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Midface Shortening Thread Lifting

Kate Signature

Midface Shortening Thread Lifting

Hello, this is Dr. Won-sang Lee,
Chief Director of Kate Clinic.
Over the past 20 years, I have treated countless patients, and today I would like to clearly answer one of the most frequently
asked questions about midface shortening
"Why is thread lifting alone not enough,
and why does it need to be combined with filler?" 

Based on two decades of clinical experience and the latest medical research,
I will explain this in an easy-to-understand way.

First, keep this in mind.
 The truth about
midface aging

The midface includes the eyes, nose, and mouth area—the central region of the face.
Aging in this area is not simply a matter of “sagging.” 
It results from two major issues that occur at the same time. Because both happen together,
a single procedure cannot fully correct midface aging.

Hello, this is Dr. Won-sang Lee, Chief Director of Kate Clinic. Over the past 20 years, I have treated countless patients,
and today I would like to clearly answer one of the most frequently asked questions about midface shortening :

“Why is thread lifting alone not enough, and why does it need to be combined with filler?”


Based on two decades of clinical experience and the latest medical research, I will explain this in an easy-to-understand way.

First, keep this in mind.
"The truth about midface aging" 

The midface includes the eyes, nose, and mouth area — the central region of the face.
Aging in this area is not simply a matter of “sagging.” It results from two major issues that occur at the same time.
Because both happen together, a single procedure cannot fully correct midface aging.

SAGGING
Sagging

Tissue descent caused by reduced skin elasticity

VOLUME LOSS
Volume Loss

Volume loss due to decreased collagen and fat atrophy

SAGGING
Sagging

Tissue descent caused by reduced skin elasticity

VOLUME LOSS
Volume Loss

Volume loss due to decreased 
collagen and fat atrophy

Limitations of thread lifting alone

What 20 years of clinical experience shows

“Doctor, isn’t thread lifting alone enough?”

This is a question I hear very often — but medical evidence clearly shows its limitations.

Limitations of thread
lifting alone

What 20 years of clinical
experience shows

“Doctor, isn’t thread lifting alone enough?”
This is a question I hear very often — but medical evidence clearly shows its limitations.

1
Limitations in
longevity
  • Initial maintenance period : about 6–10 months
  • Effect after 1 year : almost completely diminished 
    (Journal of Aesthetic Surgery, 2018)
  • Cause : Loss of mechanical support due to hydrolysis of PDO threads
2
Restrictions in
treatment scope

Thread lifting is effective only for mild to moderate skin laxity. 
When severe sagging or volume loss is present:

  • Only about 30–40% improvement compared to surgical facelift
  • Difficult to achieve full facial harmony due to vector limitations
3
Cannot address
volume loss

Thread lifting provides only upward lifting. 
It does not replace lost volume in hollow or sunken areas.

  • Can create an unnatural pulled appearance
  • May make the depressed areas look even more sunken after the procedure
  • Leads to imbalance in the overall facial proportions
Area-specific effects
of the Thread Lift + Filler combination

By combining thread lifting (support · lifting) with filler (volume restoration) for each area, you can expect three-dimensional improvement.

*Due to medical regulations, before-and-after photos cannot be displayed. Treatment goals and methods are described with illustrative images instead.

Area-specific effects of 
the Thread Lift + Filler combination

By combining thread lifting (support · lifting) with filler (volume restoration) for each area,
you can expect three-dimensional improvement.

Nasolabial Fold Improvement
Type 1: Volume-deficient type

This occurs when the deep area next to the nose (canine fossa) becomes hollow, creating a pronounced nasolabial fold. Simply pulling upward is not enough to correct this.

Treatment Goals

  • Restore volume to the sunken area
  • Recreate a natural cheek contour
  • Improve nasolabial fold depth by more than 50%

Treatment Method

  • Thread lift : Basic tissue repositioning and line stabilization 
  • Filler (main treatment) : Stepwise deep-volume restoration
  • Result : 30–50% immediate improvement, lasting 12–18 months

Nasolabial Fold Improvement
Type 2: Sagging type

This occurs when the cheek fat pad sags downward, creating nasolabial folds. When you gently lift the cheek upward, the fold improves—this is the typical pattern.

