Are Thread Lifts For Men The Next Big Thing?

It’s a known fact that women are more inclined to dabble in aesthetic procedures than men. But thanks to ongoing education and a push in the right direction from savvy dermatologists and plastic surgeons, the male population is partaking in more preventative and rejuvenating skincare, treatments, and procedures than ever before. In fact, according to data released by the American Society of Plastic Surgeons (ASPS), minimally invasive cosmetic treatments in men totaled a whopping 11.2 million procedures in 2020. Of course, botulinum toxin (read: Botox® and the like) claims the number one spot, but could a somewhat more invasive non-surgical treatment, like the thread lift, call dibs on it soon?

The idea of ‘tweakments’ for men has been growing for quite some time, says Ava Shamban, MD, a board certified dermatologist in Santa Monica, CA. “We are most definitely well past just ‘Brotox,’” she notes. “Men are now coming in droves for treatments and ongoing maintenance.” Procedures like fillers and injectables have paved the way for thread lifts, which are thought of as the next ‘step up’ for lifting, contouring, and defining an aging face.

What Is a Thread Lift?

With age, collagen and elastin levels dip, and the common signs of aging (think: fine lines, wrinkles, and sagging) become evident. Coupled with collagen degradation and volume loss, which occurs when fat begins to shift, the face can start to fall a little flat as its youthful curvatures disappear. Those changes are precisely what a thread lift targets.

Before the availability of threads, the primary tool to address volume loss and skin laxity was a surgical facelift or the placement of a permanent suture that required more invasive techniques, says Julius Few, MD, a board certified plastic and reconstructive surgeon in Chicago. “Fillers can be used to restore volume but are not designed to reposition tissue, creating a void of non-invasive options to address sagging facial skin,” he explains. That’s where the thread lift comes in.

Today’s thread lift procedures are safer and more advanced than their predecessors. The current versions involve absorbable PDO threads bearing tiny barbs that suspend the tissue. They are inserted under the skin and then pulled and locked into place to create a tighter, lifted, more defined look. There are also threads made from poly-L-lactic acid (PLLA) and polycaprolactone (PCA). Your doctor will decide which type to use based on what the skin needs. Yet, most men require the PLLA-based Silhouette Instalift®, which Yael Halaas, MD, a double board certified facial plastic and reconstructive surgeon in New York City, says pulls up their thicker tissue. “Smooth threads do not work as well for men,” she adds.

One of the many benefits of a thread lift is the creation of new collagen. As the thread material dissolves, it prompts the body’s natural collagen production processes. “This helps prolong the benefits of the lift,” Dr. Halaas shares. While the threads last three to six months, the collagen that remains lasts indefinitely (or until it breaks down on its own).

Thread lifts are a minimally invasive solution that come with no incisions or scars and hardly any downtime compared to other procedures that target similar concerns, like a facelift. The catch? The results aren't as dramatic or lasting (especially when comparted to a facelift). Even so, many doctors feel a thread lift offers a subtle yet substantial change.

Who’s Getting Thread Lifts

The average male thread lift patient is, according to Dr. Shamban, noticing skin laxity with deepening smile and marionette lines that are sometimes accompanied by neck sagging. “They are trying a range of toxins, dermal fillers, and tissue-tightening devices,” she says, but they often need more than what non-invasive options offer and aren’t quite ready for facial surgery. “Men who are doing thread lifts are concerned with either the midface and the neck and jowl or the neck area, particularly if they have a less prominent or smaller jaw structure,” she notes. Overall, they want a sharper, smoother profile and more definition in the jawline or midface.

Not everyone is a candidate for a thread lift. Because the results are short-lived on more mature skin, Dr. Few suggests them for younger guys in their mid-thirties and up into the early fifties. “Most patients over the age of about 55 will benefit more from facelift surgery,” he says. The exception? “Thread lifts can, however, be a facelift-alternative for older patients who are unable to have surgery for medical reasons, but the results will not be as dramatic as seen in the younger patient,” he adds. Additionally, because thread lifts are performed under local anesthesia, those with conditions that make them ineligible for surgery (like high blood pressure, type two diabetes, and cardiovascular disease) can more safely consider a thread lift. Just be sure to keep in mind that the procedure will not remove loose skin or treat significant sagging.

While many doctors are noticing a surge in men partaking in thread lifts, some are seeing the pendulum swing in the opposite direction. Paul Nassif, MD, a board certified plastic and reconstructive surgeon in Beverly Hills, CA, isn’t seeing as many male thread lift patients as he once did. “It was more popular in my practice pre-COVID,” he says. Nevertheless, the fellas aren't bypassing the plastic surgeon's office. Instead, Dr. Nassif notices more men coming in to treat tech neck. “They’re seeing extra skin on the neck, and the skin is heavier and thicker there, so it needs more aggressive work than what a thread lift offers,” he explains. “Most of the time, they opt for a neck lift.”

