Invited Discussion on: A Meta-Analysis and Systematic Review of the Incidences of Complications Following Facial Threadlifting

Date 25 June 2025

The last two decades (1999-2021) can be regarded as ‘‘the era’’ for non-surgical facial rejuvenation by threadlifting. In that time we have seen the response to this innovative technique wax and wane with initial scepticism (1999), followed by guarded enthusiasm (2002), then an explosion of popularity (2003–2008), a period of disillusionment and decline in popularity as certain complications became apparent (2008–2011) and then a cautious re-acceptance of the technique again (2012–2017) and in recent years (2018–present), another explosion of enthusiasm as more and more products have become commercially available around the world and complications have diminished and results have improved. During this time, good results, cheek by jowl with the suboptimal results, have shared the stage and this is understandable as threadlifting is not a single technique—it is many. There are different kinds of threads: some barbed, some with cones, some moulded, some short, some long, coiled, straight and a variety of other configurations, some monodirectional or bidirectional and some with attached needles and others that are inserted via a hollow needle introducer. We have also witnessed an evolution and changing trend of the materials used for this assortment of threads, starting with non-dissolvable barbed monofilament polypropylene threads, followed by threads with a combination of polypropylene and resorbable cones, to barbed threads and cone threads made completely of dissolvable polydiaxonone (PDO) or poly L-lactic acid (PLLA). Wu and Mendelson have already commented on the logic behind the use of dissolvable threads [1]. This meta-analysis and systematic review of the complications of threadlifting is therefore timely [2]. However, we must be mindful that in any meta-analysis, culling from a multitude of papers that have already been written and may be very disparate or even conflicting in their reporting, the authors will be reliant only on what has been already published. This has inherent flaws as some studies list out complications that are peculiar to a particular type of thread or threadlift methodology being used and it may not be possible to extrapolate or generalise these findings. Nonetheless, we congratulate the authors of this current paper for a good quality, cohesive multi-study, multi-paper analysis of the most common threadlift complications capturing all the significant papers with the exception of one [3].

We use cookies to ensure you get the best experience on our site. Cookies are used to collect information about how visitors use our site. We collect the information to compile reports and to help us improve the site. The cookies collect information in an anonymous form, including the number of visitors to the site, where visitors have come to the site from and the pages they visited. Details.