Treatment Goals

  • Lift the sagging cheek fat pad back to its original position
  • Restore a natural upward facial curve
  • Rebalance overall facial proportions

Treatment Method

  • Thread lift (main treatment):
    Focused lifting of the anterior cheek fat pad
  • Filler : Enhances indirect lifting by reinforcing the upper cheek
  • Result : Natural upward curve and overall facial improvement

Natural upward curve and overall facial improvement

As we age, superficial fat descends while deep fat decreases, making the cheeks appear flatter and giving a tired look.

　

Treatment Goals

  • Restore the youthful, full cheek volume
  • Lift sagging areas and fill hollow areas simultaneously
  • Create a natural, three-dimensional facial contour

Treatment Method

  • Thread lifting : Soft upward repositioning of superficial fat using a V-pattern
  • Filler : Direct volume restoration to deep fat compartments
  • Result: Rebuilding the Triangle of Youth with a 5–7 year younger appearance/span>

Jawline
Improvement

Sagging cheek tissue around the jawline causes a square appearance. From the side, the border between the jaw and neck becomes unclear.

Treatment Goals

  • Create a sharp and defined V-line jaw contour
  • Lift jowls for a clean facial outline
  • Achieve a beautiful silhouette even from the side view

Treatment Method

  • Thread lifting : High-strength, bidirectional cog threads (40 cm+) for targeted jawline lifting
  • Filler : Enhances chin projection to complete the V-line angle
  • Result : Defined jawline with 50–70% jowl improvement

Double Chin
 Correction

Irregular fat accumulation under the chin blurs the boundary between the jaw and neck. From the front, the jawline looks soft; from the side, the neck looks thick.

Treatment Goals

  • Compress and reduce irregular fat volume
  • Create a defined jaw–neck boundary
  • Improve the overall lower-face contour

Treatment Method

  • Thread lifting (main treatment) : U-shaped design for fat compression and lifting
  • Filler : Enhances the jaw–neck contour (supportive role)
  • Result: 60–80% volume reduction, lasting up to 18 months
Actual multi-area combination results from  real cases 
  Case 01  
A 45-year-old female
with concerns of deepened nasolabial folds, sagging cheeks, 
and an undefined jawline
case image
 Before treatment
  • Overall midface sagging
  • Aging appearance due to decreased cheek volume
  • Blurred jawline definition
 Individualized Treatment Plan
  • Step 1 : Thread lifting 
    - Nasolabial folds : Reverse Technique Cavern thread insertion
    - Cheeks : V-pattern lifting to restore the cheek volume
    - Jawline : Long cog threads in an I-shaped design to refine the entire line
  • Step 2 : Filler
    - Nasolabial folds : Volume restoration of the canine fossa (1 cc)
    - Cheeks : Deep fat compartment volume enhancement (1.5 cc)
    - Chin : Increased projection to complete the V-line (0.5 cc)
  • Post-treatment results
    (6-month follow-up) :
    - Nasolabial fold improvement: 85%
    - Cheek lifting effect: 90%
    - Jawline definition: 95%
    - Overall satisfaction: Very satisfied
Real Reviews from Our Patients
"When I only had a thread lift, my face looked unnaturally tight. After adding filler, the result looks naturally younger."

