Thread Lift — Mini Facelift

Thread lifting is a procedure that involves inserting absorbable threads (PDO, PLLA, PCL, with or without barbs) into the subcutaneous tissue using a cannula to lift sagging areas such as the cheeks, jawline, and neck, while stimulating collagen production around the threads. It is suitable for individuals with mild to moderate skin laxity, aged 35 to 55; the lifting effect is immediately visible and lasts approximately 12 to 18 months, depending on the type of thread used.

Medically reviewed by BS.Ths.CKII Nguyễn Xuân Vũ — BonBoz Clinic

Mechanism

The barbed thread (suspension thread) when placed in the subcutaneous fat layer anchors to the tissue and is pulled upwards towards the temples or jawline, lifting sagging cheeks, smile lines, jawline, and neck. The smooth thread (mesh thread) does not lift but creates a framework that stimulates fibroblasts to produce collagen around the thread, resulting in firmer and thicker skin after 2–3 months. The thread is self-absorbing within 6–12 months; the effects outlast the thread's lifespan due to the formation of new fibrous tissue.

What can thread lifting achieve?

Moderate lifting of the mid-cheek area, defining the jawline, slightly reducing smile lines, tightening a small double chin, and improving skin firmness. It cannot replace surgical facelifts when there is excessive loose skin, cannot remove excess skin, and does not restore volume (filler may be needed if cheeks are hollow). Realistic expectations are to 'turn back a few years' in the lower face, not the results of a surgical facelift.

Indications

Mild to moderate skin laxity in the cheeks, jawline, and neck; individuals aged 35–55 who are not ready for surgery; maintenance after a facelift; combined with HIFU or fillers in an overall rejuvenation plan. The doctor assesses the thickness of the fat tissue (very thin faces may reveal the threads), skin laxity, and elasticity.

Risks to be aware of

Swelling and bruising for 1–2 weeks, a feeling of tightness and difficulty smiling naturally for the first few weeks, rippling or visible threads under thin skin, asymmetry, tissue displacement, exposed thread ends (which need to be cut), infection (rare), temporary facial nerve branch damage (rare), and results not meeting expectations with significant skin laxity. Most rippling and tightness will soften after 2–4 weeks.

At BonBoz

A specialized plastic surgeon conducts a direct examination, assesses the laxity vector and tissue thickness, selects the type and quantity of threads according to the area; candidly discusses when there is significant laxity and thread lifting may not be sufficient. The procedure is performed by the doctor using a cannula under local anesthesia; patients are advised to limit strong facial movements for 2 weeks and return for follow-up in the first and third months.

Technique variants

Smooth threads (mesh)

Non-lifting threads that stimulate collagen production to tighten the skin; suitable for thin, wrinkled skin and the neck.

Barbed threads (anchor)

Lifts sagging tissue in the cheek, jaw, and neck areas; provides immediate results, lasting 12–18 months depending on the material used (PDO/PLLA/PCL).

How is it performed?

Local anesthesia is administered along the path of the thread. The doctor marks the lifting vector and creates a small entry point either in the temporal area or in front of the ear. The barbed cannula is then threaded into the subcutaneous fat layer, following the designed direction. After withdrawing the cannula, the thread is gently pulled to lift the tissue and balance both sides, and the thread ends are cut close to the skin. Smooth threads are placed in a mesh pattern in the area requiring skin tightening. The procedure lasts 45–90 minutes, and you can go home immediately.

Before the procedure

Before treatment, an assessment of skin laxity, fat thickness, and skin elasticity will be conducted, along with standardized photography. Patients should discontinue anticoagulants, alcohol, and tobacco for a few days, and ensure there are no skin infections in the treatment area.

After the procedure

- Apply a cold compress for 48 hours. - Lie on your back with a high pillow for 1 week. - Avoid massage, limit loud laughing, hard chewing, steaming, and dental work for 2 weeks. - Swelling and bruising will decrease after 1–2 weeks. - Collagen production will significantly increase after 2–3 months. - Follow-up appointments in January and March.

Possible risks — your doctor explains them before treatment

Swelling and bruising for 1-2 weeks
Tightness, difficulty smiling naturally for a few weeks
Rippling or visible suture lines on thin skin
Asymmetry, tissue displacement on both sides
Exposed suture ends
Infection (rare)
Temporary facial nerve branch injury (very rare)

Who should NOT have this?

Excessively loose skin with noticeable excess (requires a facelift).
The face appears too thin with minimal fat tissue, making sutures more visible.
Currently experiencing skin inflammation with multiple areas of inflammatory acne.
Coagulation disorders and active autoimmune diseases.
Expecting results similar to those of facelift surgery.

BS.Ths.CKII Nguyễn Xuân Vũ

Department of Plastic and Aesthetic Surgery

Master of Medicine and Pharmacy — Specialist Level I Surgical Resident, Hue University of Medicine and Pharmacy (2014–2017)
Specialist Level II Doctor in Plastic and Aesthetic Surgery
Specialist Level I in Plastic and Aesthetic Surgery — Pham Ngoc Thach University of Medicine; Specialist Level II in Healthcare Management — University of Public Health
Specialty Certificate in Orthopedics and Traumatology and Certificate in Plastic and Aesthetic Surgery (2017)
Medical Practice License No.: 007827/ĐL-CCHN — Issued by Dak Lak Province Department of Health on 04/12/2017
Over 15 years of experience, more than 20,000 surgeries
Specialist Level II Doctor in Plastic and Aesthetic Surgery at Ho Chi Minh City Hospital of Dermatology (2020–present); previously Lead surgeon for major and minor procedures at Sao Han Hospital (2018–2020)
Member of international humanitarian organizations Operation Smile and ReSurge International — performing pro bono reconstructive surgeries for patients with congenital deformities, cleft lip, cleft palate, and ptosis (2022–present)
Affiliated with Alcon Pharmaceutical (USA)
Member of the Korean College of Cosmetic Surgery (KCCS)
Medical Director of BonBoz Clinic

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Frequently asked questions

How long do thread lifts last?

About 12–18 months depending on the type of thread (PDO lasts shorter, PLLA/PCL lasts longer) and individual physiology; new collagen helps prolong the effect after the threads dissolve.

Is there pain with thread lifting?

There is local anesthesia; a feeling of tightness and swelling for a few days, bruising for 1–2 weeks; strong pain relief is usually unnecessary.

Will my face feel stiff, and will my smile look unnatural?

In the first few weeks, there may be a feeling of tightness and limited smiling; it softens as the tissue adapts. Prolonged stiffness needs evaluation by a doctor.

How is thread lifting different from HIFU?

Thread lifting provides immediate mechanical lifting; HIFU tightens through heat, with effects appearing after 2–3 months. The two methods are often combined.

Can I have thread lifting if I have a lot of sagging skin?

This is not sufficient; threads cannot remove excess skin and results are short-lived. In this case, surgical facelift is necessary.

Is it a problem if I can feel the threads under my skin?

It may be felt in the first few weeks in thin skin; they dissolve gradually. Visible bumps or exposed thread ends need to be addressed by a doctor.

What age is suitable for thread lifting?

Typically 35–55 when mild to moderate sagging begins; younger individuals rarely need it, while older individuals with significant excess skin should consider surgery.

Can I have laser or Botox after thread lifting?

Yes, after 2–4 weeks when the tissue is stable; it is advisable to inform the doctor about the thread locations to avoid those areas during other procedures.