Procedure

PDO Threads

Dissolvable stitches placed under the skin to lift it a little and prompt some collagen. The lift is real but small, it lasts months rather than years, and it is not a substitute for a facelift.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026
16:9 hero for PDO Threads. Never cropped: the tone strip and the corner logo depend on the full frame.

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Threads are the treatment I most often talk people out of, and not because they do nothing — it is the gap between the marketing and the result: a modest lift that fades over about six to twelve months.

What I find myself repeating in clinic: much of what people call sagging is lost volume, and volume is a more predictable problem to fix. If skin has genuinely dropped, the honest comparison is surgery, which repositions and removes tissue and lasts years. Threads can make sense for mild early sagging with good skin and a reason not to have surgery, but not for heavy jowls or a loose neck — ask to see their own faces at six and twelve months, not on the day of treatment.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

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Also calledThread lift, PDO thread lift, polydioxanone threads, barbed or cog threads, mono threads
Marketing namesOften sold as a lunchtime facelift or a non-surgical facelift, which overstates what it does
Downtime3 to 7 days of swelling and bruising, with soreness on chewing for up to 2 weeks
SessionsUsually one, repeated when the effect fades
Typical costAbout $1,500 to $4,500 for a face in the US, depending on the number of threads. Varies widely
Results timelineMost lift is visible on the day, then part of it settles out over 2 to 6 weeks
How long it lastsThe threads dissolve in about 4 to 6 months and the visible lift usually lasts about 6 to 12 months
PainLocal anesthetic is used. Pressure and tugging during, soreness for several days after
EvidenceMostly small studies with short follow-up and few comparisons. Weaker than the evidence for fillers or surgery
ReversiblePartly. A thread can sometimes be removed early, but not always cleanly

What It Is

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A thread lift uses absorbable sutures — the dissolving stitch material used in surgery — placed under the skin through a needle or blunt cannula. Polydioxanone, shortened to PDO, is the most common material. There are two kinds. Barbed or cone-shaped threads have small hooks that grip tissue, so the thread can be pulled to move the skin slightly. Smooth threads, often called mono threads, have no barbs and do not lift at all; they are placed in a mesh pattern to prompt a little collagen, and are sometimes sold as if they lift. Some threads are poly-L-lactic acid, or a blend of it with polycaprolactone, which dissolve more slowly than polydioxanone. In the United States, several thread products are cleared by the FDA for soft tissue approximation, including brow and mid-face lifting. That wording is narrower than the way threads are advertised, and clearance is not evidence that the result lasts.

How It Works

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Threads work two ways, and only one of them is a lift.

The mechanical part is simple. Barbs anchor into soft tissue along the thread, and when the thread is pulled, tissue gathers along it and moves a small distance, usually a few millimeters. Nothing is cut and nothing is removed. The lift is held only by the barbs' grip, which is why it works better in lighter tissue and can loosen as tissue relaxes.

The biological part is slower. The thread is a foreign material, so the body forms a low-grade repair response along its track and lays down collagen there. That firms the skin slightly, which is why results do not vanish the day the thread does.

The material dissolves over about four to six months. When it goes, the mechanical lift goes with it, leaving the collagen along the track. That is why the effect fades gradually, and why the claim that collagen keeps the lift going does not hold up: collagen along a track firms tissue, it does not hold tissue in a new position.

Be clear about what threads do not do. They do not remove skin, reposition the deeper layer of the face that a facelift moves, replace lost volume, or do much for a loose neck. A facelift lifts and removes tissue and lasts years; threads gather skin a small amount for months. Comparing them on price is what makes threads look like a bargain.

Skin is about two millimetres thick on the face. How deep a treatment reaches decides what it can change, and whether it treats all of the skin or scattered columns of it decides how long you take to heal.

How it works
Compare
Skin basics
EPIDERMISDERMISFAT0.05 mm — pigment0.5 mm — texture + pores1.0 mm — collagen1.5 mm — deep dermisPEELNEEDLINGNON-ABLATIVE LASERABLATIVE LASERGOES BELOW THE SKIN

This works below the skin altogether, in the fat or the muscle beneath it. Nothing applied to the surface reaches here, which is the whole reason the procedure exists — and why it is done by injection, by needle or with a blade rather than with a cream.

