PDO Thread Lifting (Absorbable Thread Facelift)

Thread lifting at Eva Clinic uses polydioxanone (PDO) absorbable sutures inserted under local anaesthesia to mechanically lift sagging facial contours and simultaneously stimulate long-lasting collagen formation in the tissue along the thread tract. MUDr. Chovančíková places the threads in a carefully mapped pattern under the skin, creating immediate mechanical repositioning of descended facial fat and soft tissue — lifting the cheeks, defining the jawline, reducing jowls, and tightening the neck. The PDO material is fully absorbed over 6–10 months; however, the collagen framework generated along the thread tracts persists for 2–5 years, providing durable structural improvement beyond the thread's physical presence.

PDO (polydioxanone) thread lifting bridges the gap between injectable volumising and surgical facelift: it provides genuine mechanical tissue repositioning with an effect duration and tissue-quality improvement that simple injectables cannot match, while avoiding general anaesthesia, surgical incisions, and the recovery period associated with rhytidectomy. Polydioxanone is a well-established surgical suture material, used in cardiothoracic and gastrointestinal surgery for decades. Its tissue biocompatibility is excellent, and its metabolic degradation pathway — hydrolysis to CO2, water, and oxalic acid — produces no toxic byproducts. When used in facial thread lifting, PDO threads are deployed in barbed or smooth configurations: **Smooth threads (mesonite):** Fine monofilament PDO placed in a dense matrix pattern to stimulate collagen synthesis along the thread tract. Primarily used for skin quality improvement and mild tightening rather than gross tissue repositioning. **Barbed/cog threads (standard thread lift):** Unidirectional or bidirectional barbs anchor into the subcutaneous fat, allowing the practitioner to apply traction that physically repositions descended tissue — elevating the lateral cheek, lifting the mouth corners (marionette fold area), sharpening the jawline, or elevating the submental area. At Eva Clinic, MUDr. Chovančíková offers both approaches. After applying local anaesthetic to the entry points and planned thread tracts, threads are inserted via fine cannulas through 1–2 mm skin punctures — leaving no visible scars. For cog-based lifting, traction is applied progressively until the desired elevation is achieved, then the thread is anchored and trimmed. The typical candidate is a patient aged 35–55 with early to moderate facial sagging — descended cheek fat, deepened nasolabial folds, jowl formation, or neck laxity — who is not yet seeking or is not suitable for surgical intervention. Thread lifting is frequently combined with small-volume HA fillers placed after threads are set, as the two modalities address different aspects of ageing (structural repositioning vs. volume restoration). Post-treatment, mild swelling, bruising, and a sensation of skin tightness are expected for 5–10 days. Clients should avoid sleeping on the treated side, vigorous exercise, and facial massage for two weeks. Visible surface irregularities at thread insertion points typically resolve within two weeks as swelling settles. The immediate post-treatment lift is dramatic; this softens slightly as swelling resolves and then improves again over 2–4 months as collagen remodelling builds. Contraindications include pregnancy and breastfeeding, active autoimmune disease, blood coagulation disorders, keloid tendency, and allergy to suture materials. Antiviral prophylaxis is recommended if the client has a history of herpes simplex in the facial area.