Thread lifting is often marketed as a minimally invasive alternative to surgical facial rejuvenation. Promoted for its convenience and short recovery time, it has gained popularity among patients looking for subtle lifting without surgery.

However, emerging clinical evidence—and the experience of many Plastic Surgeons—suggests that thread lifting may create challenges when patients later pursue a facelift or neck lift. In fact, for individuals who may eventually want surgical rejuvenation, thread lifting can be a poor long-term choice.

Dr. Karen Horton, a Board-Certified Plastic Surgeon in San Francisco, cautions that while threads may offer a temporary lifting effect, they can significantly complicate future surgery.

What Recent Research Reveals About Facelifts After Thread Lifting

A 2025 study published in Aesthetic Plastic Surgery examined facelift procedures performed on patients who had previously undergone thread lifting. The findings were concerning.

Surgeons reported that prior thread lifting caused lasting changes beneath the skin, including:

• Fibrosis (scar-like tissue formation)
• Distortion of normal facial anatomy
• Adhesions between tissue layers
• Reduced mobility of the SMAS (the deeper structural layer addressed during facelift surgery)

These changes made surgical dissection more difficult, increased operating time, and limited the surgeon’s ability to reposition tissues smoothly. In several cases, patients experienced visible contour irregularities following surgery, and one patient developed temporary facial nerve weakness.

The key takeaway from the study was clear: the tissue changes caused by thread lifting often persist long after the threads themselves dissolve—and those changes can interfere with safe, predictable facelift outcomes.

Why Thread Lifting Can Create Long-Term Problems

Thread lifting relies on placing barbed or cone-based threads beneath the skin to mechanically elevate tissue. While the lift may be modest and short-lived, the body’s response to these foreign materials is not.

Over time, threads can trigger inflammation, scarring, and abnormal tissue attachments. When a facelift or neck lift is later performed, the surgeon may encounter:

• Scarred planes that are difficult to separate
• Limited tissue mobility, reducing surgical precision
• Higher risk of contour irregularities or skin dimpling
• Increased technical complexity and operative risk

From a surgical standpoint, this means less control—and less predictable results.

A Short-Term Solution That Can Compromise Long-Term Options

One of the biggest concerns with thread lifting is that it is often positioned as a “bridge” between injectables and surgery. In reality, it may do the opposite—closing doors instead of keeping them open.

For patients who ultimately want a facelift or neck lift, undergoing thread lifting first can make that future surgery:

• More technically challenging
• Less refined in its final aesthetic outcome
• Associated with a higher risk of complications

This is why Dr. Horton considers thread lifting a poor choice for many patients, particularly those seeking meaningful, long-lasting facial rejuvenation.

A More Thoughtful Approach to Facial Aging

Facial aging is not one-size-fits-all, and neither is facial rejuvenation. The most important decision is not choosing the “least invasive” option—but choosing the right option based on anatomy, goals, and long-term plans.

In many cases, well-performed non-surgical treatments or a properly timed surgical procedure can offer better outcomes than intermediary solutions that alter tissue planes unpredictably.

A consultation with a Board-Certified Plastic Surgeon allows patients to understand not just what is possible now, but how today’s choices may affect future options.

Considering a Facelift or Neck Lift?

If you are thinking about facial rejuvenation—or have previously undergone thread lifting and are now considering surgery—it’s important to work with a surgeon who understands the long-term implications of both approaches.

Dr. Karen Horton is a Board-Certified Plastic Surgeon in San Francisco known for her thoughtful, anatomy-based approach to facial surgery. Her goal is always to protect tissue integrity, prioritize safety, and achieve natural, balanced results that age well over time.

To learn more or schedule a consultation, contact Dr. Horton’s office today.