A useful question for anyone who buys threads by the box: does adding more of them buy you more lift? Published January 11, 2025 in Aesthetic Surgery Journal Open Forum, this randomized controlled trial put that to the test in 22 patients across two arms. One group received 3 polydioxanone (PDO) threads per hemiface (6 total). The other received 6 per hemiface (12 total). Volumetric change and tissue displacement were measured by 3D stereophotogrammetry at baseline, 20 days, and 60 days, with satisfaction scored on the Global Aesthetic Improvement Scale.

Both arms produced significant midface and lower-face volumetric change over time (p<0.05). The catch is that the two arms looked the same. There was no significant difference in volume between the 3-thread and 6-thread groups, no difference in tissue displacement (p=0.821), and no significant difference in GAIS satisfaction. In other words, doubling the thread count did not add to the lift. Both groups also saw their early improvement largely fade by day 60, a reminder of how transient thread lifting tends to be.

The practical read: more threads is not better. Three per hemiface delivered the same displacement and satisfaction as six, so defaulting to the lower count cuts cost, tissue trauma, and chair time without giving anything up on outcome. And because much of the effect is gone by roughly two months, it makes sense to pair threads with a longer-acting modality rather than leaning on thread volume to carry the result.

Source: Aesthetic Surgery Journal Open Forum (Vol 7, ojaf002). https://pubmed.ncbi.nlm.nih.gov/40236886/