What are the differences between the various types of lifting threads (PDO, PLLA, collagen, and barbed threads)?

This article was compiled and medically reviewed by the Plastic and Aesthetic Surgery team at BonBoz Clinic.

When researching thread lifts, many people feel confused by the wide variety of threads on the market, such as collagen threads, PDO, PLLA, or barbed threads (cog threads). Each type has distinct characteristics, and no single type is universally suitable for every condition. Understanding the differences among these threads allows you to have an informed discussion with your doctor to select the most appropriate option for your skin condition and aesthetic goals, rather than simply choosing a popular trend.

Why Are There So Many Types of Threads?

Different types of threads were developed to address specific aesthetic goals and skin conditions—some are designed primarily for tissue lifting, while others focus on skin rejuvenation and stimulation, each with unique properties. Therefore, there is no single "best" thread for everyone; rather, there is the most suitable thread for each individual case. The choice depends on your skin quality, degree of sagging, the treatment area, and your personal goals. This is why a professional consultation and clinical evaluation by a doctor are essential, rather than choosing based on advertisements or the preferences of others.

What Is the Difference Between Smooth (Mono) and Barbed (Cog) Threads?

Generally, threads are categorized into smooth-surface threads (mono threads) and barbed threads (cog threads). Barbed threads are typically recognized for their tissue-lifting and repositioning capabilities, whereas smooth threads are more often utilized for skin rejuvenation, tightening, and structural support. However, the characteristics and suitability of each type depend entirely on individual conditions and goals; neither can be deemed objectively superior for all patients. Your doctor will evaluate the treatment area and skin condition to provide personalized recommendations. You should not rely solely on thread names to determine what suits you without a professional medical assessment.

How Do Threads Differ by Material (PDO, PLLA, etc.)?

Threads are also classified by their material—such as collagen-stimulating threads, or commonly used synthetic polymers like PDO (Polydioxanone) and PLLA (Poly-L-lactic acid)—each differing in longevity and biological mechanism of action within the skin. Every material presents its own advantages and clinical considerations tailored to specific objectives. Because general information regarding thread materials can be confusing, it is best to ask your doctor for a detailed explanation of which material is recommended for you and why. What matters most is that the thread matches your specific condition, not simply having the most modern-sounding name.

Who Decides Which Type of Thread to Use?

The choice of thread should be determined based on your doctor's clinical evaluation of your skin condition, the degree of laxity, the targeted treatment area, and your personal goals, followed by an open discussion to reach an agreement. You are fully entitled to ask why a specific thread was chosen, its pros and cons, and what realistic outcomes to expect. You should avoid self-selecting a thread based on advertisements or price points, as what works well for one person may not be appropriate for another. Aligning your personal expectations with professional medical expertise supports a more realistic and tailored outcome.

What Should You Keep in Mind When Researching Thread Types?

Always choose a reputable clinic with qualified physicians, and engage in thorough consultations to understand which thread type aligns with your skin condition and goals. Be sure to ask about the characteristics of the recommended thread, realistic expectations, and post-procedure care protocols. Be cautious of marketing claims that make exaggerated promises about a specific thread type, as results depend on multiple clinical factors. If you have any uncertainties, an in-person consultation with a doctor will provide far greater clarity than relying on general information found online.

Frequently Asked Questions

Are more expensive threads always better?

Not necessarily. The most effective thread is the one that best suits your skin condition and aesthetic goals, not the most expensive option. A proper clinical evaluation is necessary for accurate recommendations, so it is advisable to ask your doctor why a specific type is recommended rather than deciding based on cost.

Can I choose the thread type myself?

You can express your preferences and goals, but the final clinical decision should rely on your doctor’s professional evaluation of your skin quality and the specific treatment area. This supports the selection of the most suitable thread and sets realistic expectations for your individual case.

Do threads remain permanently in the skin?

Most threads used in aesthetic thread lifting are designed to remain in the skin for a specific period before gradually breaking down over time, depending on the material. Because each material behaves differently, you should consult your doctor to fully understand the exact characteristics and longevity of the recommended thread.

If you are considering a thread lift and are unsure which type of thread is right for you, schedule a clinical consultation with a specialist to receive a personalized recommendation tailored to your skin condition and aesthetic goals.