Fillers Versus Threads: Move What Dropped, Replace What’s Missing

What’s The Difference Between Fillers And Lifting Threads?

A youthful face isn’t just about fewer lines—it’s about putting structure back where it belongs. We dig into the real-world differences between dermal fillers and lifting threads, using a simple strategy that anyone can apply: replace what’s missing and move what dropped. With Dr. Stephen Blank guiding the conversation, you’ll learn how fillers restore volume to lips and cheeks, soften stubborn folds, and improve the way light hits the face, all while keeping results natural and balanced.

We also unpack how lifting threads address early laxity by elevating tissues along planned vectors—think mini lift without the scalpel. Dr. Blank explains comfort, downtime, and how threads gradually encourage collagen as they hold. You’ll hear the step-by-step planning process: seated assessments, mirror testing, precise facial markings, and side-by-side photography to confirm progress and avoid the overfilled look. We draw clear lines on candidacy too: when mild-to-moderate sagging responds beautifully to threads, when volume alone is the answer, and when an honest referral to a plastic surgeon will better meet your goals.

For many faces, the smartest path blends tools: a touch of filler to support the midface, threads to lift early jowls, and Botox to calm downward pull. Expect practical timing tips, realistic longevity (about a year for both), and how lifestyle and aging influence maintenance. If you’ve wondered whether to lift, fill, or combine, this conversation gives you the framework to decide with confidence. Enjoy the clarity, then share it with someone weighing their options. If this helped, subscribe, leave a review, and send us your questions for a future episode.

To learn more about Dr. Stephen Blank visit:
https://www.PSLdentist.com
Dr. Stephen Blank, DDS
184 NW Central Park Plaza
Port St. Lucie, FL, 34986
772-878-7348

Episode Transcript

SPEAKER_00 (00:03):
Welcome to the PSL Dentist Podcast, where healthy
smiles meet real talk.
Hosted by Port St.
Lucie's very own Dr.
Stephen Blank, the one dentistwho's been making the treasure
coast smile for decades.
From one visit crowns to clearaligners, Botox, and even
lifting threads, yep, yourdentist does that too.

(00:25):
So sit back, open wide, notliterally pleased.
And get ready to sink your teethinto today's episode.

SPEAKER_01 (00:34):
Two popular treatments, one youthful goal.
Discover how fillers and threadstake different paths to beauty.
Welcome everyone.
Frederick here, co-host andproducer back in the studio with
Dr.
Stephen Blank, your Port St.
Lucie dentist.
Dr.
Blank, how's it going today?

SPEAKER_02 (00:52):
Welcome back, Frederick.
Great to be with you.
It's a great day today here.

SPEAKER_01 (00:56):
Nice, nice.
Well, Dr.
Blank, uh, shall we kick thingsoff?
Um, can you tell us what is thedifference between fillers and
lifting threads?

SPEAKER_02 (01:06):
Very good question, Frederick.
A lot of patients have differentneeds, and they are two
different categories, butsometimes patients can benefit
from both treatments.
Fillers are different productsthat we use to actually increase
volume.
A common one that many peopleare familiar with is plumping up
the lips.
If a patient has a very flat lipand no shape or volume to it,

(01:29):
uh, volume can be added withdermal fillers.
It's a collagen-like materialthat takes up space and it's
biologically compatible and safeto use, and it gives volume and
more beauty to the face.
Um, when you can't tell thatit's been done, it's a great
treatment.
So sometimes we've seen patientsthat look like, yeah, they did

(01:51):
it and then they did it againand again.
We don't want that.
We want them looking natural andbeautiful.
Uh, we can also do areas uhwhere there are folds or creases
that just won't go away withBotox in other treatments.
So uh fillers can be used toplump those areas up or to add
volume on the cheekbones.

(02:12):
A lot of time patients will havethese areas drop.
Gravity kind of affects people.
So we can plump up these areas.
It also takes care of some ofthe wrinkling in this area.
When the skin is stretched alittle bit, it's like stretching
a drum.
It gets tighter.
So we don't we don't want themto look like a drum, but we want
them to look youthful.
And that's how a filler works.

