Five-Year Trends in Facial Thread-Lift Practice: A Nationwide Cross-Sectional Analysis of 106,639 Cases by Age Group and Thread Material

Abstract

Background: Facial thread-lifting is a widely accepted, minimally invasive rejuvenation technique without surgical incisions. Common absorbable sutures used are polydioxanone (PDO) and polycaprolactone (PCL); however, selection trends by demographics and procedural intensity remain poorly characterized. We aimed to investigate associations between thread material and patient demographics and to evaluate nationwide practice trends in facial thread-lift procedures between 2020 and 2024. Methods: In this retrospective cross-sectional study, we analyzed 106,639 patients from 105 clinics across Japan affiliated with the Tokyo Chuo Beauty Clinic. Data on thread material (PDO or PCL), age, gender, and thread count were analyzed using two-way analysis of variance, multivariable linear regression, interaction modeling, and time-series analysis. Results: PDO was used in 57.2% of cases, predominantly in younger patients (20s–30s), whereas PCL was more common in older patients. The mean thread count was significantly higher in the PDO group than in the PCL group (10.52 vs. 6.57, p < 0.001). We observed a significant interaction between thread material and age group. Over the 5-year period, the PDO usage rate and mean thread count gradually increased. Gender-based differences in material selection were generally minimal; however, statistically significant disparities were noted in patients in their 20s and 30s, with females more likely than males to receive PDO threads in both age groups. Conclusions: Thread material selection and procedural intensity in facial thread-lifts are associated with patient age and are increasingly individualized and strategy-driven. We provide the first large-scale, evidence-based insight into this evolving practice. Level of Evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.