Is a thread that dissolves slowly more effective for longer? PCL thread expectations versus reality

The slow dissolution of a thread and the persistence of the lifting effect are not the same thing[1]PCL (polycaprolactone) threads are reported to take longer to absorb than PDO threads, but large-scale data indicate that the visible facial results last approximately 6–12 months depending on the material and treatment area[2][1]The key to understanding this treatment is to distinguish between the properties of the thread itself and the changes that occur in the face.

How is PCL thread different from other threads?

The main differences are the dissolution time and softness. PCL has greater flexibility compared to PDO and PLLA threads, degrades more gradually, and requires approximately 12–18 months for complete absorption[2]The same report notes that patient discomfort is less with PCL than with PDO or PLLA threads[2]However, this report is from research on cog threads designed to support pelvic organs, and does not directly examine facial lifting[2]

In Facelift procedures, threads made of absorbable materials such as PDO, PLLA, and PCL have become mainstream since 2000.[1]Absorbable materials are said to trigger less foreign body reaction and promote collagen production during the breakdown process.[1]

Does the effect last as long as the thread remains?

Not necessarily. In a Japanese aggregate of 111,948 cases collected from 2020 to 2024, the duration of lift effect varies by material and location, lasting approximately 6–12 months overall, with PDO threads breaking down in 6–8 months and PCL threads persisting slightly longer at around 12 months.[1]

Researchers themselves caution about the difference between thread longevity and effect duration. In the discussion of a prospective study examining 3D cog threads, it notes that promotional materials often claim 12–18 months of sustained effect, but peer-reviewed data are not as consistent.[3]In past reports cited in the same discussion, sagging (skin laxity) returned within 6 months in half of cases, and early recurrence was observed in 14% of cases by 8 weeks.[3]

It remains unclear whether lift continues after absorbable threads dissolve. An expert consensus document summarizing the use of absorbable threads explicitly states that further in-depth research is needed regarding persistence after thread disappearance.[4]

How far can we say "minimal pain"?

This is an expectation based on the softness of the material, but comparative data for facial application are limited. The report of minimal discomfort with PCL threads was not from facial application but from a study of threads intended for pelvic support.[2]Regarding the face, there are reports that dissolvable threads significantly reduce the risk of numbness and thread exposure compared to non-dissolvable threads.[5]

The likelihood of complications depends not only on the material but also on age. A review summarizing thread materials states that using dissolvable threads and the patient being younger are associated with lower complication risk.[6]

What is the evidence behind the claim about increasing collagen?

For now, the evidence is primarily based on animal studies. In a study comparing PDO, PLLA, and PCL threads inserted into rats aged with ultraviolet radiation, PCL threads brought dermal collagen density closest to the youngest state.[7]A study in mice comparing new PCL threads with commercially available threads also stated that PCL causes collagen production for a longer period than PDO or PLLA.[8]

However, neither study has been confirmed in human faces. The authors of the rat study also note that further research is needed on long-term effects from the time the thread is absorbed until tissues are remodeled.[7]

What can and cannot be done

What can be done is temporarily lift mild Sagging (skin laxity). The Japanese Society for Aesthetic Surgery guideline on Thread lift for facial wrinkles and Sagging (skin laxity) rates it as recommendation level 2 (weakly recommended), noting that while temporary improvement can be expected, the effect is not significant and duration is short, requiring thorough explanation.[9]

A systematic review examining dissolvable thread lifts in literature from October 2018 to December 2022 also concludes that previous studies have not demonstrated long-term efficacy.[10]PCL threads are not outside this evaluation.[10]

What to confirm at consultation

You want to confirm the evidence for thread material and absorption period, and the expected duration of results for your own face. Try asking separately about "how many months until it dissolves" and "how many months the lifting effect remains visible."

The range reached by threads varies depending on the degree of Sagging (skin laxity) and skin thickness. Which areas will be treated with threads and which will use alternative methods should be decided with your doctor at consultation after examining your face.