Guide to Threadlifts in Singapore 2022 by Dr Isaac Wong

When it comes to lifting the face, a traditional facelift first comes to mind — this age-old surgery procedure has been used for hundreds of years. However, its non-surgical counterpart, threadlifts, has fast been gaining in popularity among patients who do not wish to undergo surgery.

While not as intensive as a facelift, thread lifts can lift your sagging skin, sharpen your facial contours and elevate your nose bridge with less downtime at a lower cost.

It’s true — enhancing your appearance can now be safe and convenient. Read on to find out more about threadlifts!

A thread lift is a cosmetic procedure where temporary medical sutures are used to create a subtle yet visible “lift” in the skin. Instead of surgically removing loose skin as would a facelift, the surgeon simply suspends skin by stitching up portions of it. During a threadlift, multiple threads built with anchors or cogs are used to “hook” onto the tissues supporting the skin. This produces a pulling effect, therefore tightening and lifting your face.

Besides lifting the skin, threadlifts also fight ageing by activating the body’s natural healing process and stimulating collagen production. This is due to the threads used — as they dissolve, they trigger the body to release large surges of collagen in treated areas. As we all know, collagen is the holy grail that keeps us looking young and our skin strong and supple.

In other words, a threadlift works by 2 mechanisms of action:

• Mechanical lifting effect: the threads act as a scaffolding structure for tissues within the skin to hook onto for support
• Biochemical lifting effect: the threads and procedure itself triggers collagen production, which amplifies and sustains the effects of the treatment

Threadlifts bring along a plethora of benefits, including:

• Defines and sharpens your facial contours
• Elevates your nose bridge and tip
• Rejuvenates skin for a youthful appearance
• Smoothes fine lines and wrinkles
• Brightens skin tone
• Improves appearance of stretch marks and acne scars
• Stimulates collagen production
• No need for surgery
• Natural looking results

Polydioxanone (PDO)
PDO is a material commonly used in most aesthetic clinics for threadlifts. Outside of threadlifts, PDO is also used in surgical settings to stitch up wounds. In countries like Korea, PDO is noted for eliminating folds, reducing the visibility of wrinkles, enhancing skin texture and lifting your nose, forehead and neckline.

PDO threads take about 6 months to dissolve and be processed by your skin; as it dissolves, it stimulates your skin to produce collagen. The full effects last for about 12 months.

Poly-L-Lactic Acid (PLLA)
PLLA as an ingredient is meant to rejuvenate your skin and stimulate natural tissue revitalisation. When introduced to skin, lactic acid is released into surrounding tissues, stimulating rehydration and the development of collagen. As it dissolves, PLLA breaks down into compounds like water, oxygen, lactate and carbon dioxide.

Polycaprolactone (PCA)
Out of all the threads, PCA lasts the longest, for up to 2 years. This is because PCA’s compositions and chemical bonds are more complex and thus take a longer time to fully dissolve. Due to its slow degradation period, PCA is often used on parts of the body where there are hard tissues or where healing takes a long time.

In addition, PDA is recognised as being the strongest at stimulating collagen production compared to PDO and PLLA. Even after it dissolves, collagen production continues for up to a year.

Apart from material, threads lifts also come in different types.

Mono threads
Mono threads are lined in a mesh-like pattern and inserted into the subdermal layer of skin for a tightening effect. They are smooth threads and do not contain barbs. Skin tightening effects usually take place once collagen is in production.

About 10-20 mono threads are used in a threadlift. These threads hook to a point on the skin to support a lift. To enhance tightening results, mono threads are usually used in conjunction with cog threads.

Cog threads
Cog threads are essentially mono threads that come with barbs to hook to the underside of your skin. These barbs aid in lifting sagging tissue. As such, cog threads do not require anchor points, unlike mono threads. Cog threads are particularly useful around the jawline area.

Screw or tornado threads
Screw threads are often used for general facelifting due to the volume they produce on sunken areas of the skin. Screw threads come in two threads intertwined around a needle for insertion.

As threadlifts are considered non-invasive, they can be performed on most parts of the body and face that tend to show sagging. These are the more common areas threadlifts are performed on and their effects:

• Nose: gives a sharper nose bridge, enhances the nose tip to look sharper and smaller, and can be used on deviated noses for a straighter nose bridge
• Neck: improves texture and tone in the neck to give it a soother appearance
• Eyebrows: raises the edge of the eyebrows to give you a “brighter” and more “awake” look. Can be used for eyebrow ptosis too
• Cheeks: helps to lift the cheeks to give the jawline an overall smaller and sharper face. Final result is plump and full without looking too “dry”

Apart from these areas, threadlifts can also be performed on the inner thighs, inner armpits, breasts and butt.

Men and women over 30 or individuals who are starting to show signs of ageing are best suited for threadlifts. If you display any of these symptoms, you make a perfect candidate for threadlifts:

Your skin is sagging
If your skin is starting to sag or is showing moderate signs of sagging, then a threadlift can help tighten your skin around the eyes, cheeks, brows, jowls and neck.

You want a contoured nose
If you want a sharper nose tip or simply want to correct bumps on your nose, threadlifts can help you achieve the effect of a slim and contoured nose, similar to how people contour their noses with makeup.

You are experiencing sagging eyelids due to weakened muscles
Droopy eyelids are from a disorder known as ptosis, where surrounding muscles are damaged and cannot form as well as they should. Threadlifts can help correct this saggy and droopy look.

