Does a thread lift work for nasolabial folds? What if the sagging tissue above the fold is fat?
A thread lift helps nasolabial folds only partly, and only when the fold comes from sagging. Most nasolabial folds are a mix of a deep groove where volume has been lost and a fold formed by subcutaneous fat sagging above it. Pulling does not improve the deep groove; it has to be filled with volume.
Even if you have a lot of sagging tissue above the fold, pulling alone does not fix it all. That tissue is often fat, and I have seen it improve much more with an injection that reduces fat, or even when the person lost weight. For folds that come from sagging, I improve them with a thread lift as well, and sometimes add a lipolysis injection formulated to break down fat.
The literature from outside Korea reports placing bidirectional barbed threads, 5 per side, into the sagging skin around the nasolabial folds, with most patients whose sagging was not severe being satisfied. Which kind your own folds are closer to is judged more accurately in person. Hollow cheeks and nasolabial folds are discussed in “Can I have Ultherapy or ONDA if my cheeks are hollow or I have nasolabial folds?”
Does a thread lift work for jowls?
A thread lift for jowls works best on a face where only the jowls sag while the nasolabial area and cheeks are hollow. That kind of face really does need lifting and reducing. On the other hand, if the jowls look saggy because the whole face carries a lot of fat, reducing just the subcutaneous fat layer makes the face look much lighter and younger. Many people who are not that old but say their face looks saggy simply have a lot of cheek fat.
Still, when you only reduce fat, the face can sometimes feel deflated like a balloon, so if the jowls have some sagging, adding a lift gives a much better result. Why I combine lipolysis injections with a thread lift is covered in “Which sagging and which faces suit an Aptos thread lift best, what are its strengths, and when is another treatment combined with it?”.
How many threads go into the double chin and jawline, and in which direction are they pulled?
For the double chin and jawline, I usually use 4–6 Aptos threads. A similar number goes into the jowls, the corners of the mouth and the nasolabial folds, so the whole face often comes to about 10 threads. That is the standard from my own practice, and within it I decide the number by the amount and weight of tissue that has dropped. A double chin often has both fat and sagging, so I reduce it when there is a lot of fat and pull it when it has sagged. A double chin does not go away on its own and often doesn’t shrink even when you lose weight, so it is better to treat it actively.
If the pulling direction is wrong, the cheekbones stand out and look bigger. I pull toward the back of the face, close to the hairline. That spot can swell a little and look bigger at first, but it settles quickly.
The literature from outside Korea reports that skin under the jaw and on the neck tends to sag again over time, so results on the neck are weaker than around the cheekbones. How the number of threads is decided and the types of thread are covered in “What is the difference between thread lift types (dissolving threads, cog threads, Aptos), and how many Aptos threads are placed, and how?”.
Is a nose thread lift a different thread?
A nose thread lift is a different thread: dissolving threads are placed under the skin of the nasal bridge to raise the line of the bridge. Its purpose and the thread it uses both differ from a lifting thread that hooks and raises sagging tissue. It is described separately as its own treatment.
Are the outer eye corner and forehead also lifted with Aptos?
The outer eye corner and the forehead are not areas I lift with Aptos. For the forehead and the outer eye corner, I use a different thread made specifically for those areas. The skin around the eyes and on the forehead is thin and the tissue to move is light, so it is not the place for the thick thread that hooks and raises heavy tissue such as jowls or the jawline. Aptos is a thread suited to the mid and lower face, where tissue that has dropped needs to be pulled up firmly.
The reasons an outer eye corner looks droopy are also mixed: the eye corner itself has dropped, the outer part of the brow has dropped and covers the eye corner, or the front of the cheek is hollow so the area under the eye looks longer. Which thread to use and where depends on which one it is, so I decide by looking in person.
Where does a thread lift not work well?
The outer eye corner and the forehead are areas Aptos does not suit, so they are done separately with a different thread.
For a front cheek that looks saggy because it is hollow, filling it is the right approach rather than pulling it with a thread lift.
If the sagging tissue above the nasolabial fold is fat, reducing the fat comes before threads.
Even on the jawline, if the skin has stretched a lot and there is a lot of heavy tissue, threads alone may not be enough.
Why I combine other treatments for these faces is in “Which sagging and which faces suit an Aptos thread lift best, what are its strengths, and when is another treatment combined with it?”. Side effects and failure are covered in “What are the side effects of a thread lift, how long do swelling and bruising last, and what counts as a failure?”. Which areas of your face suit threads is something we look at together at your in-person consultation, after you read visiting the clinic.