Tightening without an incision: fine absorbable threads are placed under the skin, lift the tissue immediately, and stimulate your own collagen for months afterwards. Dr. Frantzen taught the technique to other doctors at the University Dermatology Clinic in Tübingen.
Please note: A medical consultation is a chargeable service under the German physicians’ fee schedule (GOÄ). Online bookings are binding; the practice team will explain the expected consultation fee when arranging your appointment.
Medically reviewed by Dr. med. Juliane C. Finke and Dr. med. Stephan Frantzen · Board-certified plastic surgeons · Last reviewed:
A thread lift is tightening without an incision: absorbable threads are introduced under the skin through a fine needle, lift the tissue immediately, and stimulate the body’s own collagen production over the following months. The threads dissolve — the tightening effect outlasts them for a while.
We use PDO threads (polydioxanone) by Croma – the same material used for surgical sutures, which has been used in surgery for decades and is broken down by the body into water and carbon dioxide.
The second, slower effect is the more interesting one. As the material dissolves, the surrounding tissue reacts by laying down new collagen along the track of the thread. That is why the result often looks better at three months than at three days.
Which thread is used depends on whether the aim is to lift or to firm:
Typical regions in our practice: the jawline, jowls, marionette lines, nasolabial folds and the fine lines around the mouth.
Most treatments combine two of the three. How many threads are needed depends on the tissue: heavier tissue needs more anchor points, and a plan made without examining you is not worth much.
The vectors — the directions of pull — are drawn on while you sit upright. That marking is the part that decides the result; the rest is execution.
The entry points are numbed with local anaesthetic. The threads are then introduced through a fine cannula, positioned, and drawn tight so the tissue moves to where it was marked. The ends are trimmed under the skin; there is nothing to remove afterwards.
The whole appointment takes 45 to 60 minutes. You can see the effect immediately in a mirror — and while you are still on the couch, which means you can say if you want more or less.
In a personal consultation we develop an individual treatment plan with you – maximum success with minimum effort.
Together we form a picture of the findings and draw up a treatment plan tailored individually to you. There are almost countless ways of placing threads in the face – the choice is the decisive step.
The procedure takes around 45–60 minutes and is performed under sterile conditions with local anaesthetic – a general anaesthetic is not necessary. On request, sedation with circulatory monitoring is possible; afterwards you should arrange to be collected.
You can go straight home. Small treatments such as wrinkle corrections can often be carried out at the first consultation – afterwards you are usually presentable again immediately and can go to work.
All patients are checked regularly – for up to a year after the treatment; this is the only way to maintain high treatment standards. Depending on the extent of the treatment and the type of threads, we recommend a break from sport of up to 14 days; after larger procedures, no dental treatment or lymphatic drainage of the face for about three weeks.
Immediately: the mechanical lift. Visible the moment the threads are tightened, though partly masked by swelling for the first two or three days.
Over months: the collagen response. New collagen forms along the thread tracks over eight to twelve weeks, firming the tissue independently of the lift itself. This part is subtle and cumulative, and it is why the result at three months is usually the best one.
Duration is six to eighteen months depending on the material and on your tissue. Repeat treatments tend to last longer, because the collagen laid down by the first round does not disappear when the threads do.
A thread lift repositions tissue. It does not remove skin. That single sentence draws the line.
Where the excess of skin is small and the contour has only started to slip, threads do the job with no incision, no hospital and two to three days of downtime. Where there is genuinely too much skin, a thread only gathers it somewhere else — and the result looks pulled rather than lifted.
We will tell you which side of that line you are on. If the answer is a facelift, we say so rather than selling you two rounds of threads first. Equally, many patients use threads to postpone surgery by several years, and that is a perfectly good plan.
Possible complications include pain, bruising, swelling, infection, asymmetry, dimpling, contour irregularity, palpable or visible threads, extrusion or migration, altered sensation and injury to nerves or vessels. Results vary and may be short-lived; removal, correction or another procedure can be necessary.
