Thread lift, facelift or filler? What each one really does

You look in the mirror and gently lift your cheeks with your fingertips. That is the face you want back. Then you go online and find three answers: threads, a facelift, or filler. Each clinic seems sure its answer is the right one.

They are not the same thing. They fix different problems. Choosing the wrong one is the most common reason people are unhappy afterwards.

Here is how I explain the difference.

Why faces change: two different problems

As we age, two things happen at the same time.

• Volume is lost. The fat pads in the cheeks and temples shrink, and the bone underneath slowly changes shape. The face looks flatter and more tired, with hollows and shadows.
• Tissue drops. The skin and soft tissue loosen and slide down. Jowls form along the jawline. The fold beside the nose deepens.

Most people have some of each. The question is which one is the main problem in your face. That decides everything.

Filler: putting back what was lost

Filler is usually a gel of hyaluronic acid, a sugar your body already makes. I place it where volume has been lost, for example on the cheekbone or at the temple.

Well-placed filler can make a face look lifted, because it supports the tissue from underneath. But it does not tighten loose skin. If filler is used to chase sagging, the face ends up heavier, not younger.

• Good for: hollows, flat cheeks, early folds, a soft jawline.
• Recovery: some swelling or bruising for a few days.
• How long: depends on the product and the area. Often a year or more.

Thread lift: a small lift for early sagging

Threads are thin dissolvable stitches, usually made of a material called PDO. They have small barbs or cones along them. I pass them under the skin through tiny entry points, then gently pull the tissue back along a planned line.

The threads themselves dissolve over about six to nine months. Your body builds a little new collagen around them, which helps the result last a bit longer.

• Good for: early to moderate sagging of the cheeks or jawline, in someone with fairly good skin.
• Recovery: swelling and possible bruising for about five to ten days. Some tightness for one to two weeks.
• How long: typically 12 to 18 months, fading slowly rather than all at once.

The honest part: the lift is real, but small. It is measured in millimetres, not centimetres. On heavy or very loose tissue, threads give a short result and can cause dimples in the skin.

Facelift: the strongest and longest-lasting option

A facelift is an operation done by a plastic surgeon. The deeper layer of the face is lifted and secured, and extra skin is removed.

• Good for: moderate to marked sagging, heavy jowls and loose skin on the neck.
• Recovery: usually a few weeks before you feel ready to be seen socially, with swelling settling over months.
• How long: the effect usually lasts many years. You keep ageing, but from a better starting point.

It also carries the risks of any operation, including anaesthesia, bleeding, scarring and, rarely, nerve injury. Those need a proper conversation with the surgeon.

Side by side

• Main job: filler restores volume · threads lift a little · a facelift lifts a lot.
• Downtime: filler, days · threads, about a week · facelift, several weeks.
• Lasts: filler, often a year or more · threads, 12 to 18 months · facelift, many years.

What can go wrong with threads

• Bruising and swelling. Common, and settle within about two weeks.
• Dimples or puckering of the skin. Often settle as swelling goes down.
• A thread you can feel or see, usually in thin skin. Sometimes it needs to be removed.
• Uneven result between the two sides.
• Infection. Uncommon.

How I do things

I start by gently lifting your face with my hands while you look in the mirror. You see what is realistically possible before anything is decided.

If volume loss is the main problem, I treat that first, usually with filler. If threads would help, I plan them around what the filler has already done.

And if your face needs a facelift, I will tell you, and refer you to a plastic surgeon. That is not a failed consultation. It is the honest answer, and it saves you money spent on treatments that cannot give you what you want.

Questions I get asked every week

Is a thread lift a non-surgical facelift?

Not really. It gives a small lift that lasts about a year or so. A facelift moves much more tissue and lasts many years.

Can filler lift my jowls?

Filler on the cheekbone or jawline can make jowls look softer. It cannot lift heavy, loose skin. Too much filler makes the face look heavy.

Can I have threads and filler together?

Yes, often. Volume is usually treated first, and threads are planned around it.

Does a thread lift hurt?

I use local anaesthetic. Most people feel pressure and movement, not sharp pain. It can feel tight and sore for a week or two.

Am I too young or too old for threads?

Age matters less than your tissue. Threads suit early sagging with good skin. Heavy, very loose tissue usually needs surgery instead.

Read more on my thread lift in Dubai and dermal fillers in Dubai pages, or book a consultation.

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Sources

• Gülbitti HA, et al. Thread-lift sutures: still in the lift? A systematic review of the literature. Plastic and Reconstructive Surgery, 2018.
• Sulamanidze MA, et al. Removal of facial soft tissue ptosis with special threads. Dermatologic Surgery, 2002.
• Rohrich RJ, Pessa JE. The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plastic and Reconstructive Surgery, 2007.
• Mendelson B, Wong CH. Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation. Aesthetic Plastic Surgery, 2012.