Thread lifting is a office based minimally invasive technique without surgical incisions. It is an important modality because it fills a gap between botulinum toxin, dermal fillers and surgical face and neck lifting, especially for the modern day cosmetic surgery industry, where cosmetic improvement is on demand at a much younger age, done more frequently and the necessity of very little downtime. Newly developed threads are more powerful and effects can last between 1 and 5 years. Due to the composition of threads collagen synthesis and skin revitalisation is just as important as the direct lifting and anchoring effects. Modern threads have specifically designed integrated barbs of different strengths and directions to provide strength, hold and bio integration. Some are inserted into subdermal tissue lift the skin and cause fibrosis by stimulating new collagen formation. Improved facial contour is visible immediately after the procedure. Downtime after thread lifting procedures is much shorter than with surgical procedures.