PDO Thread Lift – Everything You Need To Know About The Non-Surgical Face Lift From Korea

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PDO Thread Lift Dr Siew.comThread 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
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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?

PDO Thread Lift insertion DR siew.com
PDO Threads are inserted into the skin via housing needles called cannulas, in a sterile procedure

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.

PDO Threads Floating Dr Siew.com
There are many types of PDO threads, for example the screw type threads for rejuvenation.

In general, PDO threads can be divided into floating, non-barbed threads and barbed threads. These can be further sub-classified in several ways:

PDO Threads
Non-BarbedBarbed
Mono-filament threadsUnilateral vs bilateral
Braided threadsUni-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.

PDO Threads classification Dr Siew
Broadly, PDO Threads can be classified into these large groups

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.

PDO Thread lift migration Dr siew
Migration of unilateral, unidirectional threads in one of my patients, causing thread extrusion, 1 month after the procedure. I removed the thread for her, with no permanent 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 MildTechnique RelatedSerious but Rare
SwellingProlonged skin dimplingInfection
SorenessSurface depressionGranuloma (hard nodule)
BruisingMigration of threadsParotid duct fistula (damage of salivary gland)
Temporary skin dimplingExtrusion of threadsNerve damage
Asymmetry
Prolonged pain

What Do I Need to Take Note of Before and After The Procedure?

PDO Thread Lift procedure cutting threads Dr Siew.com
While a PDO thread lift has very little downtime, expect some mild swelling and soreness 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?

Designing PDO Thread Lift Dr siew.com

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
  • Eyebrows
  • Crow’s feet (wrinkles around eyes)
  • Cheeks
  • Nasolabial folds
  • Naso jugal folds
  • Wrinkles around mouth
  • Jaw line
  • Jowls
  • Neck
Areas where PDO Threads can benefit
PDO Thread lifts can benefit practically any part of the face, and improve both skin sagging and texture,

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 provde 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 Thread used in PDO Thread Lift Dr Siew.com barbs
The barbs on a PDO Thread Lift are very small, almost invisible to the naked eye

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 woud stay away from PCL threads until there is more lierature 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?

PDO Thread Lift Dr Siew.com
A PDO Thread Lift can be performed alone, or together with other thread lifts like Silhouette Soft, or with other anti-aging treatments such as filler injections.

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 biostimulting fillers such as Radiesse and Hyaluronic Acid fillers – to provide a comprehensive anti-aging soltuion which now allows us to turn back the clock for our patients, like never before, without surgery. The treatment is now indispensible in my practice.

31 COMMENTS

  1. Hi i if i do a nose threadlift, both bridge and tip, and don’t like the results, can i get back my original nose back? any change in facial structure?

    • Hi Kerry,
      unless you remove the threads, which is often very difficult, you will have to wait for the threads to dissolve naturally. this will take 6- 9 months.

  2. Hi Dr Siew! I had the PDO procedure about a month ago, and there was a terrible dimpling and surface depression on both cheeks, one more severe than the other, it looks as if I had a terrible car accident and I had been scared for life; is there a way to fix this? Is it permanent? Is there something I can do to improve my skin??
    Can I send you some pictures so you can see the damage to my skin?

    • Hi Lizeth,

      It is best for you to arrange for a consult with me if you like me to assess your skin condition. Feel free to make an appointment at +65 6837-0507.

      Thank you.

  3. hi,

    what is 26G-38mm and 30G-25.4mm, 29G-50mm pdo threas mean? is the number before the G the thickness what does G stand for and I’m assuming that the 50mm is the length of the thread?

    I’m trying to research so I know what tehey are talking about and the length andthickness before insertion…I have a very thin face and have bells palsy, so I am nervous…i’d like to go with the thinest

    • Hi Belinda, these refer to the thickness of the cannula and length of the threads.
      The thinnest may not be the best for you… better to speak to your doctor and seek his/ her opinion!

  4. Hi Dr Siew,
    what factors affect the dissolvability of the thread ? Will regular exercise eg : dance, hot yoga and sauna make the thread dissolve faster ?

    • Hi Mia – thanks for your reply. Threads usually dissolve after 6 to 9 months after the treatment. However, there is little or no concrete studies done to show that regular exercise will affect the longevity of the threads. But your doctor will tell you more about the post-treatment protocol after the procedure.

  5. Hi Dr ..I’m New in the field of Facial aesthetics..Your article was very informative.. I hope you could become my mentor ..I’m far away from Where you practice..but I will need your guidelines in patient selection.. I will share results of patients .. on a lighter note can I try putting threads on my self in front of a mirror.. Lol.

