Thread lifting is a minimally invasive procedure that addresses skin laxity by using threads to lift and tighten facial tissues. Recent advancements, such as cog threads, have expanded its application to younger patients seeking facial contour refinement. The effectiveness of thread lifting depends on several factors, including thread material, thickness, cog shape, insertion depth, lifting vectors, and the expiration date of absorbable threads. Thread selection should be tailored to the patient's tissue laxity, with lighter threads for minimal laxity and stronger ones for significant sagging. Combining different threads can optimize outcomes and minimize side effects. Excessive traction post-procedure may lead to prolonged discomfort and skin irregularities, while post-procedural tension adjustments through massage remain debated. Understanding thread characteristics is crucial for selecting the most suitable threads based on patient conditions and procedural goals. Patient selection is critical for long-lasting results, requiring careful customization based on individual sagging patterns. Key vectors, such as oblique, vertical, and nasolabial, influence the direction and degree of skin lifting. A secure fixing point, particularly in the temporal fascia, is essential for optimal outcomes. Thread materials significantly affect clinical effects and maintenance duration. Non-absorbable polypropylene threads were traditionally used, but absorbable polydioxanone (PDO) and other materials like poly-L-lactic acid (PLLA) and polycaprolactone (PCL) are now more common. The tensile strength of threads is influenced by their thickness and cross-sectional area, with thicker threads generally exhibiting greater strength. Cogged threads, which have barbs for tissue engagement, vary in shape, placement, and number of cogs, affecting their anchoring and holding strength. Thicker and longer barbs provide better tissue engagement, while thinner barbs may have reduced durability. Multidirectional cogged threads, which engage tissues across multiple areas, offer more uniform lifting effects compared to single-directional threads. The insertion depth of threads is also crucial, with threads engaging resilient tissues like the superficial musculoaponeurotic system (SMAS) providing greater tensile strength and holding power. Threads should be inserted into deeper tissues, such as SMAS, to minimize side effects and maximize lifting effects. Proper thread placement and selection are essential for achieving optimal results in thread lifting procedures.Thread lifting is a minimally invasive procedure that addresses skin laxity by using threads to lift and tighten facial tissues. Recent advancements, such as cog threads, have expanded its application to younger patients seeking facial contour refinement. The effectiveness of thread lifting depends on several factors, including thread material, thickness, cog shape, insertion depth, lifting vectors, and the expiration date of absorbable threads. Thread selection should be tailored to the patient's tissue laxity, with lighter threads for minimal laxity and stronger ones for significant sagging. Combining different threads can optimize outcomes and minimize side effects. Excessive traction post-procedure may lead to prolonged discomfort and skin irregularities, while post-procedural tension adjustments through massage remain debated. Understanding thread characteristics is crucial for selecting the most suitable threads based on patient conditions and procedural goals. Patient selection is critical for long-lasting results, requiring careful customization based on individual sagging patterns. Key vectors, such as oblique, vertical, and nasolabial, influence the direction and degree of skin lifting. A secure fixing point, particularly in the temporal fascia, is essential for optimal outcomes. Thread materials significantly affect clinical effects and maintenance duration. Non-absorbable polypropylene threads were traditionally used, but absorbable polydioxanone (PDO) and other materials like poly-L-lactic acid (PLLA) and polycaprolactone (PCL) are now more common. The tensile strength of threads is influenced by their thickness and cross-sectional area, with thicker threads generally exhibiting greater strength. Cogged threads, which have barbs for tissue engagement, vary in shape, placement, and number of cogs, affecting their anchoring and holding strength. Thicker and longer barbs provide better tissue engagement, while thinner barbs may have reduced durability. Multidirectional cogged threads, which engage tissues across multiple areas, offer more uniform lifting effects compared to single-directional threads. The insertion depth of threads is also crucial, with threads engaging resilient tissues like the superficial musculoaponeurotic system (SMAS) providing greater tensile strength and holding power. Threads should be inserted into deeper tissues, such as SMAS, to minimize side effects and maximize lifting effects. Proper thread placement and selection are essential for achieving optimal results in thread lifting procedures.