PDO Thread Under Chin: Address Laxity and Improve Definition

The submental area, the zone under the chin that blends into the upper neck, changes earlier and more dramatically than many people expect. A little laxity, soft tissue migration toward the midline, and a modest pocket of fullness can blur the jawline and shorten the distance between chin and neck. Makeup tricks help only so much. When patients do not want surgery, a PDO thread under the chin can be a smart, targeted option that tightens, refines, and buys time before a facelift or neck lift is warranted.

I have placed thousands of PDO threads in the face and neck over the last decade, and the under-chin region remains one of the most satisfying, provided you match the technique to the tissue. Threads do not melt fat, and they do not replace the results of excising skin. What they do well is suspend and compact mild to moderate laxity, stimulate collagen, and sharpen the front edge of the jaw and cervicomental angle as part of a broader plan.

What a PDO thread is, and what it is not

PDO stands for polydioxanone, a medical-grade, absorbable suture material used for decades in surgery. In aesthetic medicine, PDO threads are preloaded into fine cannulas or needles and introduced into the subdermal plane. There are two broad families. Smooth or mono threads behave like scaffolding, encouraging collagen stimulation and subtle skin firming. Barbed or cog threads have tiny directional hooks that anchor into the soft tissue and provide immediate mechanical lift. Under the chin, we often mix the two: cogs to reposition and compact, monos to improve skin quality and help the result last.

A PDO thread lift is not liposuction, not energy-based fat reduction, and not a substitute for a well-executed lower facelift. PDO threads for face and neck sit in the middle of the spectrum: more structural than injectables or skincare, less invasive than surgery. The best outcomes appear in patients with fair to moderate laxity, reasonably elastic skin, and either minimal or well-managed submental fat.

Anatomy and why the under-chin region is tricky

The submental region is bounded by the mandible, the anterior neck, and the midline where the platysma bands meet. Skin here is thinner than along the jawline, and the area moves with speaking, chewing, and head rotation. Beneath the skin lie the platysma, the submental fat pad that varies person to person, and the anterior digastric and mylohyoid complex deeper still. Thread placement must respect the marginal mandibular nerve near the lower border of the jaw and avoid too superficial a track that can produce dimpling or visibility, especially in lean patients.

Two patterns dominate. In one, the problem is ribbon-like laxity of the skin and platysma that creates a soft fold or shadow under the chin. In the other, the central pocket of fat weighs down the area. Threads excel in the first pattern and can help in the second only when fat is mild and the plan includes fat management, often with deoxycholic acid or micro-liposuction before or alongside the PDO thread lifting treatment.

Who benefits most from a PDO thread under the chin

Candidacy rests on tissue quality and goals more than on age. I see excellent outcomes in patients between their late 30s and early 60s with:

Mild to moderate skin laxity under the chin, with or without early jowling Good skin elasticity and reasonable thickness, not paper-thin or heavily sun-damaged Minimal to moderate submental fat, ideally already optimized A desire for better definition along the front of the jaw and the cervicomental angle, without surgical downtime

Those with heavy platysmal banding, pronounced crepe-like thinning, or significant skin redundancy usually need a surgical approach or a staged plan that starts with skin quality and fat reduction, then uses threads as a finishing step. Threads can still play a role in aging skin, but expectations must be tuned to skin biology. Patients who clench, grind, or have strong depressor activity sometimes need neuromodulator support to reduce muscular downward pull that can shorten the life of a lift.

How PDO threads change the under-chin contour

There are two effects. First, the mechanical lift: barbed threads engage the subdermal fibrous septae and platysma fascia, then vector toward an anchor point to advance or compact the soft tissue. Under the chin, common vectors run from just lateral to the marionette area or preauricular region toward the midline submental space, then back toward the mandibular border. The lift is modest, but visible. Second, the biological effect: PDO threads for skin tightening trigger a controlled wound-healing response, laying down new collagen and elastin around the thread track over weeks. As the thread hydrolyzes over 6 to 9 months, the new collagen persists, so results often peak around 3 months and hold for 12 to 18 months, sometimes longer with good skin care and muscle balance.