(02:32):
It does a great job.
And it's done in one visit, um,or we do a follow-up sometimes,
but it's typically one visit,and the changes are immediate.
And then there's of course alittle bit of swelling and and
uh possible bruising.
But usually at the end of aweek, uh that's it.
There's no stitches, there's nosurgical recovery, uh, and

(02:53):
patients are very happy.
Lifting threads don't addvolume.
Lifting threads take loose skinthat has dropped and it pulls it
in the direction of the thread.
So often for uh patients thathave the sagging on the side or
dropping here, we pull them backand it makes them for a more
youthful appearance.
It's like a miniature facelift,but without doing the surgery

(03:16):
where everything gets pulledback.
This is for smaller areas or alittle bit of lifting if it's
hanging on the side, it goesupwards.
And the threads are just that.
It's a surgical thread thatallows us to go under the skin
and tug on the skin from theinside and pull it up.
And all we have is a littlecircle band-aid at the entry

(03:37):
site, snip it off, done.
Post op is minimal bruising, uh,very comfortable.
Uh we do tell patients don't dothat the day before our wedding,
just in case there is a bruise.
But uh on a typical treatment,um, patients are free to go do
whatever they want the next day.
Um, just leave the area alone,let it heal, just like any other

(04:00):
small procedure that would bedone.
The fillers work by taking upspace in the tissue layer, and
it adds volume to it.
So it actually stretches theskin from inside, and uh if we
and we do it typicallysymmetrically to make both sides
match.
Um they're injectables, so theycome out of a syringe, uh, often

(04:22):
with anesthesia built in.
So we numb the patient upsometimes to do the uh fillers
in advance, and then we use oursyringe of the filling material
to add the volume, and uh thatmakes it look beautiful.
The lifting threads uh arethey're a really interesting
product.

(04:42):
I don't know how they come upwith these, but they have little
barbs on them.
You can't really see them, butyou can feel them.
And so they slide in and weplace them under the tissue.
Kind of we always say it's likeputting a shower curtain on a
curtain rod where we slide it upand over, and we just we work it
with its way all the way downunder the tissue, and it goes
all the way through, but youcan't see it.

(05:04):
It's just under the skin.
And then when we tug on it, itpulls the skin upwards and it
holds it there.
And then we cut off the extra,and that is inside, and it
becomes fibrous tissue likecollagen later on, but they last
up to a year, holding the tissuein that lifted position.
Sometimes we'll do two or threeat different angles, depending

(05:25):
on what the patient needs.
We always check the patientsahead of time.
We have them in a sittingposition, and we practice.
We we look at see if we lifthere, if we lift there, do I
want to go horizontal, do I needto go vertical?
And then we literally draw thoselines on their face.
We clean the face, prepare itfor the procedure, and then we
mark on their face with araceable marker.

(05:46):
Um, and then we follow thoseguidelines.
So the patients and the doctorwork together to determine the
best course of care and uh howmany threads would be best.
And then we do the treatment.
We evaluate a few weeks later tosee did we get the results we
want, or would it be better ifwe added another thread?
So we can always start small andthen expand to meet the

(06:07):
patient's needs.

SPEAKER_01 (06:08):
So speaking of results, you know, what types of
results do patients usuallyexpect from each treatment and
how do the patient'sexpectations differ for each
treatment?

SPEAKER_02 (06:19):
Well, patients really love this.
They they're not sure about itbecause unless they've done this
before, there it's usually, wow,I didn't know you could do that.
And then when they find out whatcan be done and they say, I
don't need surgery, and I don'thave like a two-week recovery,
uh, it's like, oh, I could givethat a try.
So not every case is somethingthat we can do.
There are times where a plasticsurgeon and full-blown facelifts

(06:42):
are uh beneficial or or get moreof a result uh depending on the
patient's condition.
But for smaller cases, uh thisis a great start to reverse the
effects of gravity and aging,where things have dropped down,
skin becomes a little bitlooser.
Everybody has a different skintone, different facial um

(07:04):
consistency.
Some are very loose and falldown, and some people have very
firm skin and would never evenneed this.
So depending on the condition ofthe patient at the beginning, we
can customize the care to meettheir needs.

SPEAKER_01 (07:17):
Gotcha, gotcha.
Thanks for that.
And would you say um thatfillers are better for volume
while threads are better forlift, or would you disagree with
that?

