When it comes to facial rejuvenation, two options generally come to mind. We think of injectables like dermal fillers as options to provide temporary lifting, plumping, and smoothing. Or, we think of surgical procedures like facelifts, eyelifts, and fat transfers, which provide longer-lasting results. Two ends of the spectrum.

But what if there was something in between? A minimally invasive, outpatient procedure that provides longer-lasting results than fillers but doesn’t require the long recovery time and cost expenditures of surgery.

Enter Polydioxanone (PDO) Threads.

Some PDO threads are FDA cleared devices, used for threading procedures that has gained popularity over the past few years. Threads are inserted below the skin’s surface and pulled or tightened for facial contouring or to lift and smooth sagging skin or fat deposits. Similar to disappearing stitches, the threads may dissolve or be absorbed into the body.¹

Notedly, the threads also provide the subsequent benefit of helping boost collagen production, which is an essential protein that gives skin, bones, ligaments, and all body tissue its structure and firmness. When the body detects the threads, it responds by directing extra collagen to the area, which helps diminish the appearance of skin aging.²

This is because the threads are composed of polymers like Poly-L-Lactide Acid (PLLA) and Poly Lactic-co-Glycolic Acid (PLGA), which are absorbable by the body. As the body absorbs the material, it stimulates collagen production in the area.²

Some quick stats.

Your patients may be interested in learning about PDO thread techniques. The stats below are all average and approximate.

FDA approved: there are several options you may want to consider³

Cost: $2,000 - $3,500

Cost will vary by state and provider. This is a range intended to provide a general understanding of the procedure.

Procedure length: 45 minutes - 1 hour

Length of results: 1-3 years³

Recovery time: none. Your patients can resume most of their daily routines immediately following the procedure. They may experience some bruising or swelling around the targeted areas, and should avoid intensive exercise, facials, and saunas for 1-2 weeks after the procedure.⁴

Where they work.

The procedure works most effectively on areas that may sag or droop over time, such as:

1. Browline
2. Under-eye area
3. Cheeks
4. Jowls and jowl line

PDO Thread lifting is also used to lift and tighten areas of the body such as the breasts, especially after pregnancy.⁴

There are many different types of PDO Threads and techniques. Some of the threads have small barbs that help them stick to the ptotic tissue beneath the skin’s surface and provide more lifting. Other threads are smooth and held in place with knots or cones anchored at different points below the skin.⁵

The three main types of threads are Mono, Screw/Tornado, and Cog. Mono threads are smooth, without barbs, and are primarily used for lifting, but not tightening, the skin in areas like the neck and under the eyes. Screw/Tornado threads are single or double threads that are wound around the insertion needle, and are often used for plumping and volumizing the skin. Cog threads are barbed versions of Mono threads and adhere to the lines along their insertion points, which makes them effective in skin lifting and slimming.⁵

What they don’t do.

Thread lifting is lower risk, lower recovery, and far less invasive than a surgical facelift. However, PDO Thread lifting will not provide the level of results achieved by surgery. The threads can help lift skin by a few millimeters, which will certainly provide noticeable results, but will most likely be more natural-looking than a facelift. The results only last from 1-3 years.⁴

Who’s a candidate?

The best candidates for PDO Thread lifts are between their late 30s and early 50s, with mild to moderate signs of skin laxity.

These procedures are also great for patients who are considering a more intensive surgical option and would like to see how they could potentially look after a facelift. It’s a great conversation topic to broach with patients who have expressed interest in facelifts.⁴

What are the risks?

According to the American Society of Plastic Surgeons, the following are possible risks:

• Anesthesia risks
• Difficulty opening your mouth (usually temporary)
• Extrusion of a thread
• Infection
• Pain, which could persist
• Sensitivity to sun or other bright light
• Swelling and bruising
• Unfavorable result

These risks make proper training especially important.⁷

Who can perform PDO Thread lifts?

PDO Thread lifting procedures should only be performed by a licensed and trained provider. As this technique gains more popularity, it may make sense to seek additional training and certification in this area. Trainings are generally offered only to licensed or certified medical professionals with prior experience and training as an injector. Certifications and licensing requirements vary by state.⁶