Filler vs. Threads: Which One Is Better?

A common misconception about fillers is that they lift. In actuality, they fill and plump. When attempting to use fillers for lifting purposes, they often end up causing puffiness and distort the face, Dr. Halaas explains. “I always educate my patients that facial rejuvenation is a cohesive approach to volume, skin laxity, and skin texture,” she says.

Many doctors devise their own combinations of non-surgical solutions to create a natural-looking lift. For example, Dr. Halaas uses a two-stage approach of filler and threads to give men the maximum results possible for a lift through the midface. Similarly, Dr. Few invented what he calls the Inverso Suspension technique, which incorporates thread lifting, volume restoration of the jawline, and microdoses of Botox® (or Xeomin®) in the frown muscles to create “a graceful appearance that is not ‘done’ or unnatural.”

The Pros & Cons of Thread Lifts

Every procedure — surgical or non-surgical — has advantages and disadvantages, and the thread lift is not without the good, the bad, and, in some cases, the ugly (more on that in a minute). These are the points of contention and praise surrounding the 30-minute procedure:

THE PROS

• It’s a relatively quick procedure. From start to finish, a thread lift takes about 30 minutes. It is performed in the office under local anesthesia. If additional procedures, like neuromodulators, are performed in tandem, expect to block out a little more time.
• There’s minimal downtime. You won’t be recovering for weeks as you do with a facelift. Sure, there is minor swelling and bruising during the first week after a thread lift, but that soon subsides.
• It’s not nearly as invasive as surgery. While the results of a thread lift are not a mirror image of what surgery provides, that's the tradeoff for less invasivness. There is no cutting, dissection, or skin removal, making the procedure much less intrusive (it’s often categorized as ‘minimally invasive’). However, expect some minor discomfort since injecting anesthesia is necessary to place the threads properly.
• There’s no scarring. Because there is no cutting of the skin nor any incisions made, there are no resulting scars. In addition, as Dr. Shamban explains, a thread lift does not change or move the hair-bearing regions (the beard and sideburns), which may change with a full or lower facelift.

THE CONS

• Loose skin is not addressed. Even though the procedure can lift minimally saggy skin, it will not remove it. Therefore, the skin that remains before the lift is still intact afterward.
• It doesn’t last that long. On average, the lifted and improved profile lasts about nine months to two years, with the initial dissolving of the threads around the three- to four-month mark. Some patients notice the lifting effects begin to wear off after just a few months.
• There is the risk of puckering and pulling. Post-treatment bunching is to be expected, which is nothing more than the sutures fully settling into place. But when the skin stays in a puckered state for weeks or even months, it’s a sign of threads gone bad. Threads (like fillers and other treatments) can cause serious issues and pain for patients when done incorrectly. “Depending on the type of threads being used, they can be nearly impossible to remove and cause permanent tethering or scar tissue,” Dr. Halaas cautions.
• Additional procedures may be needed. A thread lift won't stop muscle activity or the formation of lines and wrinkles , which are significant factors in aging. When hanging muscles are present in the neck, Dr. Nassif suggests Botox® to help soften it. “Non-invasive procedures, like radiofrequency treatments that deliver on top of the skin, can help tighten up the neck,” he adds. Other procedures that may maximize the result are Kybella® or CoolSculpting® to eliminate excess fat.

Is a Thread Lift Right For You?

Thread lifts can make a world of difference in the right patient. In the wrong one, they won’t do much for the face and may even do more harm than good. While thread lifts sometimes get a bad rap because of their potential to crease and wear off quickly, they help create new collagen in the skin — something that is beneficial to anyone in their thirties and beyond.

If you notice sagging in the neck and a lack of definition in the jawline, you may want to consider a thread lift assuming:

• It fits in your budget. Generally, thread lifts are less expensive than surgery. But, since most providers charge per thread (it can start at $400 per thread and go up from there), it can get pretty costly to treat larger areas.
• Downtime associated with surgery is not an option. You may be a little sore or swollen for the first few days or week after a thread lift, but you won’t have to take time off work to recover as you do with a facelift. Remember, a thread lift does not remove excess fat or skin, so there needs to be small amounts of sagging to be effective.
• You’ll be happy with an understated result. Compared to a facelift, a thread lift result is less dramatic and won’t last as long. That’s because there is no skin excision or muscle, fat, or tissue repositioning. Dr. Nassif finds that his patients tend to be initially pleased with a thread lift, “and then, once the results start to go back, they’re not so happy with it.”
• Your goal is to avoid surgery. As with all non-invasive and minimally invasive procedures, a desirable outcome that eliminates the need for surgery is a win-win for the patient. Dr. Halaas adds that the convenience of threads, the quick recovery, and the result make it very appealing.

Consulting with a board certified dermatologist or plastic surgeon who specializes in men is the best way to ensure you receive the best treatment for your anatomy and aesthetic goals.