A peel or a scrub takes the skin off evenly from the surface down. Everything above the line goes and nothing below it is touched, which is why peels suit surface pigment and rough texture, and why the whole face flakes for a few days after.

Needles make hundreds of separate channels and leave the skin between them untouched. That untouched skin is what heals the rest, so recovery is quick — but a needle only injures the skin to start repair. It removes nothing.

The light passes through the surface and heats a column underneath it. The surface stays whole, so you leave red rather than raw — and it takes a course of sessions rather than one.

The laser removes columns of skin outright: the white gaps here are tissue that is gone, and new skin grows in from the sides. The strongest of the four, and the longest to heal.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

What It Treats

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No strong evidence for any condition.

Pros and Cons

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Pros
  • No cuts and no general anesthetic Awake, under local, in about an hour.
  • Something visible the same day Unlike a collagen stimulator, you see it at once.
  • Short downtime compared with surgery Presentable within a week, with makeup.
  • The material dissolves fully Nothing permanent is left behind.
  • Can suit mild early sagging Worth it in the mid-face or brow, with good skin.
Cons
  • The lift is modest A few millimeters, and less once swelling settles.
  • It is short-lived Six to twelve months, at the price of far longer options.
  • The evidence is weak Most studies are small, short and uncontrolled.
  • Complications are visible Dimpling, puckering, a poking thread end, asymmetry.
  • It is hard to undo A thread can sometimes be removed early, but not cleanly.
  • The marketing oversells it The facelift comparison does not hold.

How to Prepare

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2 weeks beforeA few days beforeOn the day
Events
2 weeks before
Do not book this within two weeks of an event. Expect swelling and bruising for about a week, and buy soft food ahead.
Blood thinners and alcohol
A few days before
Ask the prescribing doctor before pausing a blood thinner. Fish oil, vitamin E and ibuprofen raise bruising and are usually stopped a few days ahead. No alcohol for a day or two.
Photos
On the day
Have photos taken sitting upright, in the light you will be reviewed in. A settled result is hard to judge from memory.
Before you book
Get dental work done first, since wide mouth opening is discouraged for a few weeks. Reschedule if you have a skin infection, cold sore or inflamed acne in the area.

What Happens

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ArrivingThe treatmentLeaving
Arriving
You are assessed and marked sitting upright, because the face falls differently lying down. Photographs are taken and the provider explains how many threads go in and in which direction. Numbing cream first, then local anesthetic at the entry points and along the thread paths; larger treatments sometimes use nerve blocks. Your provider will ask about these things.
The treatment
Small entry points are made near the hairline or temple. A needle or cannula carries each thread along a planned path, the thread is anchored, and tension is adjusted while both sides are checked. A face takes 30 to 60 minutes. You feel pressure, tugging and an odd crunching rather than sharp pain. Soreness starts once the anesthetic wears off.
Leaving
Swollen and tight, with small marks at the entry points. Puckering or small dimples along the thread lines are common now and usually settle. The face looks more lifted than the final result.

Recovery

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Days 1 to 7Weeks 1 to 2Weeks 2 to 6
Days 1 to 7
Chewing, yawning and wide smiling are uncomfortable, and bruising at entry points is common. Stick to soft food, keep face movement small, and sleep on your back with your head raised.
Weeks 1 to 2
Small dimples and irregular lines along the threads usually smooth out. A dimple still there after two weeks should be reported, not waited out.
Weeks 2 to 6
The over-lifted look relaxes into the actual result. This is when the treatment can fairly be judged.

Aftercare

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1 to 2 days2 weeks4 weeks
Makeup
1 to 2 days
Once the entry points have closed, usually 1 to 2 days.
Face movement and heat
2 weeks
Keep face movement small — no wide yawning, tough chewing or loud singing. No sauna, steam room or hot yoga. Sleep on your back with your head raised for 1 to 2 weeks.
Facials and dental work
4 weeks
Avoid facials, massage and dental work on the area for about 4 weeks.
Exercise
About 1 to 2 weeks off, longer for impact or head-down positions.
Judging it
Wait at least 4 weeks, in photographs taken the same way as the originals.

