What is the difference between mono threads and barbed anchoring threads for thread lifts?

by Dr Wan Chee Kwang
November 3, 2020

As we age, our skin gradually becomes saggier, complete with fine lines and wrinkles. Thankfully, there are cosmetic enhancements available to help counter the effects of ageing and augment our facial features. One such method is through a thread lift

A thread lift is a minimally invasive technique that lifts sagging skin on the face and neck using surgical suture threads. These threads work by “hooking” tissues when placed into the face and anchoring those tissues at a higher level. Thus, thread lifts are also an excellent way to lift the nose bridge. In Singapore, nose thread lifts are one of the most popular aesthetic procedures to achieve a higher nose bridge and sharper nose tip without going under the knife.

Types of threads 

Generally, threads used in thread lifts are classified broadly into mono and barbed categories.


A popular thread under this category is the Polydioxanone (PDO) mono thread, which is also considered the most common option these days. PDO threads are made from an absorbable polymer that is durable and flexible for minimally invasive thread lifts. Multiple smooth thin threads are inserted all over the face. Studies have shown that PDO effectively targets the dermis, activating fibroblasts and stimulating collagen production, which thereby improves the texture of the skin and corrects wrinkling, lifting the skin. PDO threads are absorbable and can last up to a year. Poly-L-lactic acid (PLLA) or polycaprolactone (PCL) threads are also available; these last longer but are more costly.


Anchoring threads, or barbed threads, were the first thread type used in aesthetic practice to raise brows and cheeks. With anchoring threads, barbs “hook” into surrounding tissues to lift and hold them in place. Compared to mono threads, anchoring threads produce a more dramatic effect and can even be used to lift breasts and buttocks! This is because anchoring threads are more old fashioned in the sense that the skin has to be pulled as tightly as possible to achieve good results. Unfortunately, this means that anchoring threads can be quite hard on the skin and if overdone, can result in patients looking less natural. Anchoring threads are available in absorbable or non-absorbable material. Non-absorbable threads cannot be dissolved and thus stay in the body permanently. They can rather difficult to remove and thus many patients may not be comfortable with non-absorbable threadlifts. With time, even though these threads are non-absorbable, slippage of tissue may still occur necessitating repeat procedures. Hence, most medical aesthetics doctors still prefer absorbable materials like PDO, PCL or PLLA.

Choosing your thread: mono or anchoring?

Your doctor will guide you in choosing the correct thread depending on your personal preferences. Both methods rely on a similar mechanism of insertion; multiple threads are attached to a long cannula and pushed through the tissue beneath the skin. Once the thread has reached its predetermined endpoint, the thread will be released and the cannula removed. The number and position of threads used will depend on factors like your desired effect as discussed between you and your doctor. 

However, the key difference between mono threads and anchoring threads is that mono threads offer less lift but more collagen skin stimulation for contouring. Anchoring threads, on the other hand, can create a higher lifting effect. In this sense, anchoring threads might be better suited for older individuals who have obvious signs of ageing or very flat nose bridges, and PDO threads for younger individuals who are looking for subtle changes or skin collagen stimulation.

Mono ThreadsAnchoring Threads
Absorbable by the bodyAbsorbable or Non-absorbable by the body
Subtle effectMore dramatic effect
Lesser side effectsMore side effects
Minimal downtime of a few daysDowntime of few days to a week

Procedure remains the same 

Regardless of mono threads or anchoring threads, the procedure for both thread lifts remains the same. Local anaesthesia is applied over the treatment area, and patients are advised to avoid taking any medication that will disrupt the healing process. Do also inform your surgeon of any previous facial procedures done and any medical conditions that you have. 

After any thread lift procedure, you should wait around 1-3 weeks to resume any vigorous exercise. Exercise can raise the heart rate, which causes blood flow in the treatment area to increase and in turn cause swelling.

How can thread lifts enhance facial features?

Thread lifts are prized as being quick, lunchtime procedures for those looking to beautify themselves. They also cost less than a facelift and require less downtime. 

Thread lifts can help patients achieve:

  • Natural-looking facial rejuvenation 
  • Higher nose bridge
  • Sharper and more contoured nose tip 
  • Better jawline definition 
  • Reduced fine lines and wrinkles 
  • Better facial contours 
Thread Lifts

Can thread lifts replace fillers?

Mono threads and anchoring threads can complement well and have higher patient satisfaction with other aesthetic procedures like dermal fillers. 

Fillers help restore lost volume, and its effects are lengthened from the additional collagen stimulation that comes with thread lifts. While thread lifts cannot replace fillers, they can delay the need for one due to their lifting and tightening properties. If you’re unsure of what procedure to choose, speak to your doctor and he/she can advise accordingly.


  1. https://pubmed.ncbi.nlm.nih.gov/28915290/
    Karimi, K., & Reivitis, A. (2017). Lifting the Lower Face With an Absorbable Polydioxanone (PDO) Thread. Journal of drugs in dermatology : JDD16(9), 932–934.
  2. https://pubmed.ncbi.nlm.nih.gov/28863268/
    Ali Y. H. (2018). Two years’ outcome of thread lifting with absorbable barbed PDO threads: Innovative score for objective and subjective assessment. Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology20(1), 41–49. https://doi.org/10.1080/14764172.2017.1368562

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