficult for patients to judge their results. Sometimes they worry the treatment has not worked because they are assessing it too soon. In my practice I encourage patients to allow 4 weeks and up to ten weeks before we assess the more settled thread lift results. The tissue response and collagen production develop over time, so the appearance immediately after treatment does not tell the whole story

Many patients can return to light everyday activities within 24–48 hours. However, that does not mean all swelling or bruising will have disappeared. As we discussed earlier, the tissues continue healing beneath the surface. Patients should follow their personalised aftercare instructions, including temporarily avoiding strenuous exercise and exaggerated facial movements. It is important to allow some flexibility in your schedule because recovery varies between individuals

Dr. Godley: I use those terms to help explain the difference between swelling that patients can see and the healing that continues beneath the surface. During roughly the first ten days, patients may notice what I describe as “macro swelling.” Friends and family might not notice it as much, but the patient can often see or feel a difference in the treated area.

As the visible swelling settles, there can still be tenderness or a feeling of fullness beneath the skin. This is what I refer to as “micro swelling.” I sometimes compare it to a sponge that looks dry on the outside but is still wet on the inside. You expect it to feel light when you pick it up, but it feels heavier than expected. Similarly, the treated area can feel fuller or heavier even when there is less visible swelling. The recovery experience varies between patients.

Dr. Godley: There are two things to consider: the material the thread is made from and its design.

Common materials include PDO (polydioxanone), PLA (polylactic acid) and PCL (polycaprolactone). I am particularly interested in PLA threads for their longevity and potential to stimulate collagen production.

The different thread designs serve different purposes:

• Cog or barbed threads have small projections that grip the tissue, allowing us to lift and reposition it.

• Mono threads are smooth threads used primarily to stimulate collagen and improve skin quality, rather than physically lift tissue.

• Screw threads have a spiral or twisted design and are used to encourage collagen production and subtle fullness in selected areas.

You may also have heard of brands such as Aptos, Silhouette InstaLift and Silhouette Soft, all of which I have experience with.

Choosing the threads is only part of the process. The placement technique, tissue quality and the outcome we are trying to achieve all help guide the treatment plan.

For a closer look at the different materials and designs, read our Thread Lifting Essentials guide.

Dr. Godley: I have been performing thread lifts since 2018. My training has taken me to Eastern Europe, the United States, Japan and Canada.

Dr. Godley: Tissue quality and the degree of skin laxity are important considerations. As we age the tissues can become less dense and the skin can become looser. When there is significant laxity or limited tissue support, a thread lift alone may not provide the outcome we are hoping to achieve.

That is why assessing the tissues before treatment is so important. In some cases, I would consider preparation before deciding whether to proceed with threads.

Dr. Godley: In selected patients, I may recommend a collagen-stimulating treatment, such as Radiesse or Sculptra, before considering a thread lift. The aim is to improve tissue quality and support. Radiesse contains calcium hydroxylapatite, and it is one of the treatments I use as part of this approach. This is a process that takes time. We may be looking at several months of preparation and reassessment rather than proceeding directly to threads. For some patients improving the tissues first may make a thread lift a more suitable option.