I will never have a jawline sculpted from steel, that I accept. But I cannot accept a slack turkey throat either. Unfortunately, that is what is transpiring south of my chin, much to my chagrin.

However, there is a remedy – it only demands a measure of nerve and loads of confidence in the skills of an expert cosmetic doctor.

Yep, I know: Almost three years ago I said on this very same blog that a thread lift is a procedure I would never consider. But then I didn’t need it and the procedure was still in its infancy. Well, that is my story and I am sticking to it.

Wrinkles and problem skin were never an issue for me – my issue is sagging, loss of volume and structure. So, the structure is what the Silhouette Soft Technique offers. When I was invited to experience the procedure in order to pull up and tighten the loose skin under my chin with the help of resorbable Poli-Lactic Acid (PLA) sutures with L-Lactic Acid suspension cones, administered by Dr Gerhard van Niekerk, it didn’t take very long to convince myself that it was worth a try. Dr Van Niekerk is the head trainer for Silhouette Soft in South Africa and internationally.

In all honesty, I have always been apprehensive and sceptical about this procedure, because I am wary of invasive treatments and I felt that this technique crossed the line into cosmetic surgery territory. I was tempted, a few times beforehand, to cancel my appointment and run away. But, vanity is a relentless mistress…

The technology: What is it

PLA is the main component of Silhouette Soft. It is a polymer that has long been in use in the medical field and particularly for surgery. It is fully absorbable and biocompatible with human tissue. When the sutures are implanted in the subcutaneous tissue, it activates fibroblasts, which stimulates collagen production. This helps to add volume and restores the shape and contours of the face in a natural way. Over a period of two years, the sutures and cones are fully absorbed, but the benefit of newly produced collagen will be long-lasting.

Each suture has two series of bi-directional cones. They come in three lengths, with 8, 12, or 16 cones respectively – the placement position of the threads determines which length should be used. The threads look like micro-thin fishing line and the minuscule cones hook into and embed itself in the fatty layer of the skin.

The result is an immediate, noticeable lifting action and with time, skin regeneration thanks to collagen production.

The procedure

The procedure is aimed at lifting the skin and adding volume where needed. The threads are inserted in the subcutaneous skin layer below the dermis while the patient is under local anaesthetic. Injections at the entry and exit points of the sutures ensure a painless procedure. It takes less than an hour to perform the procedure. The benefit is an immediate facelift-like result, without the knife, operating theatre and anaesthesia – at a fraction of the cost and with no downtime.

Ideal for:

  • Sagging cheeks
  • Loss of volume midface
  • Sagging jawline and jowls
  • Sagging neck
  • Sagging eyebrows

My experience

Dr Van Niekerk examined my face thoroughly before deciding on three threads: One just above the jawline and two more like a hammock under my chin, anchored behind my ears. He marked out the exact positioning of the threads, very much like one would trace a pattern on the cloth before making a dress.

Top: The lines are drawn Bottom: The threads have been inserted and placed into position

While he discussed exactly what he was going to do, I learned something new: That enviable Angelina Jolie-like chiselled, sculpted Hollywood jaw and neckline depends on a 90-degree angle which is anatomically formed by the root of the tongue, oesophagus and vocal cords. It is a matter of genetics and it is known as the mento-cervical angle. Some people, like Marilyn Monroe and Renee Zelwegger, have an angle of 45 degrees and that is why one would seldom see a picture in full profile pose of them because it is less flattering. There is no way someone with a 45-degree chin/neck mento-cervical ratio can ever achieve a 90-degree look with either thread lifts or a surgical neck lift – it can damage the vocal cords and make swallowing difficult. Clearly, I am a 45-degree girl, and I will never have a neck and jawline like Audrey Hepburn.

The anaesthetic injections were the only painful part of the procedure, but thanks to my high pain threshold, I would rate it a 2 on a scale of 2-5.

I avoided watching what was happening – I am way too squeamish. I was covered in sterile cloth anyway. An absolutely sterile environment is key to avoid any bacterial contamination. My hair was tied away in a theatre cap and my skin was repeatedly swabbed with sterilizer.

Top: Before the procedure. Bottom: After the procedure. Note how the nasolabial lines and marionette lines appear visibly more shallow.

