Combining Thread Lift with Fillers: Should You Do Both?

Introduction

In recent years, more patients have been asking a familiar question during consultations at our clinic in Gangnam:
“Doctor, should I do both a thread lift and fillers — or just one?”

It’s a fair question — and an important one. As non-surgical aesthetic treatments continue to evolve, the boundaries between lifting and volumizing have become blurred. Many people see beautiful “before and after” photos online and assume the same treatment will work for them. But the truth is, thread lifts and fillers serve very different purposes — and while they can complement each other beautifully, combining them requires clinical precision, timing, and individualized planning.

At Gangnam Seoyon Plastic Surgery, we approach this question from the perspective of facial harmony, not popularity. Because when done thoughtfully, this combination can refresh and define your face in the most natural way — but when done hastily, it can distort your expression or strain the skin.

Understanding the Difference: Lift vs. Volume

Let’s start with the basics: a thread lift lifts, and fillers fill.
That might sound simple, but the distinction matters greatly when deciding your treatment plan.

• Thread Lift (PDO or PLLA Threads):
  A minimally invasive procedure using dissolvable threads inserted beneath the skin. These threads anchor and lift sagging tissues while triggering a controlled collagen response as they dissolve over time. The result is a firmer, subtly elevated contour that continues improving over several months.

• Dermal Fillers (Hyaluronic Acid, CaHA, or PLLA-based):
  Injectables designed to restore lost volume, define facial contours, and smooth out deep creases or hollows. Fillers can mimic the plumpness of youthful fat and restore proportions lost due to aging.

If you think of the face as a sculptural structure, the threads act like internal suspension wires — tightening and repositioning the base. Fillers, on the other hand, are like the clay that restores fullness and smooth texture to the surface.
Used together correctly, they can rebuild both support and softness — the twin pillars of a naturally youthful look.

Why Some Faces Need Both — and Some Don’t

Not everyone benefits equally from combining a thread lift and fillers. The decision depends on age, facial anatomy, and tissue condition — not just personal preference.

1. Younger Patients (30s–40s):
   In patients with early signs of sagging — mild jowls, loss of jawline definition, or smile-line laxity — a thread lift alone may provide sufficient lift. Their skin still has good elasticity and collagen, so threads can stimulate tightening without much need for added volume.

2. Patients with Volume Loss:
   Some people — even in their 30s — experience hollow temples, sunken cheeks, or a tired under-eye area due to genetics or lifestyle. In these cases, fillers may be added strategically after the lift to restore natural roundness and prevent a gaunt look.

3. Older Patients (Late 40s–60s):
   Age-related bone resorption and fat loss cause both sagging and hollowness. Here, a combination approach is often most effective: threads to reposition tissues, fillers to rebuild structure, and collagen stimulation to maintain long-term firmness.

To be honest, many patients expect threads to “do everything” — to lift, tighten, and even add fullness. But threads can’t replace lost volume, just as fillers can’t pull skin upward.
At Seoyon, we explain it simply: threads correct gravity; fillers correct time.
Both are needed in different amounts, depending on how aging has affected your unique features.

The Art of Timing: Which Comes First?

One of the most common — and critical — questions is about sequence. Should fillers be done before or after the thread lift?

At Gangnam Seoyon Plastic Surgery, Dr. Dong-il Choi emphasizes that timing defines outcome.

Generally, we follow this sequence:

1. Step 1: Reposition with Thread Lift
   We first lift the tissue to its ideal contour. This creates a natural foundation and reveals where true volume loss exists — not just sagging.

2. Step 2: Refine with Fillers
   After the lift, we can precisely identify the areas that need gentle volumization, such as the midface, nasolabial fold, or under-eye hollow. This ensures the filler enhances, rather than counteracts, the lifting effect.

If fillers are injected before a lift, the threads may disrupt or compress the filler material, leading to unevenness or migration. However, in specific cases — for example, when the patient has very deep hollows in the temple or tear trough — small-volume fillers before lifting can create a more stable anchor for the threads.

Every face has a different “map” of structural tension. That’s why sequence is never one-size-fits-all; it’s part of the artistry that separates natural results from artificial ones.

When Combination Treatments Go Wrong

As a revision-focused clinic, we often see patients seeking help after combination procedures done elsewhere. The problems usually share common patterns:

• Overfilled cheeks that look puffy or distort the facial line after a thread lift.

• Threads inserted over filler pockets, creating irregular pulling or surface dimpling.

• Early loss of lift because the filler’s weight counteracts thread tension.

• Visible asymmetry due to mismatched technique between two practitioners.

These issues rarely stem from the treatments themselves — but from how they’re performed. Combining treatments without precise anatomical understanding is like layering paint without letting the base dry; the result lacks clarity and balance.

