Healthy Beginnings

The PDO “Non-Surgical” Thread Lift

Google Image Files of Threads used for this article:

Barb took her index and middle finger, placed it on the angle of her jaw, and pulled the skin back toward her ear. She performed her very own, temporary neck lift.

Barb is a great patient. She came to us almost in desperation. Hot flashes night sweats, irritable, could not sleep. “I snap at the least little thing,” she said.

Barb was miserable, her husband Ron and daughter Casey were miserable. Her co-workers openly avoided her. Three months after our evaluation and beginning a Bioidentical Hormone Replacement regimen, Barb was her old self. “You fixed my insides, Dr. C.,” she said, “Now it’s time for the outside.”

After balancing her hormones, we Botoxed the frown lines between and around her eyes, added dermal fillers to raise her cheekbones and enhance her lips and improved her skin tone and with our Vampire Facelift.

“I think you look great, Barb,” I said. Barb shook her head.

“No, she said tugging the loose skin under her neck back toward the angle of her jaw. “This needs a hiking.”

Barb flattened both sides of the offending skin with her index finger and middle finger.

“I’ve got something new for you,” I said.

“No surgery,” she said. “I have to work. I can’t afford downtime.”

“No surgery,” I replied. “I have these new threads,” I said. “They create a true lift.”

“Eh,” she said, “Threads? I did them 10 years ago.”

Barb swept her blonde hair away from her shoulder, pointing to a messy scar behind her ear.

“Those were ‘permanent’ sutures,” I said. “They were inserted behind your ear and tied together, broke easily leaving one side uneven.”

“These are different,” I said. “These are called polydioxanone, or PDO threads. PDO fibers dissolve after four to six months, require, at most, only a minute pin size, less than 1/10 of 1 milliliter, of anesthetic. They’re not needles, so there’s no cutting. We thread them into place, advancing them over your skin like a curtain rod over a curtain.

“What about the ties,” she replied. “You will have a terrible time getting through those scars.”

“No ties,” I said. “When we have them in place, we smooth the threads engaging the underlying dermis. If there is excess thread, we cut them in a downward motion burying it under the skin. You will not even know they are there.”

“Neat,” Barb said. “No cuts, right?”

“No cuts.”

“And they work where?”, she asked.

“These threads work great on the cheeks, brow, jawline, neck, the nasolabial folds, the marionette lines, and on sagging arms, hands, thighs and abdomen.”

“I lost all that weight awhile back on your Paleo Cleanse Diet,” Barb said, “and I have a lot of loose hanging skin. Can we use PDO threads for that?”

“Not only on loose hanging skin,” I said, “We can even place them in the middle of the forehead.”

“You mean where I have that irrigation ditch of a wrinkle and we can’t Botox it because I’ll get an eye droop?” Barb asked.

I went on to explain: “PDO threads are popular in Asia, the Philippines, and Korea,” I said. “They’re relatively new here, but catching on fast. Not only do we get a bit of instantly gratifying skin tightening and lifting, but long term, the texture of your skin continues to improve.

“The threads agitate the tissue directly underneath the surface creating microtraumas. The body responds by kicking into gear its’ normal regenerative processes, specifically the migration of fibroblasts. As the threads dissolve, the fibroblasts produce collagen, elastin and hyaluronic acid, structural components of skin. (1)

“Magnified 200x under a microscope, collagen fibers were seen to be arranged circumferentially around the PDO threads. Neovascularization, with increased and proliferated blood vessels was evident. As the collagen fibers matured, they were seen to be arranged along the longitudinal axis of the dissolving PDO threads. (2)

“The threads absorb in about six months creating new collagen layers by creating a selective inflammatory response. The result is a controlled healing. The skin holds in place for up two years.

“We insert the sutures under the skin to tighten and lift problem areas. For skin tightening, in the cheeks, under the neck, the jiggly part of your arms, hands, abdomen, or legs, we use smooth fibers in a tic, tac, toe board or hashtag # like pattern.

“For a lift of the nasolabial folds, marionette lines or neck, for example, we use “barbed” or “cog-like” filaments to grip the skin. Once in place, we pull them both up and out instantly repositions the skin to where it was before the ‘fall.’

“No cuts. The skin tightening ‘hashtag’ threads are all inserted parallel to the skin, in the subdermal layer. When they are in place, all five to seven needles are pulled out leaving the threads behind.

“We use our less than pea-sized local anesthetic here to create a tiny opening, then we insert them under the skin. When they are in place, we pull them back, smoothing the wrinkles and lines and along the way. The ‘barbs” or ‘cogs’ catch the skin pulling it in the direction we want.

“Then, we cut the sutures, burying them under the skin. No knots. No bumps in the skin. The sutures themselves dissolve in four to six months all the while stimulating collagen growth. The skin stays in place up to two years or more.

“The thread lift will last anywhere from 18 months to a few years, and additional threads can be added anytime as maintenance. The cogs and barbs stimulate collagen continuously, resulting in continuous improvement over time.

“When we combine procedures, we see even better results. We often use the absorbable suture lift in combination with fillers, Botox, PRP, and our so-called Vampire Face Lift creating a synergistic effect. Instead of 1+1=2 we get 1+1 =5. The results can last many years and with maintenance theoretically, will never wear off.”

“And they’re safe?”, she asked.

“They’ve been used in heart surgery for 35 years,” I replied.

Barb settled back in the treatment chair.

“Thread me, Doc.”

To find out if the PDO Thread Lift or any our facial and body rejuvenation treatments are right for you, call us at 775-359-1222 or email


  1. Yoon, J., Kim, S., and Yang, S., Mini-Pig Experiment Finished,