| How long | 45–60 minutes, usually under local anaesthetic |
|---|---|
| Anaesthetic | Local anaesthetic at the entry points – you are awake |
| Stay | Day case – no hospital, you go straight home |
| Back to work | About 2 days; small treatments are presentable at once |
| Duration | 6 months to 1.5 years, depending on the threads used |
| Threads | PDO threads (polydioxanone) by Croma – smooth, twisted or barbed |
| Aftercare | No sport for up to 14 days depending on the extent and thread type, no sauna for two weeks, sleep on your back |
| Follow-up | Regular check-ups for up to a year |
| Where | Day surgery at our practice, Heinrich-Roller-Straße 15, Berlin-Prenzlauer Berg |
| Paid by | Private fee, billed according to the German scale of medical fees (GOÄ) |
What does a thread lift cost? There is no flat rate. Time in theatre, technique, anaesthetic and the extent of the procedure differ from person to person. You get a binding quote at the end of your consultation — in writing, with nothing hidden. And the consultation itself? Medical advice is a treatment in its own right and is invoiced under the German scale of medical fees (GOÄ) — including when you decide against a procedure afterwards. We tell you what to expect when the appointment is made.
Will insurance pay? As a rule, no: purely aesthetic procedures are paid privately. German statutory insurers only contribute where a medical indication is recognised; private insurers and international policies decide case by case. We will tell you honestly whether you have any prospect of cover.
These points apply generally. What applies in your case – with existing conditions or regular medication – we go through at your pre-operative consultation. That conversation is what counts.
A thread lift is the smallest of the tightening measures. We look first at whether something smaller would do the job – and we will say so if none of these procedures fits your finding.
Board-certified plastic surgeon and
board-certified general surgeon
Board-certified plastic surgeon (plastic &
aesthetic surgery), Fellow of EBOPRAS
Dr. Juliane C. Finke and Dr. Stephan Frantzen are full members of the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC) and the German Society of Senology (DGS). Dr. Finke is also a Fellow of EBOPRAS and passed the European board examination in 2010; Dr. Frantzen operates on a voluntary basis for INTERPLAST in South America. The jameda seals lead to the independent physician profiles with patient reviews of Dr. Finke and Dr. Frantzen.
Medically reviewed by Dr. Juliane C. Finke and Dr. Stephan Frantzen
It works well between roughly 30 and 60, where the contour has started to slip but the excess of skin is still modest. It does not work where skin genuinely hangs: a thread repositions tissue, it does not remove it. In that case a facelift is the honest answer and we will say so.
No. We work under local anaesthetic at the entry points; you are awake and can look in the mirror while the threads are being tightened. That is an advantage, not a compromise — you get a say in how far it goes.
The local anaesthetic stings briefly. After that you feel pulling and pressure rather than pain. A feeling of tightness for a few days afterwards is normal and settles.
Usually after two to three days, rarely more. Small treatments are presentable straight away; larger ones may leave slight swelling or a small bruise at an entry point.
No. They dissolve completely over months and are broken down into water and carbon dioxide. The materials are the same ones used for surgical sutures.
Not once healed. In the first two weeks you may feel a slight tightness or, occasionally, a small irregularity where a thread sits; both settle. If something does stay visible, it can be corrected.
Six to eighteen months, depending on the material and your tissue. Repeat treatments generally last longer, because the collagen from the first round remains.
No. The materials have been used in surgery for decades and allergic reactions are not a recognised problem with them.
PDO threads (polydioxanone) by Croma – smooth, twisted or barbed, depending on the aim. They dissolve completely. Dr. Frantzen lectures for Croma and trains other doctors in thread lifting.
Regularly, for up to a year after the treatment. The first check is shortly after the procedure; the intervals then follow how you are healing.
No sport for up to 14 days depending on the extent of the treatment and the thread type, no sauna or steam for two weeks, sleep on your back for the first few nights, and avoid rubbing the area hard when washing. Extreme facial expressions are worth avoiding for a week.
Book a personal consultation. We mark the vectors on you, show you what a thread can lift — and tell you plainly when it cannot.
Related treatments: Wrinkle treatment · FaceTite · Facelift · Facial treatments
Medically reviewed by Dr. Juliane C. Finke, board-certified plastic surgeon (plastic and aesthetic surgery), and Dr. Stephan Frantzen, board-certified plastic surgeon and board-certified general surgeon.
Last medically reviewed:
The content of this page is for general information and does not replace medical advice. A binding assessment is only possible after a personal examination.
Independent information: The German Society of Plastic, Reconstructive and Aesthetic Surgeons provides patient information on choosing a specialist, consent, limitations and possible complications. The German Medical Association explains the GOÄ fee schedule. These German-language sources supplement, but do not replace, an individual medical examination.