At Seoyon, we minimize such risks by ensuring a layer-by-layer strategy. Fillers are placed at stable, structural depths, while threads are positioned in collagen-rich planes that lift without stress. This coordination helps maintain natural facial movement, reduces complications, and prolongs results.

Collagen — The Invisible Bridge Between Both Treatments

An often-overlooked connection between thread lifts and fillers is collagen stimulation.

Both treatments, in their own way, encourage your body to rebuild what aging gradually takes away.

• Threads create micro-injuries that trigger fibroblasts to produce collagen and elastin. Over time, a new “biological scaffold” forms around the lifted tissue.

• Certain fillers (such as PLLA or calcium hydroxylapatite-based types) also stimulate collagen, leading to gradual, subtle volumization rather than instant plumping.

When combined thoughtfully, these two mechanisms reinforce each other — providing both immediate improvement and long-term rejuvenation.
This synergy is why Dr. Choi often recommends a phased protocol: threads first to “wake up” the collagen response, followed by carefully placed fillers weeks later to polish and define the outcome.

In essence, the thread sets the stage, and the filler paints the light.

A Word on Safety and Customization

Before any combination procedure, the most important step is a comprehensive, honest consultation.
At Seoyon, we assess:

• Skin quality, elasticity, and thickness

• The degree of tissue laxity and bone resorption

• History of previous fillers or thread procedures

• Presence of long-lasting or permanent filler materials

• The patient’s healing capacity and medical history

These details influence not just how treatments are combined, but whether they should be combined at all. In some cases — for example, when too much filler remains in the tissue — we may recommend dissolving it first and waiting a few weeks before performing the thread lift. This allows the face to “reset” and ensures a cleaner, more predictable lift.

Our one-doctor policy ensures that from initial diagnosis to aftercare, the same surgeon — Dr. Dong-il Choi — manages every stage. This eliminates the risk of “split responsibility,” where different providers perform different parts of the treatment. It also reflects our belief that aesthetic procedures must never be rushed or delegated — especially those involving multiple modalities.

The Natural Look Isn’t About Doing More — It’s About Doing Right

There’s a persistent misconception that more procedures equal better results. In truth, aesthetic balance is achieved through restraint.

A successful combination of thread lift and fillers shouldn’t make you look “different” — it should make you look rested, refreshed, and naturally expressive.
When harmony is achieved, the face retains softness and mobility; when overdone, it becomes rigid and disproportionate.

At Gangnam Seoyon Plastic Surgery, we often tell our patients:
“The best compliment is when people think you look younger, but can’t tell why.”

That’s the hallmark of precision-based rejuvenation — results that respect both anatomy and emotion.

How Long Do Results Last?

One of the benefits of combining threads and fillers is durability.
Threads typically last 12–18 months, though collagen remodeling continues beyond that.
Hyaluronic acid fillers last about 6–12 months, while collagen-stimulating fillers can last up to 24 months.

When performed together with proper timing, the collagen support from the threads can help extend the lifespan of the filler, while the filler can reinforce the skin’s lift and contour from within. Maintenance sessions can then be lighter and less frequent — focusing on preservation rather than correction.

The Seoyon Approach: Precision, Not Haste

Located in Seoul’s renowned Gangnam district — the heart of Korea’s aesthetic innovation — Gangnam Seoyon Plastic Surgery is known for combining surgical expertise with holistic care.
Under the leadership of Dr. Dong-il Choi, who has over 20 years of experience in revision eyelid and rhinoplasty surgery as well as facial rejuvenation, every treatment is tailored to the individual, not the trend.

Our clinic integrates plastic surgery, anesthesiology, and family medicine to provide safe, patient-centered care. Whether it’s a subtle thread lift, revision correction, or combination therapy, every decision is guided by medical ethics and aesthetic sensitivity — not haste or volume sales.

So… Should You Do Both?

If you’re noticing both sagging and volume loss — perhaps your cheeks have fallen while your under-eyes look hollow — combining a thread lift with fillers may give you the most natural and balanced result.
However, the plan must be personalized, considering your anatomy, aging pattern, and lifestyle.

If you already have filler from the past, your surgeon should evaluate whether it needs adjustment or removal before a lift. And if you’re new to both, it’s often best to stage them in phases to ensure optimal collagen response and healing.

The right combination can rejuvenate your face without changing its character — helping you look like yourself, only fresher and more confident.

Final Thought

Combining a thread lift with dermal fillers isn’t about doing more; it’s about doing smarter. When planned and performed with precision, the two treatments harmonize like melody and rhythm — one lifting, the other shaping, both rejuvenating.

If you’re unsure whether combination therapy is right for you, consider a consultation at a clinic where the lead surgeon personally performs your procedure and guides you from start to finish.
At Gangnam Seoyon Plastic Surgery, we believe beauty begins with trust — and ends with results that are timelessly, naturally yours.