Thread Lift versus Dermal Fillers – Reviews, Differences, Price

Face thread lift versus dermal fillers: which is the most suitable face anti-aging treatment for you?

This review study compares thread lifts and dermal fillers based on uses, differences and price.

When we speak of face anti-aging treatments, there is a few aspects that needs to be addressed individually to provide the best results. As we age, there are a few changes that occurs.

1. Drooping of fat pad of the mid face leading to jowls and saggy cheeks
2. Loss of skin elasticity with the loss of collagen
3. Loss of volume leading to sunken appearance
4. Formation of static lines from repeated facial expression over the years

Different Uses of Thread lifts versus Dermal Fillers

To address each of the problem mentioned, the approach is very different.

1. Repositioning of skin and fat – threads
2. Skin integrity – energy devices (HIFU e.g. Ultherapy, Ultraformer 3, Radiofrequency e.g. Thermage, Long pulse lasers)
3. Volumise – Fillers
4. Expression lines – Botox

Types of Thread lifts

In this article, I will discuss the different type of thread lifts available around the world, the expected results and how it compares to fillers.

Threads serves 2 purposes – 1. Repositioning of sagging fat pads 2. Localised stimulation of collagen

	Biodegradation period	Tensile Strength	Main aim	Discomfort
PDO Threadlift	6-8 months	Strong	Repositioning	Slight
PLLA Threadlift	14-18 months	Strong	Repositioning, volumize	Strong
PCL Threadlift	18-24 months	Weak	Collagen stimulation	Low

Upon threads are insertion, an inflammatory reaction to the surrounding area is induced. When examined under the microscope. granulation tissue starts forming surrounding the threads in the next few months and this supposedly improves on the elasticity of the skin. The longer it last (biodegradation period) the more collagen is stimulated. However, the response is localised and gradual, one may not be able to visualise and appreciate this change.

Repositioning of fat pads can be achieved with threads of higher tensile strength when strategically placed on vectors that provides the maximal ‘lift’ to the skin. The short-lived immediate ‘lifting’ effect gives great patient satisfaction in the next few weeks. Thereafter, the continuous cellular activity with fat cells bio-remodelling leads to subtle improvements in the next few months.  

However, thread lift often leads to poor patient satisfaction for the following reasons

• Unrealistic expectations from misinterpretation or misrepresentation of online sources
• Insufficient number of threads used
• Threads not placed at optimal planes
• Extended period of downtime
• Loss of immediate lift effect after first few weeks

Although threads had been highly raved about when it was first approved by the FDA in 2015 followed by the many Korean techniques and development in thread material over the years. It has not and will not replace the use of fillers. And this is why.

Thread lift versus Dermal fillers: Reviews, Price

Fillers replaces lost volume in desired areas which is able to contour the face instantly. Undereye fillers and cheek fillers are commonly done to contour the mid face. This provides immediate improvements and lifting effects that last for up to two years.

Compared to thread lifts, fillers had also been in the market for a lot longer and injection techniques and filler material are continuously improving enabling results to be increasingly predictable and reproducible.

Conventional hyaluronic acid (HA) fillers does not stimulate collagen. The effects last for about 12 months although some HA fillers claim to last longer for up to 18 months. Collagen stimulating fillers generally last longer around 4 months and due to its collagen stimulating properties the skin integrity also improves. Compared to HA fillers, the cost of these fillers are usually higher and they are not ‘dissolvable’ if you are happy with the results. As collagen stimulation is a result of inducing a low grade inflammatory response in these fillers, the risk of granuloma formation (lumpiness caused by immune response of the body to wall of foreign body) is slightly higher. An example of collagen stimulating filler would be Sculptra, containing PLLA, which is also the material used in SIlhoutte soft (FDA approved) thread.

Permanent fillers are rarely used as unwanted effects are not easily correctible and lasts permanently. Besides, our facial profile changes as we age and the fillers that remains at the same place can lead to unnatural appearance at a later stage. As such, permanent fillers containing silicone, polyacrylamide, polyalkylimide and PMMA are mainly used by only a small group of experienced plastic surgeons.

	Fillers (HA)	Collagen stimulating fillers	Thread lift
Biodegration	~ 12 months	~ 24 months	~ 6-24 months
Collagen stimulation	–	++	++
Downtime	+	+	++ – +++
Results immediate	+++	+++	++
Results at 2 months	+++	+++	+/-
Results at 6 months	++	+++	+++
Results at 12 months	–	++	+
Cost	From $700	From $1000	From $2000

Compared to thread lifts, fillers give more immediate results with less downtime. The replaced volume is easily appreciated. However, to treat problems like jowls, repositioning of fats with threads may be more ideal.

The two treatments are both treatments to restore youth. However, they are designed to treat different problems. Depending on your concerns, you may benefit more from one treatment then the other.

It is important that you have a face-to-face consultation with an experienced doctor to explore the different treatments that best suit you!