At a glance
A facelift and PDO threads are different interventions, not interchangeable versions of the same treatment. Thread lifting can provide subtle, temporary changes; surgical planning addresses tissue repositioning and, where appropriate, excess skin.1 I do not offer PDO threads. I discuss them because understanding their limits and reporting previous treatments helps us evaluate your options. Having had threads does not automatically prevent a future facelift, but the details belong in your medical history. Neither choosing surgery nor avoiding it should depend on a promise of effortless or permanent results.
Hero image: an AI-generated illustration, not a patient photograph or a treatment result.
Start with the change, rather than the procedure name
You may want a more defined lower face but feel reluctant to commit to surgery. Alternatively, you may have already tried threads and now be wondering whether a facelift could address a remaining concern. Those situations deserve different conversations, even if the search terms that brought you here were the same.
I begin by asking what you notice and what you would like to change. Show me the region that bothers you, and tell me what would count as a meaningful improvement. I also want to understand the recovery you can realistically organize, particularly if you would be traveling to Brazil.
There is no need to defend a previous treatment choice. Your experience helps me understand your expectations and history. Nor does learning about limitations oblige you to have another procedure. Waiting or choosing not to intervene can be a reasonable outcome of a consultation.
Four differences worth discussing
What is actually being done?
PDO stands for polydioxanone, an absorbable material used in some thread procedures. Thread designs and placement methods vary. A facelift is an operation with a different plan, incisions, and recovery requirements.1 The shared word lifting should not hide those distinctions.
How much change is being sought?
A subtle change may be satisfying to one person and insufficient for another. Cleveland Clinic describes thread-lift results as subtle and temporary.1 In a surgical consultation, I explain the features I propose to address and those that will remain outside the operation’s purpose.
When was the result assessed?
An immediate photograph and a later follow-up answer different questions. Ask when an image was taken and what outcome a study measured. Early appearance, satisfaction, and lasting anatomical change should not be treated as interchangeable evidence.
What happens if recovery is not straightforward?
A smaller intervention can still cause discomfort or complications. Surgery has its own risks and follow-up needs.15 Before any decision, the plan should explain how concerns will be assessed rather than relying on the description minimally invasive as reassurance.
Does using more PDO thread improve the result?
A randomized comparative study published in 2025 examined different thread quantities in 22 participants. One group received three threads per side of the face and the other six. Assessments included three-dimensional imaging at 20 and 60 days, along with perceived improvement. The investigators did not find a statistically significant difference between quantities in the main outcomes studied, and the initial changes diminished during follow-up.2
This gives a useful reason to question the assumption that more material must mean more benefit. It does not establish that every thread product or placement method behaves identically. With a small sample, a nonsignificant difference is also not proof that the approaches are universally equivalent.
Most importantly for this comparison, the study did not include a facelift group. It cannot tell you how surgery would have performed in those participants. I use it to discuss the quality of a claim about thread quantity, not to manufacture a head-to-head result that the researchers did not study.
Sixty days is a study interval, not an expiration date
The same research should not be retold as proof that every thread result disappears after 60 days. That was the observation period. It tells us about the measured changes within that period, while leaving longer-term questions unresolved.2
Likewise, the time it takes for a material to be absorbed is not automatically the time a visible result will last. You are interested in the appearance of your face, not simply whether material remains present. Those outcomes need their own evidence.
Claims about collagen stimulation also require care. A proposed biological mechanism is not, by itself, a measurement of sustained clinical improvement. The short follow-up in the 2025 trial did not settle possible later effects.2 I want expectations to be tied to what was observed, with the limits kept close to the finding.
Surgery does not stop aging either. On the deep plane facelift overview, I explain the surgical approach without giving an individual expiration date or guaranteed number of years. This comparison should help you ask better questions, not replace uncertainty about one intervention with certainty about another.
Thread complications belong in the decision
A systematic review and meta-analysis of 26 studies described complications including swelling, dimpling or surface irregularities, sensory changes, palpable or visible threads, infection, and extrusion. The included studies covered both absorbable and nonabsorbable threads.3
That mixture matters. A pooled percentage should not be presented as the exact risk of PDO alone or as your personal probability. Differences in products, techniques, follow-up, and reporting also make it inappropriate to place those numbers beside an unrelated facelift study and declare one universally safer.
In the small 2025 PDO trial, 11 of the 22 participants reported pain-related discomfort at the 20-day assessment; it was no longer reported at 60 days.2 This is not a forecast that half of all thread patients will have that experience. It does show why a less invasive description should not be understood as a guarantee of no symptoms.
I am not using these findings to frighten someone who has already had threads. Their value is to support realistic questions about expected benefit, aftercare, and what to do if something does not settle as anticipated.
