Thread Lifts vs. Hyaluronic Acid: What's the Difference, and for Whom

When facing facial sagging, two treatments often come up in conversation: thread lifts and hyaluronic acid. They are sometimes presented as interchangeable, which fuels real confusion. In reality, they follow two different approaches.

Two mechanisms, two goals

Hyaluronic acid is a filler product: it restores lost volume or corrects a hollow, with an immediate effect.

Thread lifts, on the other hand, don't fill anything: they are resorbable polydioxanone (PDO) threads, inserted under the skin, which produce an immediate mechanical lifting effect, then stimulate collagen production over time. Their goal is not to add volume, but to redefine and firm a contour that has sagged.

This difference in mechanism largely determines which of the two treatments is more relevant to your situation.

Polydioxanone, a material already well known in surgery

PDO is not a new or experimental material: it is a resorbable thread that has long been used in surgery to close wounds, valued for its good tolerance and its gradual, predictable resorption by the body. Its use in aesthetic medicine relies on this same material, simply inserted differently, under the skin of the face, to take advantage of both its mechanical hold and the effect it produces on surrounding tissue.

A two-stage effect: mechanical first, biological second

Placement produces an immediate, purely mechanical lifting effect, visible as soon as you leave the practice. But a second mechanism sets in over the following weeks: the presence of the thread in the dermis triggers a mild reaction in the body that stimulates collagen production around it. It is this second, biological and slower effect that explains why the benefit continues well beyond the resorption of the thread itself.

Who are thread lifts suitable for

Thread lifts are particularly suitable for patients with moderate skin laxity, without significant volume loss: a facial oval that is starting to sag, cheeks losing tone, without being hollow.

Conversely, if the main issue is volume loss (sagging cheekbones, hollow cheeks, deep under-eye hollows), hyaluronic acid is often the more suitable answer: there is nothing to "re-tighten" if what's really missing is volume.

The areas most frequently treated with thread lifts are the facial oval, the cheeks and cheekbones, the eye area and eyebrows, as well as the neck and décolletage. Find the full details on the thread lifts page of the site.

Key takeaway: a face that's hollowing needs volume (hyaluronic acid). A face that's sagging without hollowing needs lifting (thread lifts). The two approaches are often combined on the same face.

Acting early on emerging sagging rather than waiting

Thread lifts often give their best result when used on still-moderate sagging, before it becomes firmly established. A facial oval that is just beginning to lose definition generally responds better to this progressive approach than sagging that is already significant, where the mechanical lifting effect reaches its limits.

What thread lifts cannot correct

Pronounced skin laxity, with visible excess skin, goes beyond what a non-surgical technique can offer: threads redefine and firm, they do not remove excess skin. In these more advanced cases, a consultation allows for an honest recommendation toward the most suitable option, even if it falls outside the scope of non-invasive aesthetic medicine.

How long results last

This is a point that is often misunderstood: the thread lifts themselves are resorbed within 6 to 8 months. But their effect does not disappear at that point: the collagen stimulation they triggered keeps working, for a total estimated benefit of around 12 months.

What to expect after placement

The lifting effect is visible immediately after placement, with gradual optimization over the following month, as collagen reorganizes around the threads.

Moderate swelling and tenderness to the touch may persist for 3 to 7 days, sometimes with small bruises. Most patients resume normal activity within 2 to 3 days.

Can the two treatments be combined

In practice, thread lifts and hyaluronic acid are often used together rather than against each other: threads redefine and firm the facial contour, while hyaluronic acid restores volume that has faded over time. The decision to combine them or not is made on a case-by-case basis, depending on what the examination of your face reveals.

In brief

• Thread lifts lift and firm; hyaluronic acid fills a volume or a hollow.
• Thread lifts are mainly suitable for moderate sagging without volume loss.
• The effect of thread lifts lasts about 12 months, even though the threads themselves are resorbed within 6 to 8 months.
• The two treatments are often complementary rather than mutually exclusive.

Torn between thread lifts and hyaluronic acid? Book an appointment at Dr Mergui's practice, 8A Frishman, for advice tailored to your face.

This article is for informational purposes only and does not replace a medical consultation. Only an examination of your face can determine the most suitable treatment.