Are Smooth Threads the Next Botox? Here’s What You Need to Know About the Trending Treatment

At this point, Botox is so ubiquitous that you probably have a friend (or two) who’s done it (even if they’re not talking about it). Yep, for many people, injectable beauty treatments are, if not quite an extension of their skin care routine, no longer the “big deal” they used to be. Now, along with Botox and fillers, there’s another buzzy treatment gaining popularity: smooth threads. The minimally invasive treatment—which Duchess Fergie opened up about trying—adds volume under the skin to tighten sagging, smooth fine lines and wrinkles, and strengthen the skin overall. (Think of it like adding feathers to a limp pillow to fluff it up.) There’s little to no downtime and it’s (nearly) pain-free. Sound too good to be true? We tapped an expert to find out everything there is to know about the trending treatment.

Smooth threads are absorbable surgical polydioxanone (PDO) threads that can be used virtually anywhere on the face or body. Thinner than hair and made of protein, the threads are inserted below the skin to elicit a mild injury that the body responds to by adding structural proteins (fibrin, elastin, collagen), resulting in a smoother, plumper appearance. 

This includes your lip area, near the eyes to treat crow’s-feet, on the forehead to treat the “11” lines and around the mouth for marionette lines. According to Gerald Ginsberg, M.D., of Tribeca MedSpa in New York City, smooth threads can complement (or be used in place of) Botox, as an alternative to dermal fillers and to treat the lip area.

For heavier lifting (like a facelift effect), some patients opt for barbed threads. These sutures tend to be larger and have almost microscopic barbs etched into them, like the barb at the end of a fish hook. (Sounds scarier than it is, we swear.)

Dr. Ginsberg recommends smooth threads for areas of tired, crepey skin, common around the eyes, the upper lip, the hollows of the cheeks, under the chin and around the mouth (e.g., laugh lines).

“This treatment is so great because it’s very versatile—you can really get this treatment anywhere on the face or body where you need a little tightening or smoothing or lifting,” says Dr. Ginsberg. “There are applications for all age groups.”

Smooth threads can be done every three to four months (same as Botox treatments) and can be a great option for certain areas where Botox is not an option, such as cheeks. It’s also a milder alternative to a surgical facelift, which is both expensive and requires extensive recovery time.

First, you’ll have a consultation with your doctor to decide how many threads or barbs are needed to achieve your desired effect. Then, one-inch absorbable surgical PDO threads are inserted via a very tiny needle into targeted areas. (Barbs require numbing, whereas smooth threads do not.) It takes maybe six seconds to insert a smooth thread after an alcohol swab cleanse of the area, and doctors usually place about six per session, so it’s a quick treatment. Barbed sutures take a few more minutes to insert, so those sessions (depending on the number of barbs inserted) might take 30 to 45 minutes.

At most, you’ll feel a little pinch when the threads are inserted and pulled through the treatment area. Post-treatment, some people can experience a pulling sensation with barbed threads, which goes away after about two weeks. Usually there are no signs of the treatment except for the occasional bruise, which can be avoided by not taking aspirin or ibuprofen the week before your treatment.

With both smooth threads and barbed threads, you should look totally normal the next day, but barbed threads may leave you feeling a bit sore.

You won’t see much right away (remember this is a preventative treatment), but improvement will come as the thread dissolves and the body lays down new collagen, elastin and fibrin. It takes about four weeks to see the first results, with peak results at four to six months.

Depending on the office, a single area of smooth threads costs about $300, but it can be a little more or less depending on the number used. Dr. Ginsberg likes to do a series of three sessions separated by a month.