Previous threads may change surgical planning
A retrospective series published in 2025 described ten people undergoing facelift surgery after at least two previous absorbable-thread treatments. The author reported findings such as fibrosis, adhesions between tissue planes, and reduced tissue mobility that made surgery more difficult.4
This was a small, single-author series without a comparison group. It cannot establish how often those findings occur among all people treated with threads, and it does not show that a future facelift is automatically prohibited. The abstract identifies absorbable threads but does not specify their material.4
My practical response is to ask about prior treatment before planning surgery. An aesthetic effect fading does not make the history irrelevant. Tell me what you remember, including uncertain details; I would rather record uncertainty than have you guess a product name.
What to bring if you have had threads
Dates, product information, treated areas, and records of any complication can help. If the clinic that performed the treatment can supply documentation, bring it or arrange to share it before the consultation. If records are unavailable, explain that rather than delaying the conversation indefinitely.
Tell me whether there was infection, a thread coming through the skin, persistent distortion, or an attempted removal. These details are relevant even if the event was some time ago. Include other facial treatments as well, because the surgical history is broader than the procedure being compared in this article.
For someone living outside Brazil, gathering available records before traveling is more practical than trying to recover them during an in-person appointment. Bruna can help organize the consultation process, while medical questions and decisions remain part of the clinical assessment.
An active problem needs assessment before aesthetic planning
If you currently have worsening redness, discharge, persistent pain, or exposed material, seek medical assessment. A consultation about a future facelift is not a substitute for attending to a possible complication now. Do not pull an exposed thread or try to correct an irregularity with techniques found online.13
This page does not prescribe thread removal or a universal waiting period before surgery. Those decisions depend on the examination, the history, and what is happening in the tissues. A specific calendar interval cannot be inferred simply from the word absorbable.
If you are still at home abroad, do not postpone evaluation of an active concern until a planned trip to Brazil. Use appropriate local medical care and keep the relevant records for later discussion.
What changes if you are considering surgery?
The conversation needs to include the entire surgical plan: incisions, expected limitations, recovery, follow-up, and complications. The ASPS lists bleeding, infection, unfavorable scarring, and nerve-related problems among facelift risks.5 An operation may address a different degree or pattern of change, but it does not remove uncertainty.
I also want to know whether the recovery requirements fit your life now. The patient journey explains how our stages of care are organized. For an international patient, appointments and time in Brazil should be considered before booking travel, rather than fitted around an inflexible flight afterward.
I do not promise to recreate an image or the appearance produced by pulling your face in a mirror. Your anatomy, prior treatments, health, and expectations need to come together in an individual plan. Sometimes the most useful outcome is a clearer understanding of why it is better to wait.
Five questions to take to a consultation
- Which feature of my face explains the concern I am pointing to?
- What change is the proposed intervention intended to make, and what will it not address?
- How was the expected duration studied, and what remains uncertain?
- What information about previous treatments could affect the plan?
- How will a concern or complication be assessed during recovery, including after I return home?
You do not need to use technical language. Ask for another explanation if an answer remains unclear. An informed decision depends on understanding the proposal, not on memorizing the names of materials or tissue layers.
Frequently asked questions
Are six threads always better than three?
No such universal conclusion follows from the evidence described here. The trial of 22 participants did not find a significant advantage for the higher quantity in the outcomes studied, and its follow-up was short.2 It was not a comparison of every product or technique.
Does absorbable mean there can be no lasting tissue effects?
No. The surgical series after absorbable threads described tissue changes relevant to later surgery.4 Its small size prevents a general prediction, but it is a reason to report old treatments even if the visible effect has faded.
If I do not want a facelift, should I have threads instead?
Not necessarily. Declining surgery does not oblige you to choose another intervention. I do not offer PDO threads, and this article is not a remote recommendation to receive them. We can discuss your expectations without assuming that a procedure must follow.
Can photographs settle which option is right?
No. Images can help you explain a concern, but they do not replace examination and a health history. Timing, expression, and lighting can also change what a result appears to show. I need more than a photograph before proposing surgery.
Bring your questions and your treatment history
If you are considering a facelift in Brazil after previous threads, or want to understand the surgical option, contact Bruna to arrange a consultation with me. We can discuss your goals and the records available, without treating a previous choice as a mistake or promising that one approach suits everyone.
References
- Cleveland Clinic. Thread Lift. Public patient guidance.
- Germani M, Munoz-Lora VRM, Carnevali ACN, Geroldo AM, Teixeira FF, Giro G. Is More Always Better? A Randomized Comparative Clinical Trial About the Impact of Polydioxanone Threads Quantity for Facial Lifting. ASJ Open Forum. 2025;7:ojaf002. DOI:10.1093/asjof/ojaf002.
- Niu Z et al. A Meta-Analysis and Systematic Review of the Incidences of Complications Following Facial Thread-Lifting. Aesthetic Plastic Surgery. 2021;45(5):2148–2158. DOI:10.1007/s00266-021-02256-w.
- Yordanov YP. The Facelift After Thread Lifting: Surgical and Aesthetic Complications. Aesthetic Plastic Surgery. 2025;49:6234–6239. DOI:10.1007/s00266-025-05091-5. Interpretation limited to the verified abstract.
- American Society of Plastic Surgeons. Facelift Risks and Safety.