Not one week goes by when I don’t see a new patient who wants “a bit of a lift” to sagging tissue and believes threadlifts (not mono threads) with either barbs or cones that temporarily reposition sagging tissues, are the solution.

The vast majority of the time over the last few years on assessment they’ve not been suitable candidates and I’ve encouraged them to consider actual plastic surgery if it is enough of an issue or to consider other non surgical and minimally invasive options to address their concerns as part of a holistic plan to age well. 

I briefly offered threadlifts some years ago, buoyed by the hype around it and frequent patient requests as well as posts by influencers about their own results. 

Disappoitingly I found that for the spend ($3500-4500 on average for enough threads to do a good job), the results were disappointing - the lift lasted mere weeks; as early as 2-3 months tissue was back to where it belonged due to gravity. Any collagen induced takes weeks to months to form, and there are better options for collagen induction on the market all the time that were far more reliable and less risky. 

More importantly, when I scour the database on evidence, I’m hard pressed to find any reliable source for good results beyond 6 months, if even that.

Due to marketing trickery, many were having threadlifts, and posting their before and immediately after results but surprisingly silent on results at 3, 6, even 12 months. 

If we were honest with people, as we are with anti wrinkle treatments for example, whereby we know results only last 3-4 months at best, they could truly make an informed decision about whether the spend is worth it, but we are often told by companies results last upto 18-24 months, which means in theory, we should have great results to showcase at these timeframes by the companies and providers - there’s none that exists to my knowledge. 

It wasn’t until I began my skin cancer work in ernest, including skincancer surgery on the face, that it clicked for me. The material used in threads is similar to that used in suturing to close wounds. These materials hold the wound together for a few weeks, and then gradually lose their holding strength and are gradually absorbed by the body and removed. So the “lift” logically, would only last a few weeks, and the rest would be dependent on the collagen induced to support tissue. 

Further, during skin cancer surgery, when we sometimes don’t remove enough of the tissue with cancer in it, I advise patients to wait around 3 months to allow skin to stretch and settle before we go back for another round of excision ie skin stretches (which makes sense- think of how it stretches to accomodate pregnancy, weight gain, and then deflates with weight loss) - so how on earth, with only threads to “lift” tissue to reposition them, would we expect them to last? We would not. 

And here’s the clincher - there are easier, safer and more reliable ways to induce collagen that are less involved. Biostimulatory fillers as well as skin therapies such as laser genesis, chemical peels and radiofrequency  microneedling as well as add-ons such as the humble LED light, all work by inducing collagen over a series of treatments. The collagen gradually produced subtly adds volume to the skin, and that shiny, dewy glow but it DOES NOT LIFT. 

So where’s the lie? 

For these and other reasons - including the fact that in order for threads to even look good and to work, you need decent skin quality that is not too thin and not too heavy/ saggy as the threads only allow around 1-2cm of lift before breaking- I largely stopped offering threadlifts despite having had it twice myself with reasonable results. I simply could not justify the cost for the results for the demographic I was seeing - women in their 40s and 50s with significant volume loss and sagging, often significantly sundamaged skin whereas the only group that can be expected to have possibly decent results, are around a decade younger, when there’s hardly any sag, and it’s more of a preventive treatment. 

The closest article I could find that discussed results, admittedly old (2009) in a small sample size  was here

“Thirty-three patients underwent a thread-lift procedure alone or in combination with other facial rejuvenation procedures to the brow, midface, jowl, and neck. Ten patients underwent thread-lifts only, and 23 had thread-lifts with other procedures. Ten additional patients having had non-thread-lift rejuvenation procedures, including lipotransfer, chemical peels, and rhytidectomies, were randomly designated as controls. The mean follow-up period was 21 months (range, 12-31 months). Photodocumentation was obtained at each visit.

Although aesthetic improvement was noted in all groups at 1 month, measurable results persisted to the end of the study for all but the group that underwent the thread-lift procedure only. Aesthetic improvement scores of the non-thread-lift control group were better than the group that underwent thread-lift only. Similarly, when the thread-lift was combined with other procedures, scores were better than when thread-lift was used alone. Statistical significance was demonstrated in both of these comparisons (P < .01).”

So what are the alternatives? 

When I’m consulting with patients my key goal is to understand their concerns, and what they hope to gain from (any) treatment as well as how realistic they are about the degree of their own commitment to the process as these are the factors that will ultimately determine success. 

If sagging is their primary concern, then if they are willing and able, I’d suggest plastic surgery as there is no comparable alternative at present.

For everything else - sundamage, lines and wrinkles, volume loss, pigmentation, textural issues, collagen induction, excess fatty pockets there are non surgical and minimally invasive options available, but not significant and lasting lifting. 

As with all medical aesthetics, my goal and aim in writing this is to inform and to educate you especially given that misinformation is rife in the industry and often informed by lack of education or sadly, greed. 

Always, my honest advice to all patients is to find the one practitioner/clinic that you like, (it does NOT have to be me) feel you can trust, who has your best interests at heart and then stick to them for ALL your medical aesthetics needs.

Going from provider to provider ultimately places you at more risk of not only unwanted complications but also becoming distorted in the process.