"Thread lift" is one of the fastest-growing searches for aesthetic treatment in Accra, and we understand why. It promises what many people in their forties and fifties actually want: a firmer jawline and a less tired lower face, without a scalpel, a general anaesthetic or two weeks hidden at home. Social media adds videos of tissue being drawn visibly upwards, and the phrase "non-surgical facelift" does the rest.
We place PDO threads at our clinic, and we like them — in the right face. But the phrase carries an expectation the treatment cannot meet, and many who ask us for threads would be better served by something else. This guide explains what threads do, who suits them, and how we make that call.
What a PDO thread actually is
PDO is polydioxanone, a material used in dissolvable surgical stitches for decades. A PDO thread is a fine strand of that material, placed beneath the skin through a tiny entry point and left there. Over the following months your body breaks it down completely.
Two things happen while it is there. Depending on the type of thread, it can physically hold tissue in a slightly higher position; and the skin treats the thread as a foreign body and lays down new collagen along its path. That collagen is what carries the result after the thread itself has dissolved.
The two jobs threads do
Lifting threads
Lifting threads carry tiny barbs or cones along their length. Placed in a deliberate direction — usually from the hairline or temple down towards the jowl — they catch the tissue and hold it in a repositioned state while collagen forms around them. These are the threads in every "facelift" video, addressing a softening jawline, early jowls, a heavy brow or a descending cheek. The same principle straightens and defines the nose profile in thread rhinoplasty.
Smooth collagen threads
Mono threads have no barbs and lift nothing. They are placed in a mesh beneath the skin purely to stimulate collagen, which firms and thickens crepey, thin or lined skin over weeks — across the lower cheeks, neck, mouth and the folds from nose to mouth. They are often right for someone who asked about a "lift" but whose real problem is skin quality rather than descent. Most thread plans use both, in a proportion decided by what the face needs.
What "lift" really means
This is the part the videos leave out. A surgical facelift removes skin and repositions the deeper tissue layer; the change is measured in centimetres. A thread lift repositions tissue by a few millimetres and holds it there while collagen forms. It is a real change — the jawline reads cleaner, the jowl softer, the face less tired — but it is subtle, and people who know you will notice that you look well rather than that you have had something done.
The result on the day is also flattering in a way the settled result is not: swelling and the fresh mechanical hold make the lift look stronger than it will at six weeks. We say so before the mirror, or week six feels like a loss rather than the true result.
Who threads suit
The best candidate has mild to moderate laxity — the first descent of the jawline, early jowls, a cheek that has started to flatten — combined with reasonable skin thickness and good skin quality. That describes many people between about 35 and 55, though the tissue matters more than the number: firm, well-cared-for skin at sixty can be a better candidate than heavy, sun-damaged skin at forty.
They also suit people who are clear-eyed about the outcome: a refresh, not a transformation. The happiest thread clients we see in Accra came in wanting to look less tired on video calls, not carrying a photograph from twenty years ago.
Who threads do not suit
Heavy or very lax skin. Barbs hold a certain amount of tissue. Ask them to hold too much — a well-established jowl, a heavy neck, skin excess after weight loss — and they either fail, or hold it with visible bunching where the tissue has gathered. For advanced laxity the honest advice is surgery, and we will say so rather than place threads that will disappoint.
Very thin skin. The opposite problem. In thin or fragile skin, threads can show as ridges or be felt under the surface, and there is not enough depth to place them well. Skin quality treatment usually has to come first.
Unrealistic expectations. Anyone hoping for a surgical result, or not prepared for two to three weeks of odd sensations, should not have threads. Threads also wait during pregnancy, over active infection or inflamed skin, and need medical clearance if you take blood thinners.
Threads with filler, anti-wrinkle and resurfacing
Threads move tissue; they do not replace volume, relax muscles or resurface skin. A face rarely ages in only one of those ways, which is why threads are so often one part of a sequence rather than the whole answer.
Where the cheeks have hollowed, dermal contouring and volume restoration rebuilds the structure the threads then lift against — a lifted but deflated cheek looks odd, and filler alone can look heavy without the lift. Where the lower face is pulled down by an overactive chin or neck muscle, anti-wrinkle treatment of those muscles lets the threads do less work and last longer. And where the skin surface itself is crepey, lined or sun-damaged, full face CO2 resurfacing changes something threads cannot touch. We sequence rather than stack, spacing each treatment so it can settle, in an order set by what is most limiting.
What happens on the day
The appointment begins with mapping — where the tissue has moved, where it should be held, and which entry points and directions will achieve that. Local anaesthetic is placed along the planned paths, which is the least comfortable part. The threads are then inserted through entry points so small they need no stitches. The session takes around 45 to 60 minutes, and you leave slightly swollen, distinctly tight, with a list of instructions.
For the first two weeks: sleep on your back with your head raised, avoid wide mouth opening (big yawns, dental work, hard chewing), no facial massage, no vigorous exercise, and no dragging at the skin while cleansing, so the threads can integrate before the tissue is tugged.
The first weeks: tightness and dimpling
Tightness, a pulling sensation on movement and mild swelling are normal for several days. Small puckers or dimples at the entry points, and sometimes along the path of a barbed thread, are common in the first week and settle as the thread beds in, as does slight early asymmetry.
What is not normal — spreading redness, heat, increasing pain, a thread visibly emerging — needs a call the same day. It is rare, and fixable.
How long results last
The threads themselves dissolve over a few months. The collagen scaffold they leave behind carries the result, typically for 12 to 18 months, and maintenance placement before it has fully faded extends the benefit. Threads do not stop ageing; they reset tissue that will continue, gradually, to descend.
When we advise something else
Two situations come up repeatedly. The first is the client whose skin has lost snap rather than position: lax, crepey and soft, but not actually descended. Lifting that skin does little. Our skin tightening protocols, which stimulate collagen through the deeper layers without breaking the surface, address the real problem.
The second is the client whose complaint is texture — lines, sun damage, uneven tone — who has been told threads will "refresh" the face. They will not. CO2 resurfacing will, and on darker skin tones it is done with settings and preparation Amanda has refined over three decades. Threads sit beneath the skin and carry no pigmentation risk, a genuine advantage on deeper skin tones that cannot be assumed of every energy-based treatment — which is why the choice is made by someone who treats this skin daily.
Does a thread lift hurt?
The anaesthetic injections are the sharp part; the placement itself is felt as pressure and tugging rather than pain. Afterwards, expect tenderness and tightness rather than pain, manageable with ordinary paracetamol.
Can threads be removed if I do not like them?
Not easily, and not usually necessary. A misplaced thread, or one you can feel, can be adjusted or, occasionally, removed in the early days; beyond that, the threads dissolve within months and the result fades with them — which is why the assessment matters more than the procedure.
Thread lift or filler — which do I need?
If your face has descended, threads. If it has deflated, filler. If both — which is most faces over 45 — usually filler for structure and threads for position, sequenced. If neither, and the problem is the skin itself, neither. Clients visiting Ghana from abroad should allow a week before flying home, with a review at two weeks by photograph.
Getting a straight answer
Threads reward good judgement and punish enthusiasm. Every thread consultation at our clinic in Cantonments, Accra is with Amanda Fourie — a registered aesthetic injector with more than thirty years' experience — and ends with one of three honest answers: threads, something else first, or not yet. Prices for every thread treatment are published on the PDO thread lifting page and on our price list. Book a consultation to find out which is yours.