*Due to medical regulations, before-and-after photos cannot be displayed. Treatment goals and methods are described with illustrative images instead.
  Case 02  
A 38-year-old male
concerned about double chin,
sagging cheek,
and an overall tired appearance
case image
 Before treatment
  • Blurred boundary between the neck and jawReduced midface volume
  • Reduced midface volume
  • Overall lower-face sagging
 Individualized Treatment Plan
  • Step 1 : Thread lifting
    - Double chin : U-shaped bidirectional cog threads for compression lifting
    - Cheeks : Lateral lifting for an overall upward effect
    - Jawline : V-pattern design pulling inward from below each ear
  • Step 2: Filler
    - Double chin: Jaw–neck contour enhancement (0.5 cc)
    - Cheeks: Cheek volume restoration (1 cc each side)
    - Jawline: Angle correction and contour refinement (0.5 cc)
  • Post-treatment results (6-month follow-up) :
    - Double chin improvement : 80%
    - Facial contour definition : 90%
    - Rejuvenation effect : Looks 5–7 years younger
    - verall satisfaction : Very satisfied
Real Reviews from Our Patients
"As a man, I didn’t want anything that looked obvious, but the improvement is incredibly natural. My coworkers even asked if I had lost weight because my jawline looks so much defined."

*Due to medical regulations, before-and-after photos cannot be displayed. Treatment goals and methods are described with illustrative images instead.
  Case 03  


A 52-year-old female
concerned about severe
nasolabial folds, overall facial
sagging, and downturned
corners of the mouth
case image
 Before treatment
  • Moderate skin laxity
  • Multi-layered, complex aging changes
  • Overall facial volume lossIndividualized Treatment Plan
 Individualized Treatment Plan
  • Step 1: Thread lifting (wide-area)
    - Nasolabial folds: Reverse Technique Cavern thread insertion
    - Overall midface: 3D vector lifting
    - Mouth corners: Gentle upward lift using micro-barb threads
  • Step 2: Filler (stepwise approach)
    - Phase 1: Deep structural support (2 cc)
    -Phase 2: Superficial volume restoration and finishing (1.5 cc)
  • Post-treatment results (12-month follow-up) :
    - Nasolabial fold improvement: 75%
    - Overall lifting effect: 85%
    - Natural expression: 95%
    - Duration: Extended by 6 months beyond expectation
Real Reviews from Our Patients
"I was worried that my age would affect the results, but the improvement was far better than I expected. Best of all, it looks completely natural, and I finally feel confident in pictures again."

*Due to medical regulations, before-and-after photos cannot be displayed. Treatment goals and methods are described with illustrative images instead.
Actual multi-area combination
results from  real cases 
Case 01


A 45-year-old female
with concerns of deepened nasolabial folds, 
sagging cheeks, and an undefined jawline
Before treatment
  • Overall midface sagging
  • Aging appearance due to decreased cheek volume
  • Blurred jawline definition
Individualized Treatment Plan
  • Step 1 : Thread lifting
    • Nasolabial folds : Reverse Technique Cavern thread insertion
    • Cheeks : V-pattern lifting to restore the cheek volume
    • Jawline : Long cog threads in an I-shaped design to refine the entire line
  • Step 2 : Filler
    • Nasolabial folds : Volume restoration of the canine fossa (1 cc)
    • Cheeks : Deep fat compartment volume enhancement (1.5 cc)
    • Chin : Increased projection to complete the V-line (0.5 cc)
  • Post-treatment results (6-month follow-up) : 
    • Nasolabial fold improvement: 85%
    • Cheek lifting effect: 90%
    • Jawline definition: 95%
    • Overall satisfaction: Very satisfied


Real Reviews from Our Patients


"When I only had a thread lift, my face looked unnaturally tight. After adding filler, the result looks naturally younger."


*Due to medical regulations, before-and-after photos cannot be displayed. Treatment goals and methods are described with illustrative images instead.

Case 02


A 38-year-old male
concerned about double chin, sagging cheek,
and an overall tired appearance
Before treatment
  • Blurred boundary between the neck and jawReduced midface volume
  • Reduced midface volume
  • Overall lower-face sagging
Individualized Treatment Plan
  • Step 1 : Thread lifting
    • Double chin : U-shaped bidirectional cog threads for compression lifting
    • Cheeks : Lateral lifting for an overall upward effect
    • Jawline : V-pattern design pulling inward from below each ear
  • Step 2: Filler
    • Double chin: Jaw–neck contour enhancement (0.5 cc)
    • Cheeks: Cheek volume restoration (1 cc each side)
    • Jawline: Angle correction and contour refinement (0.5 cc)
  • Post-treatment results (6-month follow-up) : 
    • Double chin improvement : 80%
    • Facial contour definition : 90%
    • Rejuvenation effect : Looks 5–7 years younger
    • Overall satisfaction : Very satisfied


Real Reviews from Our Patients


"As a man, I didn’t want anything that looked obvious, but the improvement is incredibly natural.
My coworkers even asked if I had lost weight because my jawline looks so much defined."


