Thread lifts or Botox? The most frequent question
As a doctor specialized in aesthetic medicine, one of the most common consultations is: “Which is better, thread lifts or Botox?” The short answer is: it depends on what you want to correct.
Both treatments are excellent, but they have completely different functions and, in fact, complement each other perfectly. In this guide, I’ll explain the differences so you can make the best decision.
Fundamental differences: What does each do?
Botox (Botulinum Toxin)
Main function: Relax muscles
Botulinum toxin acts on facial muscles, relaxing them to:
- Prevent and smooth expression lines
- Reduce dynamic lines (those that appear when gesturing)
- Prevent the formation of deep wrinkles
- Improve the appearance of certain areas (forehead, between brows, crow’s feet)
What it doesn’t do: It doesn’t lift tissues, doesn’t fill, doesn’t correct sagging.
Thread Lifts
Main function: Lift and tighten tissues
Thread lifts act on the skin and subcutaneous tissue:
- Elevate fallen areas of the face
- Correct mild to moderate sagging
- Redefine facial contours
- Stimulate collagen production
- Improve skin quality
What it doesn’t do: It doesn’t relax muscles, doesn’t prevent expression lines.
Complete comparison table
| Characteristic | Thread Lifts | Botox |
|---|---|---|
| Main function | Lift and tighten | Relax muscles |
| What it corrects | Sagging, contours | Expression lines |
| Type of wrinkles | Static (from gravity) | Dynamic (from movement) |
| Result | Immediate lifting | Smoothing in 7-14 days |
| Duration | 10-14 months | 3-4 months |
| Procedure | 30-45 min | 15-20 min |
| Anesthesia | Local | Not necessary |
| Recovery | 3-5 days | Immediate |
| Pain | Mild-moderate | Minimal |
| Cost | \(-\)$ | $ |
| Main areas | Cheeks, jawline, neck | Forehead, between brows, crow’s feet |
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Read moreWhen to choose Botox?
Botox is the best option when your main concern is:
Expression lines
- Forehead: Horizontal lines that appear when raising eyebrows
- Between brows: Vertical lines between eyebrows (elevens)
- Crow’s feet: Wrinkles around the eyes when smiling
- Bunny lines: Wrinkles on the nose when scrunching
Aging prevention
- Starting at 25-30 years as preventive
- To prevent expression lines from becoming permanent
Complementary treatments
- Hyperhidrosis (excessive sweating)
- Bruxism (teeth grinding)
- Gummy smile
When to choose Thread Lifts?
Thread lifts are the best option when your main concern is:
Facial sagging
- Drooping cheeks: Loss of malar definition
- Facial oval: Undefined jawline contour
- Cheeks: Sagging in the middle third of the face
- Eyebrows: Drooping of the eyebrow tail
Contour redefinition
- Diffuse jawline
- Marked nasolabial folds
- Loss of the “triangle of youth”
Rejuvenation of specific areas
Why combining them is the best option?
The truth is that you don’t have to choose one or the other. The combination of both treatments usually gives the best results because:
They complement each other perfectly
| Problem | Treatment |
|---|---|
| Wrinkles when gesturing | Botox |
| Sagging and fallen tissues | Thread lifts |
| Both problems | Combination |
Example of combined protocol
45-year-old patient with:
- Forehead with expression lines → Botox
- Drooping cheeks → Thread lifts
- Crow’s feet → Botox
- Undefined facial oval → Thread lifts
Result: Comprehensive rejuvenishment that neither treatment could achieve alone.
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Read moreComparative prices
Botox
| Area | Approximate units | Orientative price |
|---|---|---|
| Forehead | 10-20 units | $75 - $125 USD |
| Between brows | 15-25 units | $100 - $150 USD |
| Crow’s feet | 10-15 units | $60 - $100 USD |
| Combined areas | 30-50 units | $175 - $300 USD |
Thread Lifts
| Area | Approximate threads | Orientative price |
|---|---|---|
| Eyebrows (4-6 threads) | 4-6 threads | $200 - $300 USD |
| Cheeks (6-8 threads) | 6-8 threads | $300 - $400 USD |
| Complete oval (8-12 threads) | 8-12 threads | $400 - $600 USD |
Note: Prices are indicative and may vary according to each specific case.
Which to choose according to your age?
