Where does Thread lift work on the face? How to choose threads by area

Thread lift is not a treatment that works the same way everywhere on the face; the threads used and expected results vary by area. The most substantial research accumulation is in the midface and nasolabial fold, with several positive evaluations reported[1][2]. On the other hand, no prospective trials targeting the neck alone have been found[3].

Midface and nasolabial folds: how much can you expect?

Among Thread lifts, this is the area with the most materials available. Prospective research using 3D bidirectional cog threads in the midface and nasolabial fold has been reported[1]. In midface treatments combining hyaluronic acid and threads, there is also a pilot study conducted in a blinded manner at the 1-year and 2-year timepoints[2]. For nasolabial folds, an approach has been presented that varies the insertion method depending on the type of cause classification[4].

Jawline and double chin: what about those?

Thicker threads come into play. Thicker threads with larger barbs are organized as being suited to lifting heavy, sagging tissues in the lower face[5]. The same report notes they are also used for the lines extending downward from the corners of the mouth, double chin, and eyebrow descent, and are also used to correct laxity remaining after facial liposuction or for correction when fat descends after fat grafting[5].

Around the eyes—can you use the same thread?

Different threads are used. Thin threads with small barbs are considered suitable for delicate areas like around the eyes[5]. Using thicker threads does not simply mean stronger effect; threads that are too thick for an area can cause dimpling or palpability. It is best to confirm which thread is planned for each area during consultation.

Neck and submental area: how should we think about this?

Textbooks include soft tissues of the neck as well as the face in the scope of thread treatment[3]. However, among the papers referenced this time, no prospective trials targeting the neck alone were found, and this is an area with thinner data compared to the midface[3]. "Can be done" and "confirmed to work" are different, so be aware of this distinction.

When should you combine this with other treatments?

When there are elements that threads alone cannot address. If there is sagging plus volume or skin quality issues, combination with fat grafting or laser has been reported[6]. For cases where additional tightening is desired, there is an observational study examining combination with high-intensity focused ultrasound (HIFU)[7]. Regarding thread count, a randomized controlled trial has been conducted examining the effect of PDO thread quantity on outcomes[8], and more is not necessarily better.

In fact, even in a compilation of over 110,000 cases, Thread lift is increasingly used in combination with other treatments rather than as a standalone procedure[9].

What to confirm at consultation

First, have the doctor explain which area of the face is causing your sagging. It has been noted that the position of facial soft tissues changes between supine and seated postures during evaluation; having the doctor also examine you in a seated position reduces discrepancy with how it feels[10]. In addition, asking about the thread thickness and number to be used by area, as well as the magnitude of expected change, will give you the information needed to make a decision.