The thread lift procedure involves the insertion of barbed polypropylene threads under the skin of the face using a ‘tunnelling’ technique. Pulling the threads taut and anchoring one end in the deep tissues above the hairline produces lifting of lax tissues. Scar tissue subsequently forms around the threads, anchoring the facial skin in the elevated position. Thread lifts are often advertised as a convenient, inexpensive, safe and effective form of treatment for sagging cheeks and jowls. Thread lifts are advertised under trade names such as the Aptos thread lift, Contour thread lift, Silhouette lift, Feather lift or may occasionally referred to as stringlifts.

However, our experience of the thread lift procedure was very unsatisfactory. We abandoned the use of thread lift surgery several years ago due to poor final results. The following summarises the difficulties we encountered.

• In our experience, very few patients (less than 20%) had satisfactory results – any beneficial effects tended to be relatively short lived (months, rather than years).
• Thread lifts are expensive to purchase – this cost is reflected in the price you pay. Typically the total price of thread lift surgery is more than we charge for an advanced mini face lift.
• The threads can be felt underneath the skin of the face and may occasionally even be visible.
• Visible puckering of the skin is very common after thread lift insertion.
• The threads can break or become dislodged; if this happens within the first month it can result in a lopsided appearance of the face (resembling a stroke).
• The infection rate in our experience was much higher than expected.
• The technique does not remove redundant skin – it simply draws it back into the hairline where it remodels after a few weeks.
• Downtime is usually at least a week – much longer than advertised.
• Many patients describe persistent severe headaches after a thread lift procedure.
• Removal of thread lifts is difficult once they have become embedded in scar tissue – however, they can be removed at the time of definitive face lift surgery.
• FDA approval for the Contour Thread Lift system has been withdrawn after multiple reports of problems.

The only real advantages of the threadlift technique appeared to be:

• It can be performed under local anaesthetic, although this is uncomfortable.
• Scarring is minimal and hidden in the hairline.
• The bruising is significantly less than with a mini face lift, although any bruising obviously takes the same time to disappear.
• Previous thread lift surgery does not preclude a mini or full face lift.

If you are looking for a convenient, effective and cost-effective solution for sagging facial tissues that is less invasive than a full face lift and does not require a general anaesthetic we would suggest that you consider an advanced mini face lift.