Abstract: Facial lifting with polydioxanone barbed threads has been widely used in aesthetic treatment for years. However, gravity resists the thread and continuously pulls the face downward. This study aims to determine methods to lift the skin more efficiently with longer longevity. The quality of the thread is important and is defined by the pulling and pullout strengths. Moreover, the method of using threads is also important. We compared five thread-implantation techniques and six angles for the V-shaped implantation methods using a polydimethylsiloxane model to simulate thread migration in tissues. The results of the simulated thread-lift techniques can provide valuable information for physicians, enabling a more precise design of facelift surgery techniques. 1. Introduction Facial aging is a dynamic process involving dramatic changes in different facial structures, including the skin, soft tissues, and facial skeleton. Thread lifting is a cosmetic procedure that offers a minimally invasive alternative to facelift surgery. Thread lifts claim to tighten the skin by inserting medical-grade thread material into the face and “pulling” the skin up by tightening the thread [1,2]. This technique has been used since the 1990s, and innovations in materials used for thread lifts have increased in international popularity [3–6]. Thread materials with various shapes and surface characteristics are available on the market [7,8]. Moreover, thread technologies, techniques, and procedures are evolving [9–11]. Improved patient experience and an increase in the number of peerreviewed publications contributed to the body of evidence and helped improve safety and efficacy. Patient selection is of the utmost importance, along with patient communication and understanding of the procedure, before- and after-care and management of patient expectations determine the fine line between patient satisfaction and dissatisfaction. In particular, patients should undergo a comprehensive consultation with the discussion of the complete information regarding preoperative care, the procedure, expectations, pretreatment and posttreatment care, recovery time, and possible need for multidisciplinary treatment. It is important to emphasize to the patients that this procedure is different from a surgical facelift, which results in a quick “lift” with no downtime.