摘要

Objectives: Long-term success in facial thread lifting relies on applying biomechanical principles to efficiently distribute gravitational loads. Anatomical and mechanical planning with multiple fixation points ensures even load dispersion. Thread count closely correlates with satisfaction, with older patients often requiring more. Cog threads provide mechanical lift, while volume threads restore contour; their combination yields natural, lasting antigravity effects. Evidence-based design of placement, vectors, and count maximizes durability and outcomes. Introduction: Thread facial lifting, a minimally invasive option between non-invasive care and surgery, offers immediate lift and gradual biostimulation. Success depends on counteracting gravity via strategic thread placement and load redistribution. Adequate or increased thread numbers enhance gravitational resistance, support, and durability, with minimal downtime and repeatable benefits. Materials / method: This retrospective study was conducted at PangPang Clinic, Seoul, Korea, from January 2024 to June 2025. Only cog threads and volume threads were used, without adjunctive procedures. Placement was planned anatomically and biomechanically to resist gravitational pull. Patient satisfaction and the number of inserted threads were analyzed for correlation. Results: A total of 2,962 patients underwent thread lifting with 80,780 threads excluding mono (mean 27.3/session, range 10–59). Eighty-seven (2.9%) had secondary touch-up. In the dissatisfaction group (n=51), 43.1% had ≤18 threads initially vs 16.7% in the satisfaction group (n=36) (p<0.001), with similar mean age. Dissatisfied patients returned sooner (1.7 vs 4.8 months, p<0.05) and received fewer threads initially (23.7 vs 29.1) and at touch-up (7.3 vs 22.3, p<0.01). Thread need increased with age, and cog+volume threads outperformed cog alone in satisfaction. Conclusion: Optimal outcomes require not only technical skill and aesthetic insight but also the application of biomechanical principles, particularly gravitational force distribution. Using an adequate — and when necessary, increased — number of threads allows for more effective counteraction of gravitational pull, greater load dispersion, and improved result longevity. Combining lifting (cog) threads with volumizing threads remains key for achieving natural, youthful facial contour rejuvenation.