  6. I had threads placed in my upper cheek/under eye to help minimize the appearance of a malar crease about 4 days ago. Immediate results looked great and I understand that was due to the possible swelling, etc. the 2nd day I was extremely happy as there was no additional swelling when I woke up. Yet, yesterday and this morning I have a big swollen under-eye (looks like when people swell from allergy or too much salt). My fear is that the collagen is building and this will be long-lasting! the area that has the threads has gotten firmer so I am just nervous that this is how it will settle? more nervous that I possibly could have gotten an infection or something? Am I just being over-concerned and should wait it out for another week?

    • Hello – Sorry to hear about this. Treatments especially around the eyes can be challenging because the area can be sensitive. Please go back to your doctor for a follow-up to see if he is able to help you to expedite the healing process.

  7. Hi Dr Siew. I had the PDO procedure done a few months ago and the pain was awful. I was “numbed” 3 times, but never was really numb. I usually have a pretty high pain tolerance lever, so I was surprised at the pain! Results were minimal at best. I would like to try again, but am dreading the pain factor. Would a pain pill before procedure help? Or is there a different “numb-er” that I could ask for?

    • Hi Fawncyne – Thanks for your enquiry. There are several ways to make the treatment more comfortable such as taking painkillers, sedation, numbing, or even anaesthesia. Please check with your doctor on the suitability. Good luck!

  8. Hello Doctor

    I had an eyebrow thread lift three days ago. The pain in the evening across my head was excruciating and I was vomiting all the next day. This is now day three and i still have extreme tenderness across my head and especially where the anchoring points are. I believe the threads used are silhouette soft threads. Is this normal and do you think it will settle. Even any eye movement at the moment is VERY tender. My surgeon was NOT helpful in any way. Thank you so much, Carol

    • Hi Carol,

      Sorry to hear about your problem. But it is important for you to go back to your doctor quickly and let him know your problems. Otherwise, please go straight to another doctor to do an assessment.

  9. Hello. Let me ask you a TECHNICAL question, if you can answer me … I’ve read a lot about the cares in after-procedure of Silhouette, which I consider to be extremely important for the final result, I say this only wrapped up by what I read, a series of facial movements that you can seriously avoid.

    But there you are. The cares in after-procedure is so severe, some doctors even forbid chewing gum, some extend the care for a month … And, in contradiction, I know a person who have put the wires and, less than an hour later, she had a strong punch on her cheek (a baby children), and, worried, she immediately sent pictures to her doctor, and this one, without any personal examination, said that she thought everything was fine. And that was all. It’s a contradiction! Less than 1 hour later!

    If we should avoid facial massages for a month, we should not even chew food everyday.
    I ask:

    Can you know what the really fixing power of Silhouette the instant it is put and over the days ? What kind of facial or body movement are REALLY able to pull the thread out of place? OR THESE AFTER-PROCEDURE RECOMMENDATIONS ARE JUST ESPECULATIONS?

    I’m self-taught. If you, for some reason, can not answer me, can you send me or indicate any study material on this subject? (That’s not ok for me, imediatelly after put Silhouette, get a punch on your cheek if you not even may sleep with your cheek on a pillow…)
    Hope for an answer. Thank you very much.

  10. I had a full face and neck PDO lift 5 weeks ago and still have pains either side of my head where the entry point would have been. Had 3 courses of antibiotics but still this pain. I have sleepless nights because if I roll onto my side i get very sharp shooting pains in my head. Please help, any suggestions as to why this would happen. I would have these taken out right now because of the pain it is causing me. I have of course been to the dr who performed this lift several times and he said this is normal. from what i read i disagree that there would be this much discomfort after 5 week

    • Hi Lainey – Sorry to hear about your discomfort and experience with thread lift treatment. Please go back to your doctor to have it checked. It is rather unusual that such side effects still persist after so many weeks.

  11. Mine keeps makicking cracking sounds and feeling like they pull away on my left cheek is that normal the first week ??:/

  12. Thank you for all this great information, Dr.

    Is there a doctor you would recommend in Los Angeles? Thank you

  13. Hi Dr Siew, is there any non-invasive procedure on droopy eyelip – ie the space between the eyebrow and eye sagging due to aging? Didn’t see that thread lift can help in such condition…

    Thanks.

  14. Hello are you able to email me some before and after pictures of the 20 point Korean threadlift you offer. I am travelling from Australia and am very interested in seeing your results before making a booking with you pls. Thanks

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