Multicenter Review of More Than 110,000 Facial Thread Lifting Cases From a Cosmetic Surgery Group

Background: Thread lifting is a minimally invasive aesthetic procedure that has gained popularity for facial rejuvenation. However, large-scale multicenter studies assessing trends, patient characteristics, and procedural variations are limited. This study aimed to evaluate longitudinal changes in facial thread lifting use, patient demographics, procedural composition, and combination treatments across a nationwide cosmetic surgery network during a 5-year period. Methods: We retrospectively analyzed 111,948 facial thread lifting procedures performed between 2020 and 2024 across more than 100 Tokyo Central Cosmetic Surgery Group clinics. Statistical analyses included the Kruskal–Wallis test with Bonferroni-adjusted post hoc comparisons for age-related trends. Results: Procedure volumes increased during the 5-year period, as did the median patient age ( P < 0.001), with procedural patterns shifting toward an older demographic. Seven procedural combinations were identified, with polydioxanone + polycaprolactone threads being the most common. The use of nonabsorbable threads increased substantially, with more than 60% of patients undergoing thread lifting with additional treatments, such as fillers or toxins. Conclusions: Thread lifting is increasingly used as part of multimodal facial rejuvenation strategies, with trends toward older patient populations and broader procedural integration. These findings highlight the evolving role of thread lifting in evidence-based aesthetic medicine.