SPEAKER_02 (07:27):
You got the lesson 100% grade A on today.
Uh that's exactly how it works.
So sometimes volume is what'sneeded, and other times there's
plenty of volume, but it's justin the wrong place.
So then the lifting is thebeneficiary.
And sometimes it's acombination.
We add to the cheeks a littlebit, and then we pull up from
the bottom.
And sometimes when patients havethe the jowls or the gum, the

(07:51):
cheeks are dropping, uh, we pullup here, but we also can add
Botox underneath so the musclesdown below don't pull the skin
on the side downwards.
So it's often a combination uhtherapy of what is needed and
then what are our tools that wecan use to accomplish that need.

SPEAKER_01 (08:10):
Mm-hmm.
And you did touch on thisearlier, but if you can just
reiterate, how long do theeffects of each typically last?

SPEAKER_02 (08:19):
Well, good.
Both of them I would expect totell a patient to expect a year.
Um, there may be times wherethey want additional care
sooner, or at the end of theyear they're plenty happy and
they let it go a while.
Um, it's not that the treatmentdoesn't last, it's the patient
continues to age.
So as we grow and we age, thingschange.

(08:42):
And sometimes they gain weight,they lose weight, uh, and things
happen.
So we look and evaluate overtime.
In my dental practice, wetypically see patients two times
a year, maybe three or four.
So when they come in for theirroutine hygiene preventive care,
we're able to look and assessthose needs, or the patients
tell me, hey, I think I'm readyfor one more thread on this

(09:04):
side, or uh, I think I need alittle bit more filler, and
that's how we make ourassessments.

SPEAKER_01 (09:09):
Gotcha, gotcha.
And so what factors help youdecide, you know, which option
is right for a patient?

SPEAKER_02 (09:17):
Well, we literally just do like I was showing with
the the facial marks, we do thepractice.
If I can push back a little waysand the area that we're we're
looking at is improved, then Ifeel confident I can do that
with a thread.
If I do that and I do a littlelift up and it's still just a
lot more skin than I can manage,then we start thinking it's time

(09:39):
to talk to a specialist that cando surgery.
So this is a non-surgicalsolution we're looking for.
So each patient has to bemeasured on their merits, on
what their current condition is,and then we can compare can we
achieve those results?
And it's also clinicalexperience.
After doing enough cases, I havea very good feeling of yes, I

(10:02):
can help you, or this might getyou some results, but not
everything you want.
And and then patients tell me,well, I don't want surgery.
If this can make me better, I'llbe happy.
Or they may say, Well, allright, I'll skip this step,
we'll go straight to the plasticsurgeon.
But uh, everybody's differentthat way.
It depends what they bring tothe table at the beginning.

SPEAKER_01 (10:23):
Yeah, gotcha.
And you know, the previousquestion I asked you was about
like choosing either or, but dopatients ever combine fillers
and threads for enhancedresults?

SPEAKER_02 (10:33):
Oh, all the time.
We do that uh often.
Sometimes it'll be in the samevisit, and sometimes we'll do
one step, like we might do Botoxand then wait two or three
weeks, and then we may do thelifting threads and the filler
on the same day.
It just depends, again, on thatpatient's needs.
So uh, and that's a planneddecision that we do at the

(10:55):
beginning, that we'll start youknow with this with baby steps,
and then we'll take it to thenext phase and then the next
step.
We also start with a full seriesof photographs uh of the
patient's face up close fromdifferent angles, and then we
can do a comparison.
So when we sit down at there-evaluation point a couple
weeks out, uh we can put thepictures up side by side to see,

(11:17):
all right, this is where wewere, this is where we are, and
are we happy now?
And then we can decide a littletweak here or we're happy.

SPEAKER_01 (11:26):
Wow.
Well, thank you so much for theclear and thorough answers, and
thank you for breaking down thedifferences between fillers and
lifting threads.
For everyone else tuning in,thank you for joining the
journey, and we'll see you allnext time.

SPEAKER_02 (11:39):
Thank you, Frederick.
Have a wonderful day.

SPEAKER_00 (11:45):
That's a wrap for the PSL Dentist Podcast, where
smiles are brighter and laughteralways cavity-free.
To keep your smile in shape,call 772-878-7348 or visit
psldentist.com to schedule yourappointment with Dr.
Stephen Blank, the one-stop docfor smiles, beauty, and

(12:09):
everything in between.
Until next time, keep flossing,keep smiling, and keep
listening.