Characteristics of Volumizing, Scaffold, Lifting Cogged Thread, and Monofilament Threads

Facial threading, a popular nonsurgical cosmetic procedure, involves inserting threads into the skin to lift, tighten, and rejuvenate facial tissues. Threads made of materials like polydioxanone or poly‐L‐lactic acid cater to different treatment needs but have sparked controversy regarding their effectiveness. Originally inspired by theories in acupuncture, this technique aimed to induce tissue contraction and firmness. Modern advancements expanded its focus beyond skin layers, targeting deeper connective tissues to enhance firmness and stimulate fibroblast activation and proliferation. Recent trends emphasize combined therapies, including fillers, botulinum toxins, and energy‐based devices, to create overall facial harmony rather than merely lifting or tightening specific areas. Mono threads have evolved from basic designs to volume threads, offering skin tightening, acting as fillers, and modifying facial shapes. They stimulate collagen regeneration, tissue metabolism, and fat tissue liquefaction, reducing volume and enhancing skin quality. The primary effects of these threads are supportive, akin to reinforcing concrete blocks, while barbed threads offer lifting effects by anchoring tissues upwards, inhibiting muscle movements that cause wrinkles. Histologically, threads induce tissue reactions, leading to fibrosis, but debates persist about the lasting lifting effects after complete thread absorption. Ongoing innovations focus on thread designs to optimize cosmetic outcomes, requiring evaluation for desired aesthetic goals. Despite widespread use, ongoing research aims to clarify mechanisms and improve thread designs for better cosmetic results.