With modern technology and ever-evolving improvements in the aesthetics scene, it’s becoming increasingly possible for patients to look their finest without going under the knife. While each aesthetic treatment is proficient and unique in its own way, patients frequently ask if it’s possible to combine treatments for the best results. One common enquiry I get in particular is if thread lifts can be supported with fillers.

The short answer is yes; thread lifts can be combined with fillers. But whether or not they are really necessary for every individual is a different story. Before I go into more details, here’s a quick recap on thread lifts and fillers.

Thread lifts

A thread lift is a minimally invasive technique where surgical suture threads are used to produce a subtle but visible lift on a patient’s skin or nose. Thread lifts are used either on the face (face thread lift) to lift saggy skin and tissue or on the nose (nose thread lift) for a more defined nose bridge. During a thread lift, multiple threads are attached to a long cannula and pushed through the soft tissues beneath the skin or nose. These threads then “hook” onto the tissues supporting the skin, pulling the skin back or nose bridge up slightly and tightening the skin or propping up the nose bridge and tip.

In my practice, I prefer to use polydioxanone (PDO), poly-L-lactic acid (PLLA) or polycaprolactone (PCL) threads which are biocompatible with the body. These threads are bio-resorbable; they will dissolve naturally in the body in 6-12 months, 12-18 months or 16-24 months respectively. They are broken down by our cells into carbon dioxide and water and will not have any long-term residue.

In addition, while in your body, they cause your tissues to stimulate natural collagen production. What this means is that the results derived from your thread lift will continue to improve and provide ongoing and progressive rejuvenation, even after the threads have fully dissolved. 

Fillers

Dermal fillers are injectable hydrogels that contain hyaluronic acid. Hyaluronic acid is a naturally occurring substance that helps bind water to skin, thus stimulating cell renewal and resulting in a slew of benefits like regenerating volume and recreating lost structure. Similar to thread lifts, dermal fillers can be used on the face to restore youthful skin or on the nose for a higher nose bridge.

Fillers can be classified into temporary, semi-permanent and permanent fillers. Temporary fillers are the most popular and can be classified into volume replacement fillers, most commonly composed of hyaluronic acid; and collagen stimulation fillers that contain materials such as calcium hydroxyapatite and polycaprolactone.

How can I combine both treatments?

From the bigger picture, both thread lifts and fillers provide the same objectives — tighter, younger looking skin and a sharper, more defined nose bridge. However, they work differently and should either be chosen carefully or used together depending on the individual and desired results. 

For example, facial ageing is caused by a combination of skeletal and soft tissue degeneration and skin changes that lead to volume loss and soft tissue laxity. Fillers are particularly helpful in restoring lost volume from ageing while face thread lifts assist in lifting and tightening the skin. The advantage of this combination is that with thread lifts, less fillers need to be used, thus reducing the risks that come with fillers. Thread lifts cannot replace surgical procedures like a facelift, but when used with other treatments, they can delay the need for one. 

Whether or not you should combine both treatments depend on the degree of your facial skin laxity. If you merely have drooping and sagging skin, then just a thread lift alone will suffice. However, if you’re experiencing volume loss around the cheeks too, then dermal fillers can give youthful, plump cheeks that thread lifts can’t. 

Similarly, while both nose thread lifts and nose fillers can be combined for synergistic results, it depends on the shape of your nose and end result you are looking for. I would recommend combining both nose thread lifts and nose fillers for a patient with a very flat nose bridge with a hump. The nose thread lift can lift the nose bridge, and a little filler can be introduced to smoothen out the dorsal hump. This results in a higher nose bridge and more enhanced nose contours and definition. 

Otherwise, I usually recommend performing a nose thread lift first before considering whether fillers are required for safety reasons. For patients who have already done fillers in the past, if the filler shape is not ideal or synergistic with the nose threadlift, I would advise them to dissolve the fillers or wait for 9-12 months for the fillers to dissolve before going for a nose thread lift. 

Before making a decision, it’s best to consult an experienced doctor to discuss your preferences and the risks involved.