Risks

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Serious complications are uncommon, but the ones that happen are visible and can take weeks to settle. This is more surgical than most injectables, and the risks reflect that.

Dimpling or puckering after two weeks
Small dimples along a thread line usually settle. One still there at two weeks needs looking at rather than waiting out.
A thread you can see or feel
A thread end can work toward the surface or poke through an entry point. It usually needs trimming or removing, by the person who placed it.
Uneven sides
Some asymmetry is normal at first. If it persists past a few weeks, say so.
Pain when you open your mouth
Ongoing pain with movement is worth reviewing.
Redness, warmth, pus or fever
These suggest infection along a thread track and usually need antibiotics, sometimes removal.
Numbness or a weak facial movement
Usually temporary nerve irritation, but it has to be checked rather than watched at home.
Hair loss at a temple entry point
Uncommon and usually temporary, but report it early.

In Deeper Skin Tones

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There is no evidence that the amount of lift or how long it lasts differs by skin tone. Threads work on tissue, not pigment.

What differs is how skin responds to being punctured and pulled. Entry points are small wounds, and in deeper skin tones they are more likely to leave post-inflammatory hyperpigmentation — a flat brown mark where the skin was inflamed. It usually fades, faster with daily sunscreen and early treatment, and bruising can look darker and last longer.

Keloid scars are the second consideration. The risk from a small puncture is low but not zero, so anyone with a history of keloids should raise it and ask where the entry points will go. Points near the hairline are easier to hide than ones on open skin.

The practical steps are the same for everyone but matter more here — fewer entry points, careful placement, sun protection from the day after, and treating any mark early rather than waiting to see if it fades.

If You Stop

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If you do not repeat it, the face returns to its own path. The material has already dissolved by about six months, so there is nothing to remove and nothing to wear off beyond the lift.

There is no evidence that stopping leaves you worse than if you had never had threads, and the change back is gradual.

One point worth knowing for later: scar tissue forms along each thread track, and some surgeons say previous threads make a later facelift slightly more fiddly while others do not. Nobody says it rules surgery out, but tell a surgeon you have had them.

Combining Treatments

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Same day
Topical retinoid
Works on the surface, so it does not conflict with threads.
Same day
Sunscreen
Works on the surface while threads work underneath.
Same day
Skin-quality treatments
Surface treatments, so no conflict.
Order matters
Botulinum toxin
Usually given before threads rather than after.
Order matters
Filler
Most providers restore lost volume first, then decide if a lift is still needed.
Wait 2–4 weeks
Laser, RF or microneedling
Two to four weeks either side on the same area, either order.
Wait 4 weeks
Facials, massage, dental
Avoided on the treated area for about four weeks.
Wait 4 weeks
Judging the result
Wait at least four weeks before judging it or agreeing to more.

Insurance Coverage

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Insurance does not cover it. Be careful with packages bought upfront, since the honest decision about repeating can only be made once the first result has settled.

Ask Your Doctor

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If you are pregnant or breastfeeding
Ask the doctor managing your pregnancy or breastfeeding first.
If you have loose neck skin or heavy jowls
Ask whether threads can do anything useful here, and what the surgical answer would be.
If you have had threads or surgery before
Say when and what was used, because it changes where new threads can go.
If you are prone to keloid scars
Raise it before entry points are planned.
If you take a blood thinner
Do not stop it without asking the doctor who prescribed it.
If you have a bleeding disorder
Say so, and say what medicines you take for it.
If you have an autoimmune condition
Discuss it first, particularly if it is active.
If you have an infection in the area
Broken skin, a cold sore or inflamed acne should clear first.
If you have dental work booked
Do it beforehand, since wide mouth opening is discouraged afterward.
If you have reacted to stitches before
Say what happened and what material it was.
If it is sold as a facelift alternative
Ask to see their own photographs at six and twelve months, not on the day.
If you are allergic to suture material
Say so. Also say what threads, filler or facial surgery you have had, and when.

