Cosmetic threading is a minimally invasive procedure where a practitioner inserts dissolvable medical-grade threads beneath the skin to lift sagging tissue and stimulate new collagen production. Sometimes called a “thread lift,” it’s designed as a middle ground between injectable treatments like fillers and full surgical facelifts. The procedure takes about an hour, uses local anesthesia, and produces results that typically last 6 to 24 months depending on the type of thread used.
How Thread Lifts Work
The basic concept is straightforward: a thin needle called a cannula is used to place threads under the skin, where they either physically reposition sagging tissue or act as a scaffold that triggers your body’s healing response. When your body detects the thread as a foreign material, it launches a mild inflammatory reaction around it. That reaction stimulates the production of new collagen and increases the density of the surrounding skin tissue. Over time, even after the threads dissolve, the collagen framework they prompted can maintain some of the structural improvement.
There are two broad categories based on how they work. Lifting threads have barbs or hooks that grab onto tissue and physically pull it upward, creating an immediate visible lift. Biostimulating threads are smoother and work primarily by triggering that collagen-building response rather than mechanically repositioning skin. Many procedures use a combination of both.
Types of Threads
Threads differ in both their physical shape and their chemical composition, and each combination suits different goals.
Shape and Structure
- Mono threads are smooth, single-strand threads that tighten skin and boost collagen. They work well for fine lines on the forehead, under the eyes, and for mild neck sagging.
- Cog threads have barbs or hooks that anchor into tissue, providing the strongest lifting effect. They’re used for jawline definition, cheek lifting, and heavier skin folds.
- Screw threads are coiled or intertwined, designed to add volume to sunken areas. They’re especially effective for nasolabial folds (the lines running from nose to mouth), hollow cheeks, and deep wrinkles.
Thread Materials
The three main materials dissolve at different rates, which directly affects how long results last. PDO (polydioxanone) threads are the most common and are absorbed by the body within 6 to 8 months. PLLA (poly-L-lactic acid) threads take about 12 months to dissolve and can maintain their effects for 18 to 24 months. PCL (polycaprolactone) threads are the newest option, known for being more flexible and causing less discomfort. They dissolve over 12 to 18 months and eventually break down into carbon dioxide and water.
All three materials are biodegradable and have been used in various FDA-approved medical devices, including surgical sutures.
Who It’s Best For
Thread lifts work best for people with mild to moderate skin laxity. According to the American Society of Plastic Surgeons, the ideal candidate is usually in their late thirties to early fifties. People over 55 generally see more dramatic improvement from surgical facelifts, though threading can be a useful alternative for older patients who can’t undergo surgery due to conditions like high blood pressure, type 2 diabetes, or cardiovascular disease. Because the procedure only requires local anesthesia, it carries far fewer risks for these patients than general anesthesia would.
If your skin has significant sagging or you’re looking for results that last years rather than months, a surgical facelift will deliver more. Threading is better suited for someone noticing early jowling, mild cheek drooping, or neck laxity who wants improvement without the downtime and cost of surgery.
What the Procedure Feels Like
The entire process takes about an hour. Your practitioner applies local anesthesia to the treatment area, so you’re awake but shouldn’t feel pain during insertion. A thin cannula is used to guide threads into position beneath the skin. The number of threads varies widely depending on the treatment area and your goals. Some targeted treatments use just a few threads, while a full-face procedure may use dozens.
You’ll likely notice an immediate lifting effect with cog threads, though the final result develops over several weeks as swelling subsides and collagen production ramps up.
Recovery and Restrictions
Recovery is relatively quick compared to surgery, but the first week requires some specific precautions to protect thread placement.
For the first 24 to 48 hours, avoid touching or washing your face, applying makeup, or doing anything strenuous. Sleep on your back with your head elevated for at least 3 to 5 nights, as side or stomach sleeping can put pressure on the threads and shift their position. Gentle walking is fine after 3 to 5 days, but high-impact workouts, heavy lifting, saunas, and steam rooms should wait at least 1 to 2 weeks.
Avoid facial massages, exaggerated expressions, and chewing hard foods, especially if threads were placed near the jawline. Dental work should also be postponed during the initial recovery period, since opening your mouth wide can strain the treated area.
How Long Results Last
A large multicenter review of over 110,000 thread lift cases found the average longevity of visible lifting effects is approximately 6 to 12 months, depending on the thread material and the area treated. PDO threads tend to show results for 6 to 8 months. PLLA threads can maintain effects for 18 to 24 months. PCL threads fall somewhere in between, with some providers reporting results lasting up to 12 months or slightly longer.
The collagen stimulation triggered by the threads can provide some residual skin quality improvement even after the threads dissolve, but the lifting effect itself gradually diminishes. Many people schedule touch-up treatments to maintain their results.
Potential Side Effects
A meta-analysis of thread lifting complications found that swelling is the most common side effect, occurring in about 35% of patients. This is typically temporary. Skin dimpling, where the skin surface looks slightly uneven, affects roughly 10% of patients. Temporary numbness or tingling (paresthesia) occurs in about 6%. More serious but less common issues include thread visibility or palpability under the skin (4%), infection (2%), and thread extrusion, where a thread works its way out through the skin (2%).
Absorbable threads carry lower risks than permanent ones. Patients treated with absorbable threads experienced paresthesia at a rate of 3.1% compared to 11.7% with non-absorbable threads, and thread extrusion dropped from 7.6% to 1.6%. Patients over 50 face higher rates of dimpling (16% vs. 5.6%) and infection (5.9% vs. 0.7%) compared to younger patients.
Cost Breakdown
Pricing depends heavily on the treatment area, the type of thread, and how many threads are used. In the United States, a PDO thread lift generally costs between $700 and $4,500. A targeted treatment for just the neck or jawline typically runs $800 to $1,000. Treating the cheeks or brows costs $1,200 to $1,800. A full-face treatment including the neck and jawline starts around $2,000.
The individual thread costs reflect the difference in complexity: smooth collagen-stimulating threads run $20 to $40 each, while barbed lifting threads cost $200 to $500 per thread. Since results are temporary, you should factor in the cost of future touch-up sessions when comparing threading to longer-lasting surgical options. Most insurance plans do not cover cosmetic threading.