Thread lifts used to involve surgery and became associated with undesirable side effects such as infections and thread breakage. However, the thread lift procedure has radically changed. Most thread lifting procedures today are non-invasive. While there are many different types of thread lifts, such as Silhouette Soft, the PDO thread lift is amongst the most popular today. The threads are made in South Korea, and is one of the most commonly performed skin lifting procedures today.
What is the PDO Thread Lift?
The PDO Thread Lift is a treatment which lifts and tightens sagging skin tissue, using threads made of Polydioxanone (PDO). The threads introduces them into the deeper layers of the skin. Once introduced, the threads produce 3 effects in the skin:
- Instant Skin Lifting through mechanical effects
- Cellular Renewel, through Collagen stimulation, and neovascularisation to improve skin texture, fine lines and elasticity
- Skin Tightening, by contracting fat tissue
About 6 months after the procedure, the PDO threads will disappear through simple hydrolysis (they are absorbable). The lifted facial contours will remain for about 3-6 months more, due to the cellular rejuvenation effects. Your skin cells are stimulated to produce new collagen, and new blood vessels to improve skin microcirculation. At the same time, the PDO threads cause the fat tissue to contract, producing a skin tightening and facial slimming effect.
How is PDO Thread Lift Done?
A PDO Thread Lift is a minimally invasive procedure. After numbing and infusion of local anesthetia, the PDO threads are inserted via sharp or blunt tip needles (called cannulas) into different layers of the skin. Once inserted, the threads anchor the skin and lift it upwards. The excess threads are then cut off.
Depending on the areas treated, the procedure takes 15-30 minutes. There is some discomfort during the proceudre, but because of the improved techniques, my patients are experiencing less and less pain.
See the procedure:
Are There Different Types of PDO Threads?
There are many types of PDO threads – and this can be confusing for patients, and even doctors.
In general, PDO threads can be divided into floating, non-barbed threads and barbed threads. These can be further sub-classified in several ways:
|Mono-filament threads||Unilateral vs bilateral|
|Braided threads||Uni-directional vs bi-directional vs z-type|
|Cutting barbs vs molding barbs|
You may have heard of fancy names like “double screw” or “tornado”, or “heart barbs”. They all refer to threads in one of the categories described above. In addition, PDO threads come in different thickness and length. These all affect their quality, tensile strength, effectiveness, and of course, price of your treatment.
Your doctor may choose to use different threads for you, depending on your skin lifting and rejuventation needs. I will not describe the different threads in detail here as it is very much a professional discussion – you can ask your doctor more during your consult with him/her.
Is PDO Thread Lift Safe? What are the Possible Side Effects?
This treatment is surprisingly safe. Compared to fillers, the side effects are, in fact, much milder (fillers can even cause skin death and blindness). Because PDO threads are inserted via needles and not surgery, and are absorbed in 6-8 months, many of the side effects associated with older thread lifting procedures, such as infection and thread breakage are also minimised.
Depending on the types of threads used and areas treated, bruising may or may not occur. For the High Definition K-Lift which I do in my clinic, there is no to minimal bruising. Expect some mild swelling and soreness for 3 to 5 days after the procedure, and a sensation of tightness (mild) of up to 2 weeks. Temporary mild dimpling of the skin can also occur – an resolves in a few days.
Some side effects are related to the technique of insertion, and the types of threads used. These include surface depressions, thread migration and even extrustion, facial assymetry, prolonged pain, and prolonged dimpling. PDO threads are not created equal – and your doctor’s training in the procedure is also extremely important in ensuring a good outcome with minimal side effects from your procedure.
Finally, more serious side effects, though rare, can occur. These include infection, nerve damage, formation of nodules, and damage to the salivary ducts. The face has a very complex anatomical structure. Intimate anatanomical knowledge is required to perform a PDO thread lift well, and to avoid serious side effects.
The side effects are mostly manageable – removal of threads may be required in cases such as migration and extrusion. I previously had to remove some threads from my patients because some of the PDO unidirectional barb threads did not hook on well enough. There was no scarring after removal, and the problems resolved completely. Of course, I have stopped using those threads since.
The list of possible side effects from a PDO thread lift procedure include:
|Possible Side Effects From PDO Thread Lift|
|Common but Mild||Technique Related||Serious but Rare|
|Swelling||Prolonged skin dimpling||Infection|
|Soreness||Surface depression||Granuloma (hard nodule)|
|Bruising||Migration of threads||Parotid duct fistula (damage of salivary gland)|
|Temporary skin dimpling||Extrusion of threads||Nerve damage|
What Do I Need to Take Note of Before and After The Procedure?
Like other treatments involving injections, avoid alcohol, supplements such as Vitamin E, Omega Fish oils, some Chinese medicines (e.g.白凤丸), gingko for 1-2 days before and after the procedure. Avoid going to the steam room, sauna, and engaging in heavy exercise such as High Intensity Interval Training (HIIT).