At-Home Versions

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Topical retinoid
Good alternative
Improves skin quality and builds collagen over months. It changes texture and fine lines, not position.
Daily sunscreen
Good alternative
The most reliable way to slow further collagen and elasticity loss.
Microcurrent devices
Okay alternative
Short-lived firming at best, needing frequent repeat use. No lasting lift.
Face taping and facial exercises
Bad alternative
Taping holds skin while it is on and nothing after. Facial exercise has no good evidence for lifting and may deepen some lines.
Thread kits sold online
Bad alternative
Do not. Placing threads without training risks infection, scarring, nerve injury and threads that cannot be retrieved.

How It Compares

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Facelift surgery
Better
Repositions deeper tissue and removes skin, and the effect lasts years. Real surgery, real recovery, much higher cost. For moderate sagging this is the honest comparison, and threads do not approximate it.
Fillers for lost volume
Different job
A large part of what reads as sagging is lost support. Filler is predictable, and hyaluronic acid versions can be dissolved. It restores shape rather than lifting skin.
Biostimulators like Sculptra or Radiesse
Better
Slower and with no lift, but longer-lasting change and fewer visible complications. Often a better answer for a flattened cheek than a thread.
Radiofrequency and microfocused ultrasound
Better
Tighten skin without incisions, over several sessions, with results that are also modest. The closest comparison in ambition to threads, with less that can go visibly wrong.
Botulinum toxin brow lift
Better
A few millimetres of brow lift for a much lower cost and lower risk, wearing off in three to four months. Only useful for the brow.

Finding a Provider

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Threads are closer to minor surgery than to an injectable. Entry point placement, thread direction and tension all depend on knowing the anatomy, and complications are handled by whoever placed them.

In the US, threads are placed by physicians, physician assistants and nurse practitioners, with rules varying by state. Ask which thread material and brand they use and how many they plan, what they do about a dimple that has not settled at two weeks, whether they remove threads themselves, and whether follow-up is included.

Ask for their own photographs at six and twelve months, taken at the same angle. Day-of-treatment photographs show swelling and tension, not a result.

Red flags: the phrase non-surgical facelift, day-one photographs only, unbranded threads, a price clearly set as a promotion, no local anesthetic plan, no follow-up visit, and any comparison to surgery that does not mention how long each lasts.

Myths

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  • "A thread lift is a non-surgical facelift." It is not. Surgery repositions the deeper layer and removes skin, and lasts years. Threads gather skin a few millimeters for months.
  • "Threads last for years." The material dissolves in about four to six months and the visible effect usually fades within a year.
  • "The collagen keeps the lift going." Collagen forms along the thread track and firms the skin a little. It does not hold tissue in a lifted position.
  • "There is no downtime." Most people have visible swelling and bruising for about a week, and sore chewing for longer.
  • "More threads means a better lift." Past a point, more threads mean more entry points, more dimpling and more chance of a thread showing.
  • "If it goes wrong they just pull them out." Sometimes possible in the first days or weeks, often not cleanly, and not at all once the material has started to dissolve.

Questions Patients Ask

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How much lift do threads actually give?

A few millimeters, and less once swelling settles. Enough to soften an early jowl or lift a brow slightly in the right face. Not enough to change the outline of a face — anyone promising that is describing surgery.

How long do PDO threads last?

The material dissolves in about four to six months. The visible effect usually lasts around six to twelve months, then fades gradually. Some firming from the collagen along the tracks remains after the lift has gone.

Is a thread lift the same as a facelift?

No, and that comparison is the main reason people are unhappy afterward. A facelift moves the deeper layer of the face and removes skin, under surgery, and lasts years. Threads gather skin along a stitch for months.

Does it hurt?

Under local anesthetic it feels more strange than painful — pressure and tugging. The days afterward are sore, especially chewing or yawning, and that usually settles within one to two weeks.

What if I get a dimple, or a thread shows?

Both are recognized and both are fixable, but they need the provider who placed them. Dimples in the first two weeks usually settle on their own. A thread poking through, or a dimple still there at two weeks, should be reported rather than waited out.

Are threads worth the money?

It depends what you are comparing them with. For mild early sagging, in someone who cannot or will not have surgery and understands it lasts under a year, they can be. For heavy jowls or a loose neck they are not, and the same money spent on volume or put toward surgery usually gives a result people are happier with.

References

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