I didn’t feel the threads entering the central entry point and being pulled across to the exit points, at all. But I could hear it! It was like a soft tearing sound, much like ripping a piece of fabric. Admittedly, I do have a very active imagination. Dr Gerhard did tell me beforehand that it was going to happen, so it wasn’t unexpected. For the rest, there was no drama, bar the movie that played inside my head, and I started to tremble a bit with anxiety. Fortunately, the doctor’s calm and controlled demeanour helped me to settle down. But I would take some Rescue Remedy beforehand should I ever repeat the experience!

Doctor in action: The procedure.

Dr Gerhard inserted the threads first into the left side of my neck and jaw. The three threads were implanted in a flash and gently pulled sideways and upwards to slightly lift the skin. I then sat upright to compare the two sides of my face. The difference was obvious, yet subtle: The nasolabial lines from my nose to my mouth appeared shallower, as did the marionette lines below my mouth corners.

Right side done.

After the right side of my face was done and the doctor was satisfied that he achieved the desired effect, the ends of the threads were snipped off and the entry points were sterilized again. The little holes close up within 24 hours and only needed some Bactroban antibiotic ointment for the first few days.

I left with some ice packs and aftercare instructions.

Unfortunately, I am prone to hectic bruising, so by the next day, it looked like I had an encounter with the Boston Strangler. Two days later the swelling and bruising at my throat were still very noticeable.

Before and After. Compare the saggy tissue under my chin (left) with the firmer angle afterwards (right). The sutures are still sticking out so that the doctor can determine if he needs to pull them tighter before snipping off the ends.


  • Apply antibiotic cream at the entry and exit points for 5 days
  • Apply ice to the treated areas immediately afterwards for 5-10 minutes, and regularly for the next 2-3 days
  • Sleep on your back and elevate your head for the first three nights
  • Clean your face gently and don’t rub or massage your skin (5 days)
  • Apply makeup very gently (5 days)
  • No sun exposure or tanning beds (2 weeks)
  • No facials or massages (3 weeks)
  • Avoid strenuous exercise and contact sports (3 weeks)
  • Avoid saunas and heat treatments (3 weeks)
  • No dental surgery (3 weeks)
  • Avoid exaggerated facial movements like chewing, talking, yawning (3 weeks)

The Silhouette Soft treatment can be successfully combined with other aesthetic procedures, but one has to check with the doctor exactly how long before or after the procedure various treatments (such as botox, fillers, laser etc) may be done. I am scheduled for some BTL radiofrequency sessions in October and according to Dr Van Niekerk, it will definitely complement and enhance the Silhouette Soft treatment results.

How do I feel and look now?

It is a good thing that I cleared my diary before the procedure because 48 hours later I really looked like I’ve been through the wringer, literally. The left side of my neck was very bruised and swollen and I became best friends with my scarves collection. However, looking at my face straight on, a much cleaner and firmer jawline are clearly visible and the side profile angle from chin to neck definitely sharper. I am very curious to compare the final results with the before photographs in a few weeks’ time.

Day 5: The bruising and swelling, especially on my left side, is very noticeable.


Day 6: The swelling is subsiding and the bruising has improved. My jawline looks visibly firmer.


One month later: There is still some swelling (very little) as well as bruising, plus slackness around the jowls, but the line from chin to neck is noticeably firmer and the saggy, baggy throat is clearly reduced.

Are you interested?

Aesthetic physicians countrywide are currently being trained in the procedure, and quite a number are already certified to perform the procedure. Training is rigorous and not every doctor passes the tests, says Dr Van Niekerk.

Do your homework and have a proper consultation with a certified doctor beforehand. Ask to see pictures of his or her work – you definitely do not want to be a guinea pig.


That depends on the number of threads needed and the areas of the face where it will be placed. Prices can vary from R12 000-R20 000.

