Anti-Aging Treatment in Korea in Your 50s: Threads Plus Filler

I'm Dr. Jong Hoon Lee, a doctor at Gangnam HERA in Seoul. I have been in practice for more than 25 years and co-wrote the textbook LIFTINGOLOGY: Science and Clinical Practice in Aesthetic Medicine. In this video you can watch a whole visit from start to finish: the consultation with a patient in her fifties who came in because her face had started to look tired and dropped, the treatment, and her check-up three weeks later.

My short answer: looking younger in your fifties usually means treating two things together — lifting the tissue that has dropped, and replacing a little of the volume that has gone. Neither alone gives the same result.

What did she want to change?

Forehead lines, a frown line, deepening smile lines and an overall feeling that her face had dropped. She described it well in front of the mirror: her face used to look lifted, and now the skin felt as if it had slid down. The frown line had appeared as her eyesight worsened and she squinted more. She had had one thread lift about a year earlier.

When I looked with her, the main change was in the lower face. The soft tissue beside the mouth had dropped and the jawline had lost its clean edge. When I lifted her cheeks gently with my hands, she could see in the mirror how much of the problem was position rather than skin quality.

Why didn't I start with her forehead lines?

Because her brows were lifting to help her heavy eyelids, and relaxing the forehead could have made her eyes feel heavier. I asked her to close her eyes and then open them gently. She was lifting her brows high to keep her eyes open, which is what creates the lines across the forehead.

If someone simply says "take my forehead lines away," a wrinkle-relaxing injection will do that. But when the brows are working to compensate for a heavy upper lid, softening those muscles takes away the help, and the patient can feel that opening the eyes has become harder. So I told her honestly that I would like to treat the forehead too, but that it is better left for later, once we have dealt with what matters most to her now. Choosing what not to treat is part of the plan.

Device, threads or surgery: how do I decide?

By how far the tissue has dropped. When sagging is mild, an energy device can lift it. If you want a stronger effect, that is where a thread lift comes in. When laxity is more severe than that, the answer is eventually surgery that removes skin. For her, I said clearly that a facelift would be too early — her sagging was moderate, which is exactly where threads work well.

If you are unsure which group you are in, what a thread face lift can and cannot change shows the range of realistic results.

What can't lifting fix on its own?

Lost volume. Even while I was holding her cheeks up, a groove remained along her smile lines. That groove is a hollow, not a drop, and lifting does not fill hollows. Filler placed there smooths it much more than lifting can.

Her chin was a second example. Her upper jaw sits slightly forward, which makes the smile lines look deeper, and her chin is short, which makes the mouth look a little protruding. A small amount of filler at the chin brings the line forward, and the mouth then looks as if it has moved back. The whole lower face reads as a softer V-line. Chin filler covers what this can and cannot do.

Why does the front of the cheek matter so much for a younger face?

Because a little fullness at the front of the cheek is one of the strongest signals of youth, and lifting can leave this area looking flat. There is a groove that runs down and outward across the front of the cheek. When the face is pulled up, that area can look flat. When the volume there is restored even slightly, the face looks far more three-dimensional.

So the plan we agreed was:

• A thread lift for the overall drop of the lower face and jawline.
• Filler for the groove across the front of the cheek, the smile lines and the short chin.
• Nothing on the forehead for now, to protect how easily she opens her eyes.

How is the filler placed?

After numbing, in small amounts, checking side by side as I go. I started with the cheek groove, then the smile line, then the chin. Patients feel a stinging sensation at first and then a feeling of something passing under the skin; I ask them to tell me straight away if pain suddenly increases.

Faces are never perfectly symmetrical, so I do not inject the same amount on both sides. In her case the left and right cheek grooves both needed filler, but only the right smile line did, and the right front of the cheek needed less than the left. Turning her to the side, the difference from the chin filler was clear. By the end, the smile line we treated had almost disappeared. If smile lines are your main concern, nasolabial fold filler explains the options.

Which threads did I use, and how long do they last?

About 80% were Mint threads, the thread most widely used in Korea, plus a longer-lasting absorbable thread. After cleansing the entry points and numbing them, I placed the threads. Patients often notice a sound as the thread passes; it is uncomfortable rather than painful, and I tell people that honestly.

• Mint threads dissolve in about six months.
• To extend the result, I added an absorbable thread designed to last around a year to a year and a half.
• That does not mean repeating every six months. Repeating about every two years keeps the result in good shape, partly because the fibrous tissue that forms as threads dissolve also helps support the face.
• After a first thread lift, the face largely returns over time. After two or three rounds, it tends not to fall back as much.

What should I avoid in the first week after a thread lift?

Opening your mouth very wide, and sleeping on your side, for about a week. The threads have small barbs that grip the tissue, and both of these movements put strain on them. Other things to expect:

• For a day or two, the temples can feel uncomfortable when you chew.
• The face looks more lifted than the final result at first; it settles down as it should.
• Some fullness right after treatment is just the local anesthetic and swelling.

What did she look like three weeks later?

Smoother and natural, with most of the swelling gone. She told me the first days were unsettling — she could not open her mouth easily — but by her visit she felt much better. Two to three weeks of some discomfort is normal, because a thread lift works by pulling, and the temples take a lot of that load when you eat.

The groove across her cheek and the overall volume looked much smoother than before treatment, and nothing looked unnatural. Because she had filler at the same time, she also had a little more early swelling — she described feeling "like a steamed bun" at first. In her own words, the thread lift felt reassuring compared with procedures she found frightening, and after about a week daily life was no problem. If anything still needs adjusting once the swelling has fully settled, a small touch-up is possible.

The honest limits

This is not a facelift, and the result is not permanent. Threads reposition tissue and filler replaces volume; neither removes excess skin. Both have side effects — swelling, bruising, tightness, temporary discomfort when eating — and results vary from person to person. Which threads, how many, which filler areas and how much are decided at your consultation, and you receive an itemized written estimate before treatment. International patients pay the same as local patients, and an English interpreter is with you throughout.

Looking ten years younger is rarely about one dramatic change. It is about reading the face correctly, treating the right things in the right order, and leaving alone what should be left alone. You can see real HERA results in our before-and-after gallery.