Facial aging involves both volume loss and sagging, so the most natural approach is to lift what’s sagging with a thread lift and use only a minimal amount of filler for the hollows. Here’s why we recommend a thread lift before filler when sagging is your main concern, which areas a thread lift can address, and how to approach treatment in stages.
Hello from DAYONE Clinic. “People have told me my face looks big for as long as I can remember. My cheekbones stick out, and now that I’m older my eyes have started to droop, so I’ve come to hate having my picture taken.” We hear concerns like this in consultations all the time.
Many of these patients arrive thinking, “Can’t I just fix this with filler?” So today I want to explain clearly why, when sagging is part of the picture, we recommend a thread lift before filler.
Facial aging: two causes at work
Broadly speaking, the changes your face goes through with age come down to two things.
Volume loss and sagging. Hollows begin to form all over the face—along the smile lines and marionette area, in the cheeks, under the eyes, in the upper eyelids, and between the brows. At the same time, skin and tissue descend, creating smile lines (nasolabial folds) and marionette lines.
These two problems have different causes and call for different solutions. Hollow areas need to be filled; sagging areas need to be lifted. The key is to treat each cause separately.
Why not just use filler for everything?
There was a time when filler was used to fix everything. But what happens if you try to correct sagging with filler alone? Once you start filling the sagging areas too, you need more and more filler, and eventually the face starts to look puffy and bigger. The result looks unnatural and overdone.
To get a natural-looking result, the approach has to match the cause: lift what has sagged and fill what has hollowed. That’s how you can keep filler to a minimum and still end up with a face that looks far more natural—and smaller.
Some faces call for a thread lift
For patients whose main concern is sagging, we generally recommend a thread lift first. Because a thread lift physically pulls sagging tissue back up, its immediate lifting effect is the most dramatic. Here’s how that breaks down by area.
Smile lines—a cheekbone thread lift, which pulls up from the cheekbone area
Marionette lines—a lower-face thread lift, which lifts sagging tissue in the lower face
Drooping eyes—a thread lift at the outer corners of the eyes, which can reveal a hidden eyelid crease and help the eyes feel more comfortable
Once those sagging areas have been lifted, filling only the hollows that remain with a minimal amount of filler is the way to get the most natural, best-looking results.
You don’t have to do it all at once
Many of our working patients ask, “Can I go back to work the next day?”
Bruising or swelling can occur after treatment, so it’s ideal to build in some recovery time if you can. But if your schedule is tight, there’s no need to do everything in one session. Going in stages, starting with whatever will make the biggest difference, works perfectly well. If sagging is your most pressing concern, start with a thread lift, address hollow areas with filler afterward, and keep up with regular Botox for maintenance.
The bottom line
Because facial aging involves both volume loss and sagging, the approach should match each cause: lift what has sagged and fill what has hollowed. If sagging is your main concern, the most natural approach is to lift first with a thread lift, then fill only the remaining hollows with a minimal amount of filler. If you have any questions, feel free to contact DAYONE Clinic near Gangnam Station anytime.
This article is adapted from an interview on DAYONE Clinic’s YouTube channel, Face Design Lab.
This article is general information about the treatment and does not replace an individual diagnosis or treatment plan. Results and their duration vary from person to person.
Wondering what would suit you?
Whether a treatment suits you, and how to plan it, is best decided with a doctor.