You need a little touch up from your previous facelift
If you find that the effects from your facelift done previously are fading, a little help from threadlifts can restore the tightness you once had.

The threadlift has its limitations — I find this aspect not addressed enough. These are some factors the threadlift is not able to fix:

You have fragile skin
If you have very thin or fragile skin caused by ageing, you might not be suitable for threadlifts. This is because in order for threadlifts to work, a decent facial structure is required to retain the suture.

You have heavy sagging
If you have strong or severe skin sagging, threadlifts won’t be able to make much of a difference.

You have a severely crooked nose or extremely flat nose bridge
Nose threadlifts cannot replace a rhinoplasty. Nose threadlifts are better suited if you already have some height to your nose bridge, but just want a little extra elevation and more definition. Likewise, if you have a severely crooked or deviated nose, threadlifts cannot correct that.

Your first consultation would involve:

• Checking your suitability for threadlifts
• Your doctor lets you know what to expect, from medical technicalities, level of pain, medication to take etc. During this consultation, you should also ask as many questions as you can
• Discussing and managing your expectations

In addition, I often ask patients to avoid consuming caffeine and smoking for at least a week before the treatment to avoid any interference with the anaesthetic.

The actual threadlift procedure will go something like this:

• Measurements and markings are made on the treatment area. 
• Numbing cream is applied for 15 minutes. Local anaesthesia is then injected to reduce any discomfort and pain felt during the treatment.
• A small needle is used to create an entry point for the threads. 
• The threads are inserted via a cannula. Once the threads enter your skin, the cannula is removed.

In Singapore, the cost of a threadlift will range between $1000-$5000, depending on factors like:

• The number of threads used
• Type of threads used
• Experience of your doctor

Most patients can see effects after their face heals and collagen forms.

Threadlifts are not permanent, mainly because you cannot stop the process of ageing. Unlike facelift surgery that can last for up to a decade, threadlifts last for about 1 to 3 years. However, due to the convenient and ease of this procedure, threadlifts can be done repeatedly at appropriate intervals for longevity.

As threadlifts are a non-invasive procedure, downtime is very minimal with mild swelling and bruising that resolves on its own after 1 to 3 days. Most patients can go back to work and resume daily activities after their treatment.

Although there is minimal downtime, patients are advised to do the following for faster recovery and to avoid any complications:

• Avoid applying makeup for 48 hours
• Avoid going for massages or intense exercise for 2-3 weeks
• Avoid facial creams for 48 hours
• Avoid chewing gum for 14 days
• Keep your head elevated for 5-7 days, especially when sleeping
• Ice the treatment area for 30 minutes for the first 5 days
• Try to avoid using straws to minimise movement of your facial muscles

You should avoid flying on an airplane 48-72 hours after your threadlift procedure. This is because air pressure is higher in the air than the ground; therefore there’s a higher chance of blood pressure fluctuations and splitting of the wound, resulting in a longer recovery period.

Side effects from threadlifts are rare. If they do occur, you may experience:

• Nausea from the anaesthesia
• Bruising
• Swelling
• Infection
• Migration
• Foreign body reaction
• Facial nerve trauma
• Tenderness and pain after the anaesthesia wears off

Fortunately, if you do not like the results you see, they won’t be permanent. However, you have to wait till the threads fully dissolve, and that might take at least a year. Hence, it’s important that you set your expectations right with your doctor and of course choose a doctor that’s experienced enough.

Absolutely — threadlifts can be done concurrently with other aesthetic treatments such as fillers to produce synergistic results.

Threadlifts are a safe and effective way to correct signs of ageing by lifting and rejuvenating your skin. They’re also a great option if you’re looking to boost the height of your nose non-surgically. To find out if threadlifts can meet your cosmetic goals, it’s best to book an appointment with an aesthetic doctor in Singapore to enquire on your best options.

As a rule of thumb, I always encourage patients to start small, especially if it’s their first time doing threadlifts or any aesthetic procedure in general. Start with a small amount, and if you like the result you see, you can always top up or maintain later on. Remember — the goal of aesthetics is to enhance your appearance and produce natural looking results, not to drastically change your appearance to the extent that you look unnatural.

Got questions? Feel free to contact me through these various methods:

• direct message me on Instagram (Instagram.com/dr.isaac.wong)
• whatsapp me @ +65 88089887
• email me @ dr.isaac.kj.wong@gmail.com

References

(1) Garvey PB, Ricciardelli EJ, Gampper T. Outcomes in threadlift for facial rejuvenation. Ann Plast Surg. 2009 May;62(5):482-5. doi: 10.1097/SAP.0b013e31818c18ed. PMID: 19387145.
https://pubmed.ncbi.nlm.nih.gov/19387145/

(2) Sardesai MG, Zakhary K, Ellis DA. Thread-lifts: the good, the bad, and the ugly. Arch Facial Plast Surg. 2008 Jul-Aug;10(4):284-5. doi: 10.1001/archfaci.10.4.284. PMID: 18645100.
https://pubmed.ncbi.nlm.nih.gov/18645100/

(3) Kang SH, Moon SH, Kim HS. Nonsurgical Rhinoplasty With Polydioxanone Threads and Fillers. Dermatol Surg. 2020 May;46(5):664-670. doi: 10.1097/DSS.0000000000002146. PMID: 31517664.
https://pubmed.ncbi.nlm.nih.gov/31517664/