Skin Tightening and Back to Your Day: What You'll See When You Walk Out
Radiofrequency face tightening and downtime: what your skin shows when you leave, how long the redness lasts, and what the manufacturer does and does not promise.
Your face is loosening, and two options keep coming up: thread lifts and radiofrequency. They don't do the same thing. A thread hooks tissue and pulls it upward; radiofrequency heats the skin to tighten it where it is, leaving nothing inside.
We'll say it up front: we don't place threads. This article compares the two fairly, with what each requires and what neither does.
Two different approaches
A thread is slipped under the skin with a needle or a cannula. Its small barbs catch the tissue, which is then pulled in one direction. The thread dissolves over time.
Radiofrequency introduces nothing. It sends heat into the deep layers of the skin, which contracts existing collagen and restarts its production. The skin becomes firmer where it is.
The two side by side
| What matters | Thread lift | Radiofrequency (XERF) |
|---|---|---|
| The procedure | Insert a thread under the skin and pull it | Heat the skin through the surface |
| What does the work | The thread's pull | Heat on collagen |
| What stays in the skin | The thread, until it dissolves | Nothing |
| Needle or cannula | Yes | No |
| What neither does | Remove excess skin | Remove excess skin |
The two don't replace each other. A thread targets tissue that has descended; heat targets skin that has lost its hold.
What the literature says about threads
A 2021 meta-analysis (Niu et al., Aesthetic Plastic Surgery) pooled 26 studies on facial threads. The most reported side effects:
- swelling, in about 35% of cases;
- small dimples in the skin, about 10%;
- altered sensation, about 6%;
- a thread you can see or feel, about 4%;
- infection or a thread that pokes out, about 2% each.
The same authors note lower satisfaction in the long term than right after the treatment, and more dimpling and infections after age 50. These figures pool very different studies and threads: they give an order of magnitude, not a risk for you.
We found no study directly comparing threads and radiofrequency. Nobody can tell you which one lasts longer.
What Health Canada asks for
Health Canada has published an advisory on thread lifts. It makes two points:
- only absorbable threads authorized for cosmetic use should be used;
- they should be implanted by a physician or under a physician's supervision, preferably in a healthcare setting.
The advisory also warns against threads sold for do-it-yourself use. If you're considering threads elsewhere, you can ask for the product name and check that it is licensed.
A thread hooks and pulls. Heat tightens without leaving anything in the skin. Neither removes excess skin.
What radiofrequency requires, and its limits
XERF is done in at least two sessions, 4 to 6 weeks apart, then a yearly upkeep. A session lasts 90 min, for the full face and neck, and costs $1,500, taxes extra. No downtime: back to your usual activities the same day. Temporary redness is possible.
Its limits are clear:
- the effect builds over a few months, it isn't complete when you leave;
- it tightens, it doesn't lift tissue that has descended;
- according to the clinic, results can last 12 to 18 months after a full series, and they vary.
According to the manufacturer (Cynosure Lutronic), the device combines built-in cooling with a reading of the skin's resistance at every pulse. Here, a medical esthetician sets the depth and intensity. The article HIFU or radiofrequency compares ultrasound heat and radiofrequency heat.
Why we don't place threads
We chose treatments that introduce nothing under the skin to firm it, and injections given by nurses for volume. Threads aren't among our treatments, and we won't tell you they're bad: we'll only tell you we don't place them.
When threads or surgery are the better answer
If your tissue has descended and you want to see it lifted, heat won't do that. Depending on the degree of laxity, a physician who places authorized threads, or a plastic surgeon, answers that request better. The article radiofrequency or surgical facelift helps place that limit. The full details are on the XERF page.
Questions we are asked
Do threads last longer than radiofrequency?
No comparable study lets anyone say. Both have durations that vary from person to person, and they've never been measured side by side.
Are threads authorized in Canada?
Health Canada states that only absorbable threads authorized for cosmetic use should be used, implanted by a physician or under a physician's supervision. A specific product's status is checked by its name.
Can I do both?
They are two different procedures, which can target two different problems. If you already have threads, mention it at the assessment.
What happens when a thread dissolves?
It slowly disappears from the tissue. The pulling effect fades with it.
Can I have radiofrequency with threads in place?
That is decided at the assessment, based on the type of thread and when it was placed. We don't set a rule in an article.
Sources
- Health Canada. Only absorbable threads authorized for cosmetic use should be used in thread lift procedures (public advisory). recalls-rappels.canada.ca
- Niu et al. A Meta-Analysis and Systematic Review of the Incidences of Complications Following Facial Thread-Lifting. Aesthetic Plastic Surgery, 2021;45(5):2148-2158. PubMed
- Austin GK, Struble SL, Quatela VC. Evaluating the effectiveness and safety of radiofrequency for face and neck rejuvenation: a systematic review. Lasers in Surgery and Medicine, 2022. PubMed
- Cleveland Clinic. Radiofrequency (RF) Skin Tightening. my.clevelandclinic.org
- Cynosure Lutronic (manufacturer). XERF. cynosure.com/xerf