Think of it as a tent-pole effect, then a reknitting of the fabric. In photographs, the best PDO threads results show crisper shadowing under the jaw, a longer-appearing chin-to-neck distance, and fewer accordion-like folds when the head turns.

The consultation that sets you up for success

A good PDO thread consultation is part measurement and part storytelling. I ask what the patient sees in a mirror versus in photos and videos. People often notice laxity most in candid profile shots. I take standardized pouted and relaxed photos from the side and three-quarter angles, then palpate the submental area to judge skin thickness, fat, and platysma tone. If I can pinch and roll a thin, mobile layer without bulky fat, PDO threads for sagging skin usually perform well. If the central pad is stubborn, I propose a staged plan with lipolysis. I also check for dental occlusion issues and masseter hyperactivity that can worsen lower-face heaviness.

We discuss options: a pure PDO thread lift, PDO threads for skin rejuvenation plus neuromodulator to soften platysma pull, or a combination with energy devices. We calibrate expectations: a non surgical facelift effect, not a surgical one. And we talk budget and maintenance. In most U.S. markets, PDO threads treatment cost for the under-chin and jawline ranges roughly from 900 to 2,500 dollars, depending on the number and type of threads, the operator’s experience, and whether other areas are included. Packages that blend jawline, cheeks, and neck can run 2,500 to 4,500 dollars. Geography matters as much as technique.

Preparing for the procedure

Patients do better when they arrive prepared. I ask them to pause high-dose fish oil, vitamin E, ginkgo, and other blood-thinning supplements for a week if medically safe, and to avoid alcohol the evening prior. Those prone to cold sores under the chin or near the lips receive prophylactic antivirals. Good hydration and a simple, fragrance-free skincare routine the night before reduces irritation. If we plan deoxycholic acid to reduce submental fat, I schedule it at least three weeks before the PDO thread lifting procedure so swelling subsides.

What the day looks like

After consent and pre-procedure photos, we map vectors with the patient upright. Under the chin, I usually plan two to four cog threads per side, sometimes more in heavier tissue, and a lattice of 6 to 12 mono or smooth threads to reinforce the skin envelope. The skin is cleansed thoroughly. I infiltrate small blebs of lidocaine with epinephrine at entry and exit points, and a whisper of tumescent fluid along the planned track for comfort and hemostasis. Patients feel pressure and tugging, not sharp pain.

Using a blunt cannula for most passes reduces bruising. The cannula slides into the subdermal plane, and with steady hands you can feel the correct glide between skin and muscle. Once the barbed thread is in place, I seat it gently with counter-traction, then trim the ends flush with the skin. You see an immediate but subtle lift. The monos thread in quickly. We repeat for symmetry, then check the result with the patient upright to ensure balanced definition. From start to finish, a focused under-chin PDO thread therapy session takes 30 to 60 minutes.

Aftercare and recovery time

Recovery is usually quick. Expect swelling for 24 to 72 hours and some mild bruising, more so in patients who bruise easily or are on aspirin. You may feel tightness or a pulling sensation when you turn your head or smile widely. This softens over ten to fourteen days as tissues settle. I advise sleeping on the back with the head slightly elevated for two to three nights, avoiding heavy exercise and exaggerated neck movements for a week, and skipping dental cleanings or wide mouth opening for ten days if we treated close to the commissures or marionette lines. Keep skincare simple. No facials, saunas, or masks for one week.

Most people return to work the next day. Makeup can cover small entry points within 24 hours if the skin is intact. Tenderness to the touch fades gradually. Threads are typically not visible, but in very thin skin, a subtle line or small puckering can appear at first and smooths over two to three weeks. If we paired PDO threads for face tightening with neuromodulator in the platysma, the muscle softening begins at day three and helps offload the downward pull.

