A woman in her mid-thirties, hair cascading to her waist, is the very picture of L.A. high maintenance: pale pink lipstick and matching eye shadow, a black catsuit, and fur mules. She’s perfectly Zoom-ready, except for one thing: 12 five-inch-long black threads protruding from tiny holes in each of her cheeks.
She’s undergoing the current trend in age abatement, a quick-fix procedure known as PDO (polydioxanone) threading, a less invasive and more natural-looking alternative to a full-blown face-lift. First developed by Russian and American surgeons working independently in the 1990s, thread lifts have surged in popularity in recent years, thanks to the development of more reliable sutures, increasing affordability, and of course, Instagram, where some 305,000 images are tagged #threadlift.
To perform the procedure, the doctor first maps the patient’s bone structure and fat deposits with a chalk pen, dotting threads wherever gravity could use some defying: typically the cheeks, jowls, under eyes, and jaw, but also décolletage, buttocks, lips, and arms. Next, a topical numbing agent is injected through each dot. Then threads of various lengths and thicknesses are sewn into the skin to stimulate the production of collagen. “I use a lot of threads,” explains Dr. Simmi Goyle, based in Glendale. “We resculpt the fat pads, placing threads in areas of skin laxity.”
It all takes about an hour, and you can go back to work the next day, if you don’t mind being red and puffy. It takes a few weeks to fully recover, with best results seen after a few months. The threads themselves dissolve in six to nine months, and results last up to two years.
Dr. Kian Karimi is an otolaryngologist at Providence St. John’s Health Center in Santa Monica who helped to develop the procedure using NovaThreads, the market leader in the creation and distribution of PDO threads. “The procedure provides a subtle result,” he explains. “It doesn’t depend so much on age, but how much fat in a particular face that can be lifted. You can only really pull so much.” Often thread lifts are supplemented with fillers to add extra volume to sagging skin. “The threading won’t replace a surgical face-lift for someone 50 or older,” he says.
Celebrities are relying on the procedure to look camera-ready, and some are out about it. In November 2020, Eva Mendes posted a selfie to Instagram showing pink-edged needles stuck in her neck. Mendes’s Beverly Hills-based doctor Mariana Vergara is a fan of the treatment, but she has her own limits. She’s not down with the cat-eye lift in which threads are used to raise the brows to achieve a Bella Hadid-esque look. “The millennials want it, but in 15 years those ladies will have very thick temples,” says Vergara.
While there are dozens of places throughout the city offering the service, done by everyone from medspa aestheticians to plastic surgeons, many of the physicians who cater to celebrity clientele are based elsewhere and travel to Los Angeles. Dr. Julius Few is a Chicago plastic surgeon who flies into town once a month at the behest of a group of very discerning private patients: “It started out as a favor for my dear friend Gwyneth Paltrow,” he says. After that, he was in high demand with the Goop set. Another traveling doctor is Mariano Busso. He flies in from Miami once a week to tend to Beverly Hills clients.
As for pricing, it varies from about $1,000 for the face, to up to $5,000 for multiple procedures—much cheaper than a $20,000 facelift. However, Dr. Goyle says a new method is on the horizon: suture suspension, which could last up to two years.
“But I can’t talk about that yet,” she teases.
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