More information:

Karen 082 775 7442









  1. Hi Helena. Thanks for noticing my absence! The past two years have been crazy, hectic, and traumatic. TWO house moves in less than two years (from Johannesburg to Mossel Bay), downsizing, stupid falls and breaking bones, Covid, loss of my beloved dog… etc
    So I almost crawled into a dark hole, spiraling down into a very deep depression. I will share more of this in an upcoming post because I don’t think I am the only one who went through a period of loss, isolation, and detachment from the things that gave them joy and made sense of life.
    Your comment comes almost as a sign that my decision (yesterday!) to renew my passion for Mooipraatjies, graceful and joyful ageing, and writing creatively about it on my blog, is the right one. Thank you!
    To answer your question about threads: Since I had my experience, the technology and research around this procedure have skyrocketed and become much better and more effective. I am still satisfied with my neck and jawline, but I have to add that I am also hooked on face yoga and pressure points massage, and I am convinced they helped my results to last so well. Have a look at Pinterest, Instagram, and YouTube for more information about these exercises and treatments.

  2. Hi Elsa, its been about two years since you last posted. Read your story and I am interested in getting threads but I would like to know from you the following
    How long did it last for you?
    Did you experience anything out of the norm as time went by?
    Were you happy with the results after 2 years?

  3. I had a critical look at my neck and jawline recently. My jawline is still firm, but I notice that some crepiness from excess skin is settling on my neck. Was wondering if it might be time for a refreshing tweak!

  4. Hi Nicole. I had a good look at my neck and jawline last week and have to say, I was wondering what it would have looked like had I not done the procedure. The lifting and tightening effect is still noticeable. Just please choose a well trained and experienced aesthetic practitioner or specialist.

  5. Hi Elsa, your results were great. Im looking into get thread lifting done, and stumbled upon your experience. I would be very interested in knowing how long your results lasted?

  6. I’ve just had the same done 36 hours ago and I’m quite shocked at your bruising, mine is a fraction of that.

  7. It is hard to say, because one becomes so used to your own face! But I would say it definitely made a difference, especially at my neck and jawline.

  8. You will need your doctor’s advice. Normally one has to stop taking aspirin or similar blood thinners at least 7 days before any invasive procedure. Please ask the doctor about it.

  9. The results improve with time. After about 3 months one can really notice the difference. Unfortunately, it is not forever. The procedure may have to be repeated after 2 years.

  10. I recently heard about this procedure and I am very interested. How long does the procedure last once it has been done?

  11. I’ll get onto it – I am also curious to make a comparison! My personal observation is that my neck and jawline still are noticeably firmer, but photographs will probably show if it is the case.

  12. Please do a one year update with comparison photos from all angles. I am hesitant as to whether this procedure is worth the cost.

  13. thank you so much for publishing this. I am looking into this treatment and your results do look great

  14. Ouch, that sounds really disastrous, Barbara. Sorry to hear about that. Did you have a chance to check out this doctor’s work beforehand?
    I am glad to say that my experience and results were much better, but then I must point out that I was in very good hands with reputable doctors.

  15. I had a barbed thread lift done by Urban Beauty in Phuket.
    Local anesthetic. Very painful procedure.
    Had bad bruising ( 2 completely black eyes and neck.
    One side of face lifted higher than the others. The other side has deep wrinkles across cheek.
    After nearly 3 weeks swelling, bruising and mushaped face still present.
    Will now have to find an AU surgeon to rectify this disaster.

  16. Hi there!
    You look wonderful. Thank you so much for sharing. How is your face today? And negative reactions? Would you do it all over again? I am scheduled to have nova threads for a butt lift, 50 in each cheek. I have read so many negative stories. I am so nervous and scared. But it’s for a tv segment and it’s free, it’s the only reason why I might do it. Still undecided. Any insight you can give me from your experience would be helpful. Thank you!!!

  17. Dok ek stel belang in n vol PDO.threadlift asb.Ek werk my alie af om geld op te spaar vir die prosedure. My gesig het n “totale Uplift ” nodig…en dis kritiek.

  18. You look GREAT. Good for you that you were so brave to go through with this! I have an appointment tomorrow in Switzerland for a consultation, but I am super nervous. I keep thinking what will happen if the sides are not equal?! lol … I would love to not have a saggy jowl. Enjoy your lovely face 🙂

  19. Nice!
    Very Impressed with LYFT. My skin definitely feels an improvement in texture, and its tone appears much brighter. Even some sagging areas feel tighter! Great product, thank you!

    Ben V. Kellfris

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