What results look like and how long they last

PDO threads before and after images under the chin show their worth. Immediate change tends to be 20 to 40 percent of the final outcome. The true gains show up around week three to six as collagen consolidates. When the plan includes both lift and skin support, definition continues to improve for a couple of months. Longevity varies with biology and behavior. For most, results hold nicely for 12 to 18 months. In smokers or in very thin, sun-damaged skin, the curve is shorter. A light maintenance session with mono threads at 9 to 12 months can extend the life of the lift by firming the envelope that supports the cogs.

A patient example helps illustrate the arc. A 44-year-old with mild laxity and minimal submental fat wanted better jawline definition without downtime. We placed four 19G barbed threads per side, anchored near the preauricular fascia and vectored under the chin to the midline, then added ten 29G mono threads across the submental skin. At two weeks, her cervicomental angle sharpened visibly, with a crisper border where the jaw meets the neck. At three months, skin texture improved and the shadow under the jaw looked cleaner in three-quarter photos. She maintained with two small mono-thread sessions at 10 and 20 months.

Risks, side effects, and how we minimize them

PDO threads are a safe treatment when done by trained hands, but every medical aesthetic procedure carries risk. Common, expected effects include swelling, bruising, soreness, transient puckering, and sensation of tightness. Less common but known side effects are thread visibility in thin skin, asymmetry that settles as swelling resolves, and palpable knots where ends were trimmed. Rare events include infection, thread extrusion, salivary gland irritation near the jaw angle, or injury to small subdermal vessels that create a persistent hematoma.

Technique matters. Staying in the right plane reduces dimpling. Gentle, precise vectoring minimizes trauma and improves even lift. Strict aseptic prep reduces infection risk. I give patients a clear contact path after their PDO thread appointment and prefer a scheduled check at 10 to 14 days to address minor puckering or adjust massage guidance. If a thread sits too superficially or causes an unwanted tether, it can often be released with a fine needle. Antibiotics are rarely needed, but I start them promptly if there is warmth, increasing pain, or drainage.

How PDO threads fit with other treatments for the under-chin area

PDO threads for double chin are most effective after fat is addressed. If the submental pad holds a modest bulge, we can use deoxycholic acid in one or two sessions a few weeks apart. For more volume or for those who want one-and-done debulking, micro-liposuction under local anesthesia gives crisp contours that threads can then support. Energy-based devices, such as radiofrequency microneedling or ultrasound-based tightening, improve dermal thickness and complement PDO thread collagen stimulation. Repeated small neuromodulator doses in the platysma can quiet the pull that fights the lift. Skincare is the foundation. Retinoids, vitamin C, and diligent sunscreen slow the degradation of newly built collagen.

When patients ask if a PDO thread facelift replaces a surgical lift, I explain that PDO threads are a non surgical skin lift that repositions tissue within the constraints of the skin envelope. Surgery removes and redrapes, threads reorganize and support. Many of my surgical patients still use threads strategically in the years after a neck lift to maintain finesse in areas that want to soften first, especially under the chin where gravity and posture constantly work against definition.

Technique nuances specific to the submental region

Under the chin, two technical steps matter more than most people realize. The first is vector choice. I favor a Y pattern that converges in the submental midline, then tracks laterally to secure fascia near the mandibular border and preauricular area. This compacts central laxity while defining the jaw. The second is layer discipline. Staying in a consistent subdermal plane creates a smooth, broad grip rather than a superficial line that can dimple. In thicker tissue, a slightly deeper track captures the platysma fascia more effectively.

Monos do the quiet work. Lacing them in a crisscross or parallel array under the chin builds a dermal mattress. They are small, inexpensive, and forgiving. In younger patients with early laxity and excellent skin, a session of monos alone every 9 affordable pdo threads Florida to 12 months can delay the need for barbed threads at all. In older skin, they serve as rebar around which barbs can hold better.

Cost, value, and when to wait

Patients often ask about PDO threads treatment cost first. Value matters as much as price. A low-cost session that uses too few threads or places them poorly will not hold and can sour people on the technique. A well-planned PDO thread cosmetic procedure under the chin, executed with the right mix of cogs and monos, typically uses 6 to 12 total threads. This supports both the immediate lift and the long game of collagen boost. In many practices, that translates into a cost in the low thousands for the submental and jawline unit. If extensive work is needed across cheeks, marionette lines, and neck, the cost rises accordingly.