25-35 years
Main recommendation: Preventive Botox
- Incipient expression lines
- Aging prevention
- Thread lifts only if there’s premature sagging
35-45 years
Recommendation: Combination of both
- Botox for expression lines
- Thread lifts for first signs of sagging
- Ideal time to start with threads
45-55 years
Recommendation: Thread lifts as protagonist
- More evident sagging
- Botox as complement
- Possible combination with fillers
55+ years
Recommendation: Personalized evaluation
- Thread lifts if sagging is moderate
- Botox for expression lines
- Possible need for surgery if sagging is severe
Frequently asked questions about Threads vs Botox
Can I get both treatments at the same time?
Yes, it’s very common. They can be performed in the same session or with a few days difference. Your doctor will determine the best protocol.
Which lasts longer?
Thread lifts last longer (10-14 months) than Botox (3-4 months). However, Botox requires less investment per session.
Which is more painful?
Botox is practically painless (small pinches). Thread lifts require local anesthesia and may cause more discomfort, but are tolerable.
Which has more risks?
Both are safe in expert hands. Botox has less risk of visible complications. Thread lifts can cause irregularities if not placed correctly.
Which is better for between the eyebrows?
Botox is the treatment of choice for between the eyebrows. Thread lifts don’t act on expression lines in this area.
Which is better for drooping cheeks?
Thread lifts are the indicated option for elevating drooping cheeks. Botox has no effect on sagging.
Can I start with Botox and then add threads?
Yes, in fact it’s a very common sequence. Many patients start with Botox and add threads when sagging appears.
Are the results of both natural?
Yes, when performed by trained professionals with adequate doses and techniques. The key is not to overdo either treatment.
Conclusion: Which to choose?
The decision between thread lifts and Botox is not mutually exclusive. Most patients benefit from both treatments:
- Choose Botox if your main concern is expression lines
- Choose thread lifts if your main concern is sagging
- Combine both for comprehensive rejuvenation
The best way to determine what you need is through a professional consultation where your face is evaluated personally.
If you’re considering these treatments, I invite you to an evaluation consultation where I’ll analyze your specific case and design a personalized plan that may include one or both treatments according to your needs.
Want to learn more about this treatment?
Schedule your consultation with our doctors and discover the ideal treatment for you
Schedule your treatment * Limited spots this weekUpdated: June 2026 — Prices verified and comparison updated by Dr. Tatiana Leal
This article is for informational purposes and does not replace consultation with a medical professional. Each case is unique and requires personalized evaluation.
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Frequently asked questions
Which treatment lasts longer — thread lifts or botulinum toxin injections?
PDO thread lifts typically provide visible lifting effects for 12 to 18 months, after which the threads have fully absorbed and collagen remodeling gradually diminishes. Botulinum toxin results last 3 to 6 months on average, requiring more frequent sessions, though the cumulative muscle-training effect can slightly extend intervals over time.
Can thread lifts and botulinum toxin be performed during the same appointment?
Yes, combining both treatments in the same session is a common and well-accepted practice, as they target different mechanisms: threads provide structural lift through tissue traction, while botulinum toxin relaxes specific muscles to smooth dynamic lines. The sequence typically places threads first, followed by toxin injection, to avoid any distortion of anatomical landmarks from prior swelling.
For which facial zones is botulinum toxin clearly superior to thread lifts?
Botulinum toxin is the preferred treatment for dynamic wrinkles caused by repetitive muscle movement, including forehead lines, glabellar frown lines, crow's feet, and lip lines. Thread lifts are ineffective in these zones because threads cannot prevent muscle contraction, which is the root cause of expression-related wrinkles.
Which treatment has the higher total long-term cost: thread lifts or botulinum toxin?
When calculated over a 3-year period, cumulative botulinum toxin costs often exceed those of thread lifts because toxin requires 3 to 4 sessions per year versus approximately one thread lift session annually. However, thread lift sessions individually cost more upfront, so the comparison depends on the number of zones treated and the frequency each patient requires maintenance.
Which treatment requires less downtime — thread lifts or botulinum toxin?
Botulinum toxin injections involve virtually no downtime: patients can return to work immediately and the risk of visible bruising is low. Thread lifts typically involve 5 to 10 days of noticeable swelling or bruising and carry restrictions on facial movement, sleeping position, and certain activities during the first week, making toxin the clear winner in terms of social downtime.
What happens if I combine thread lifts with botulinum toxin without consulting a doctor?
Combining both treatments without proper medical supervision can lead to unaesthetic results or complications. Incorrectly applied botulinum toxin can cause eyelid ptosis or asymmetry, which can worsen if threads have also been poorly placed. It's always essential that a single physician plan the complete protocol, knowing exactly what has been applied in each area, to avoid unwanted interactions.