At a glance: do a facelift and a PDO thread lift do the same thing?
No. A PDO thread lift (polydioxanone, an absorbable material) is a nonsurgical procedure that produces subtle, temporary changes [1]. A facelift is surgery that repositions the deeper facial tissues, with scars, recovery time and risks of its own. I don’t perform thread lifts; I explain the difference to help you decide, and because previous threads need to be part of your medical history.
- Procedure: threads are placed under the skin without surgery; a facelift is an operation.
- Duration: Cleveland Clinic describes thread-lift results as temporary [1].
- Quantity: in a small trial, six threads per side did no better than three [2].
- Complications: swelling, dimpling, altered sensation, visible threads, infection and extrusion [3].
- Surgery after threads: scarring and adhesions can make a facelift more difficult [4].
- Scope: I don’t offer thread lifts; in consultation, I assess facelift surgery and fat grafting.
My deep plane facelift guide explains the operation. Here I compare the two approaches and cover what to bring to a consultation if you’ve already had threads.
First, what do you want to change?
Perhaps you want a more defined face without surgery, or you’ve had threads and want to understand why the effect no longer matches what you expected. Those are different conversations. I start with what you notice and what you’d like to achieve, without passing judgment on earlier choices. An assessment can also end with the decision to wait or to do nothing.
Four differences to organize your questions
What is done
Threads are placed under the skin, and designs and techniques vary. A facelift is an operation with its own incisions and plan [1]. The shared word “lift” shouldn’t hide that difference.
How much changes
A subtle change may satisfy one person and disappoint another. In consultation, I explain what surgery is meant to treat and what falls outside it.
When it was assessed
A photo taken right after a procedure doesn’t tell you how long the effect lasts. Ask when the image was taken and what the study measured.
If recovery doesn’t go to plan
A smaller procedure still involves discomfort and complications. Before deciding, know who will assess you if something unexpected happens.
What the research says about threads
A 2025 randomized trial compared three and six PDO threads per side of the face in 22 patients, using 3D photography at 20 and 60 days. There was no significant difference between the groups, the early improvement had diminished by 60 days, and adverse events were minor and transient, mainly pain [2]. The study did not compare threads with a facelift, nor did it follow patients for years.
A systematic review and meta-analysis of 26 studies found that the most commonly reported complications were swelling, skin dimpling, altered sensation, visible or palpable threads, infection and thread extrusion; at 6 months, satisfaction was lower than immediately afterward (88% vs. 98%) [3]. The review included absorbable and nonabsorbable threads; absorbable threads, such as PDO, had lower rates of altered sensation and extrusion, and none of these figures is your personal risk. How long the material takes to dissolve is also not how long the effect lasts.
I’ve had threads. Does that change a future facelift?
It can, which is why I want to know your history. A 2025 retrospective series described 10 patients who had a facelift after two or more absorbable thread treatments: the surgeon found scarring (fibrosis), distorted tissue, adhesions between layers and reduced mobility of the SMAS, which made surgery more laborious and longer [4]. It is a small, single-surgeon series without a comparison group: it can’t predict what will happen to you, and it doesn’t rule out surgery.
Bring what you have: approximate dates, treated areas, the product name if you know it and any complication (infection, a thread coming through the skin, removal). If a record is missing, we note the gap; there’s no need to guess.
An active problem comes before planning
Persistent pain, worsening redness, discharge or a thread showing through the skin need medical assessment now, with whoever performed the procedure or another clinician, wherever you live. Don’t pull an exposed thread. A consultation to plan a facelift is no substitute for that care, and this article does not advise thread removal or a waiting period before surgery.
If surgery is what you prefer
I want to explain the whole plan: incisions, limits, recovery, follow-up and risks. Bleeding, infection, unfavorable scarring and facial nerve injury are among the risks listed by ASPS [5]. Choosing surgery doesn’t remove uncertainty, and the patient journey shows how each stage is organized.
Questions
Do more threads mean a better result?
Not necessarily. In the 22-patient trial, six threads per side did no better than three on the outcomes measured, with 60 days of follow-up [2].
Do absorbable threads leave no lasting effects?
That isn’t a safe assumption. In the series of facelifts after absorbable threads, tissue changes made surgery more difficult [4]. That’s why it’s worth mentioning older treatments, even if the effect has faded.
If I don’t want surgery, should I have threads instead?
No. Not wanting surgery doesn’t mean you have to choose another procedure. I don’t perform thread lifts and don’t recommend them.
Can I decide from photos alone?
No. Images help you form questions, but they don’t replace an examination, your health history and your previous treatments.
Let’s work out what makes sense for your face
If you’re considering a facelift or want to know how earlier treatments affect that decision, write to us on WhatsApp: Bruna, my AI assistant, handles the first contact and then puts you in touch with Isanna to arrange a consultation with me. Bring any records you have.
References
- Cleveland Clinic. Thread Lift: What to Expect, Benefits & Complications.
- Germani M, Munoz-Lora VRM, Carnevali ACN, et al. Is More Always Better? A Randomized Comparative Clinical Trial About the Impact of Polydioxanone Threads Quantity for Facial Lifting. Aesthet Surg J Open Forum. 2025.
- Niu Z, Zhang K, Yao W, et al. A Meta-Analysis and Systematic Review of the Incidences of Complications Following Facial Thread-Lifting. Aesthetic Plast Surg. 2021.
- Yordanov YP. The Facelift After Thread Lifting: Surgical and Aesthetic Complications. Aesthetic Plast Surg. 2025.
- American Society of Plastic Surgeons. Facelift Risks and Safety.