When should you wait? If you just had dental surgery, if you have an active skin infection, uncontrolled autoimmune disease flares affecting healing, or if you are pregnant or breastfeeding, reschedule the PDO thread appointment. If you are in the middle of meaningful weight loss, hold off. The face and neck will change, and better to set vectors after your weight is stable for a few months.

Before and after photos, and how to read them critically

PDO threads before and after pictures can be convincing, but lighting and posture trick the eye. Look at the position of the chin to chest, the tilt of the head, and the shadow under the jaw. Slight extension or brighter chin lighting can fake definition. In good comparisons, the tragus, angle of the jaw, and corner of the mouth line up similarly, and the camera height stays constant. The hallmark signs pdo threads near Orlando, FL of authentic improvement are a sharper break between the underside of the jaw and the neck and a more continuous jawline without midline sag or peppling.

Realistic expectations and common myths

A few myths persist. Threads do not make you look puffy long term. Swelling is transient. Threads do not dissolve overnight; they hydrolyze gradually over months while leaving a collagen footprint. Threads do not always need to be repeated wholesale every year. Sometimes a touch-up with fewer threads sustains the result. And while PDO threads for wrinkles help in certain lines that are the surface expression of laxity, etched static lines from decades of sun or sleep posture may still need resurfacing or filler support.

The realistic expectation under the chin is a 20 to 40 percent improvement in contour, a crisper cervicomental angle, and fewer small folds. People notice in candid photos and on video calls. Friends may not know what changed, just that your jaw looks cleaner.

A simple decision framework

If you have mild laxity and little fat, PDO threads for skin firming under the chin can be your primary treatment. If you have modest fat and mild laxity, plan fat reduction first, then threads. If you have significant laxity or heavy platysmal bands, consider surgery or a staged plan that starts with skin quality, then uses threads selectively. If you want the longest life from a thread lift, add neuromodulator for strong platysma and keep skincare and sun behavior consistent. If your timeline is short, threads provide a visible improvement with minimal downtime, but schedule at least three weeks before events for best settling.

What to ask during your PDO thread appointment

A thoughtful conversation prevents disappointment. Ask your provider which thread types they use and why those choices fit your anatomy. Ask how many cogs and mono threads they plan for the submental region, and where the anchor points will be. Discuss any history of keloids, bleeding tendencies, and dental or jaw issues that affect mouth opening. Ask to see representative PDO threads for face and neck cases in your age range and skin type. Clarify aftercare, how to reach the clinic if something feels off, and what the plan is for maintenance. A clear plan is part of the treatment.

The role of threads in a long-term aging strategy

Aging is a slow negotiation between gravity, tissue quality, and muscle pull. PDO threads for facial lifting are one of several tools. For many patients in their 40s and 50s, they can postpone surgery by several years while maintaining a defined lower face. For others, they serve as polish after fat reduction or as an interlude between energy-based tightening sessions. Threads do not lock you into a path. They can be repeated, paused, or paired with other treatments as your face changes.

In my practice, a typical long-term plan might include one substantive PDO thread facial treatment focused on the under-chin and jawline every 18 months, with a smaller skin support session using mono threads at the 9 to 12 month mark. Neuromodulator in the platysma two or three times a year, light energy-based tightening annually, and steadfast skincare round out the program. The goal is not to chase every millimeter, but to keep structure and definition in balance.

Final thoughts for those considering a PDO thread under the chin

If the mirror shows a soft buckle under the chin that makeup cannot hide, and you want definition without surgical downtime, a PDO thread tightening treatment can be a measured, effective move. Choose an experienced injector who works the submental region often, be candid about your goals, and be open to pairing threads with fat management or skin quality work if the anatomy calls for it. Done thoughtfully, PDO threads cosmetic treatment under the chin can restore a clean edge to your jaw and extend the runway before more invasive options are necessary.

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Pub: 15 Feb 2026 07:42 UTC

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