*Due to medical regulations, before-and-after photos cannot be displayed. Treatment goals and methods are described with illustrative images instead.

Case 03


A 52-year-old female
concerned about severe nasolabial folds,
overall facial sagging, and downturned corners of the mouth
Before treatment
  • Moderate skin laxity
  • Multi-layered, complex aging changes
  • Overall facial volume lossIndividualized Treatment Plan
Individualized Treatment Plan
  • Step 1: Thread lifting (wide-area)
    • Nasolabial folds: Reverse Technique Cavern thread insertion
    • Overall midface: 3D vector lifting
    • Mouth corners: Gentle upward lift using micro-barb threads
  • Step 2: Filler (stepwise approach)
    • Phase 1: Deep structural support (2 cc)
    • Phase 2: Superficial volume restoration and finishing (1.5 cc)
  • Post-treatment results (12-month follow-up) : 
    • Nasolabial fold improvement: 75%
    • Overall lifting effect: 85%
    • Natural expression: 95%
    • Duration: Extended by 6 months beyond expectation


Real Reviews from Our Patients


"I was worried that my age would affect the results, but the improvement was far better than I expected.
Best of all, it looks completely natural, and I finally feel confident in pictures again."


*Due to medical regulations, before-and-after photos cannot be displayed. Treatment goals and methods are described with illustrative images instead.

 Final Thoughts
from 20 Years of Experience

Why is combination treatment so important?

1. Backed by research: 17.71% higher effectiveness than single treatments

2. Longer-lasting results: Average results last 4.67 years vs. 4.13 years with single treatments

3. More natural outcomes: 99% patient satisfaction

4. No increase in complication rates

A sincere note 
from your doctor

After treating countless patients over the past 20 years, I’ve learned that the best procedures are the ones that feel so natural, you forget you ever had anything done.


The combination of thread lifts and filler : 

  • Enhances what each treatment does best
  • Delivers a naturally lifted, youthful look
  • Provides excellent long-term value
One last thing 
to remember

Success in midface treatment relies not only on technique, but on truly personalized design.

Your features are uniquely yours.

My philosophy in aesthetic medicine is to honor 
that individuality while bringing out your most natural, confident expression.


Through a tailored, one-on-one consultation, I will recommend the treatment plan that suits you best.

"With 20 years of experience and scientific evidence, I’m here to help you regain your confidence."

Operating Hours

 Tel. +82 2-6952-1234
Weekdays 
11:00 am ~ 8:30 pm 🌙
Saturday 
10:00 am ~ 4:30 pm 
(No lunch break)
Lunch Break
1:30 pm ~ 2:30 pm

Address
7F, Kate Clinic, 148 Yanghwa-ro, Mapo-gu, Seoul, Republic of Korea

   

Kate Clinic
 Business Registration Number: 525-36-00662 
 Representative : Lee Won-sang   |   E-mail : kateclinic@naver.com
Terms of Use   |   Privacy Policy

 ⓒKATE CLINIC. All Rights Reserved

 Operating Hours

 Tel. +82 2-6952-1234
Weekdays11:00 am - 8:30 pm 🌙
Saturday10:00 am - 4:30 pm (No lunch break)
Lunch Break1:30 pm – 2:30 pm

Address   7F, Kate Clinic, 148 Yanghwa-ro, Mapo-gu, Seoul, Republic of Korea

   

Kate Clinic   |   Business Registration Number : 525-36-00662   |   Representative: Lee Won-sang   |   E-mail : kateclinic@naver.com

Terms of Use   |   Privacy Policy    |   ⓒKATE CLINIC. All Rights Reserved