Following 2 weeks after the PDO Thread Lift, you are also discouraged from undergoing any dental treatment (which requires you to open your mouth excessively.)
You are also advised to sleep on your back to allow the swelling to subside and to avoid the putting pressure on the face that might cause misalignment of the threads. I give the option of some simple taping on the face to ensure the best results.
How is the Treatment Designed?
The PDO Thread Lift procedure is designed according to what we want to treat, and which areas we want to concentrate on. For example, for lifting, I use a combination of barbed threads of different thickness and lengths, inserted in 3-4 entry points. The treatment can also be designed according to your lifestyle needs – if you can take more swelling, I will insert more threads, and vice versa. The treatment can also be designed according to your lifestyle needs – if you can take more swelling, I will insert more threads, and vice versa.
PDO threads can be used for lifting, rejuvenation (improving skin texture and wrinkles), volumising, and even reducing fat. Different threads are used for different purposes. Every doctor’s technique is different, and the possibilities are endless – fo example, a “vertical method” is described in this study.
What Areas Can Be Treated with PDO Thread Lift?
The PDO thread lift is very versatile, allowing practically all areas of the face to be treated, including the:
- Undereye area
- Crow’s feet (wrinkles around eyes)
- Nasolabial folds
- Naso jugal folds
- Wrinkles around mouth
- Jaw line
The cheeks and lower face, in particular, benefit greatly from the procedure, allowing a lift which is synergistic to other skin lifting treatments such as Ultherapy.
What Results Can I Expect After The Treatment? How Long Do They Last?
Your skin is immediately lifted after a PDO thread lifting procedure, as the threads provide support to lift skin in its new position. You may look slightly tighter than the final result, but in about 1 week, you will begin to look much more natural.
The rejuvenative effects kick in after 1-2 months – you will notice better skin texture, firmer and smoother skin. Your doctor may concentrate more on either skin rejuvenation, or skin lifting during your procedure. Depending on the technique and which is used, the results will vary from person to person.
In about 9 months after the treatment, the threads would have dissolved, but the results will still continue for many more months. I recommend repeating the procedure 6-9 months after the first procedure, to allow for a long lasting result of up to 3 years.
Who is Suitable For a PDO Thread Lift?
The PDO Thread Lift is an effective non-surgical facelifting treatment that is suitable for anyone looking to improve the appearance of sagging skin. This treatment is suitable for someone who is willing to undergo some injections, and who want to attain an immediate lift of the facial contours without undergoing a facelift surgery. It is best suited for men and women who are unwilling to tolerate the long downtime of a facelift surgery but want to look refresh and lifted – naturally.
Compared to non-invasive face lifting options like Ultherapy, the PDO thread lift works faster, and has more visible results. However, the procedures work even better when combined for synergistic results.
There Are Now Korean PLLA and PCL Threads. Are They Better?
PDO, PLLA, and PCL are all names of different types of materials. These have been made into threads because they have high tensile strength, and are inert, so that they do not cause problems with excessive inflammation.
The main difference is in longevity, stiffness and tensile strength:
PDO (Polydioxanone) dissolves after 6-9 months
PLLA (Poly L Lactic Acid) dissolves after 12-18 months
PCL (Polycaprolactone) dissolves after 24- 36 months
While PLLA and PCL last longer than PDO threads, the longevity itself could be a double edged sword. Patients often report that Korean PLLA threads feel harder in the skin, with more tightness. This is owing to its higher tensile strength. Theretically, PLLA threads are a longer lasting alternative to PDO threads. However, more scientific literature is required to understand its efficacy and safety compared to PDO threads.
PCL threads are much newer compared to PDO threads, and reports are beginning to emerge about side effects associated with PCL threads such as increased migration, thread extrusion, and thread breakage. I would stay away from PCL threads until there is more literature supporting its use in non-surgical facial thread lifting.
How Does Korean PDO Thread Lift Compare with Silhouette Soft Thread Lift?
Both PDO thread lift and Silhouette Soft thread lift are excellent skin lifting procedures. However, they have very important differences. PDO better lifts skin, due to its configuration, while Silhouette Soft is better at compressing skin tissue to produce a volumising effect. Although Silhouette Soft threads are made up of PLLA, the technology is very different. They use cones instead of barbs to lift sagging skin.
Because we also use more threads during a PDO thread lift compared to a Silhouette Soft procedure, the PDO Thread Lift also pulls the skin back more.
In my opinion, the 2 procedures complement each other, and work even better, when performed together in a combination thread lift treatment.
Which Treatments Work Well With PDO Thread Lift?
The PDO Thread lift can be combined with other treaments such as HIFU or Ulthera to give a natural lifting result. It works particuarly well with bio-stimulating fillers such as Radiesse and Hyaluronic Acid fillers – to provide a comprehensive anti-aging solution which now allows us to turn back the clock for our patients, like never before, without surgery. The treatment is now indispensable in my practice.