The Truth About Thread Lifts: Will Your Skin Sag After the Threads Dissolve?
Darlene asked me a question that so many of you are thinking about, and it's a good one. She wanted to know: if you get a facial threading treatment—specifically a PDO thread lift—and the threads eventually dissolve, will your skin end up looser than before? She was afraid of doing something that would make things worse, leaving her with a result she never wanted.
Let me tell you a story about what really happens beneath the surface.
When we talk about facial threading, most people are referring to PDO threads. There are other materials, like PLLA and PCL, but PDO is the classic. And within PDO, we have two main types: smooth threads, which are like little collagen-building nests, and barbed threads, which have small hooks and are designed to lift. Darlene's question is really about those barbed threads, the ones that pull and lift the skin.
Now, the fear is understandable. People think, "If this thread is holding my skin up under tension, and then it dissolves, won't my skin just fall back down, maybe even looser than before?" But here is the key insight you need to understand.
Your body is not a passive piece of fabric. It is a living, healing system. PDO threads have been used for decades in resorbable sutures. If you have ever been stitched up for a surgery or an injury and the stitches dissolved on their own, you already have PDO in your body. And what did you notice about that scar? In that area, the skin became firmer, tighter, and better. That is not a coincidence.
This happens because the thread stimulates a powerful biological response. When the thread is placed, it triggers fibroblasts, your body's master repair cells, to rush to the area. They begin to produce new collagen and initiate a natural wound-healing cascade. This process actively tightens and thickens your skin from within. You are not relying on the thread to hold you up forever; you are using the thread to activate your body's own tightening mechanism.
For smooth threads, the goal is purely this collagen-building effect. They don't lift, but they tighten and improve skin quality. Most people do these a few times a year, and the results are cumulative. The smooth threads are excellent for areas like laugh lines, the borders of the lips, the neck, and even the abdomen.
The barbed threads, which are what most people think of when they want a lift, do provide an immediate mechanical lift. But here is what few people realize: that lift is only the beginning. These are larger threads, often delivered with an 18-gauge cannula. That volume of material in the tissue creates an even stronger, longer-lasting collagen stimulation. The scar tissue that forms is dense, fibrous, and creates a permanent structural improvement.
So what about the fear of ending up looser? I have personally performed thousands of these procedures—hundreds and thousands, not hundreds of thousands, but certainly in the thousands—and I have taught this technique all over the world. I have never, in my entire career, seen or even heard of a case where a patient's skin became looser after the threads dissolved. It simply does not happen. In fact, the opposite is true. The skin is tighter and better than it was before you started, even years later.
Now, there is a reason some people spread fear about this. You might hear stories from practitioners who have never done a thread lift themselves, or who see patients in their clinic who have had bad results from other providers. But those bad results almost always come down to one thing: poor patient selection. If you thread a face that has severe, excessive loose skin that truly requires a surgical facelift, you will not get a satisfying result. The threads cannot fix what surgery is meant to fix. That is not the problem of the thread; it is the problem of unrealistic expectations.
For patients with mild to moderate loose skin who want a subtle, natural lift, threads work beautifully. And if you need a facelift later in life, you can absolutely still have one. I have interviewed many plastic surgeons who have performed facelifts after thread lifts, and they confirm that the threads do not interfere with surgery. In fact, the collagen stimulation can make the skin healthier and easier to work with.
So the real story here is about finding the right candidate and a skilled, experienced practitioner. Be wary of anyone who either oversells the lift or tries to scare you away with baseless claims. The fear of sagging after threads dissolve is not based on real-world clinical evidence. It is based on misunderstanding and, sometimes, on people protecting their own livelihoods from a treatment they do not know how to perform.
Get your information from people who do this every day. A good practitioner will be honest with you: if you need a facelift, they will tell you to get one first, and then maintain with threads. But if you are a good candidate, threads are a powerful tool that can lift your face while simultaneously building stronger, tighter skin from the inside out.
Your skin will not be looser after the threads are gone. It will be better. And that is the truth the story tells.