The PSL Dentist Podcast

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

• Dr. Stephen Blank • Episode 4

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0:00 | 12:20

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

SPEAKER_00:

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 dentist who's been making the treasure coast smile for decades. From one visit crowns to clear aligners, Botox, and even lifting threads, yep, your dentist does that too. So sit back, open wide, not literally pleased. And get ready to sink your teeth into today's episode.

SPEAKER_01:

Two popular treatments, one youthful goal. Discover how fillers and threads take different paths to beauty. Welcome everyone. Frederick here, co-host and producer back in the studio with Dr. Stephen Blank, your Port St. Lucie dentist. Dr. Blank, how's it going today?

SPEAKER_02:

Welcome back, Frederick. Great to be with you. It's a great day today here.

SPEAKER_01:

Nice, nice. Well, Dr. Blank, uh, shall we kick things off? Um, can you tell us what is the difference between fillers and lifting threads?

SPEAKER_02:

Very good question, Frederick. A lot of patients have different needs, and they are two different categories, but sometimes patients can benefit from both treatments. Fillers are different products that we use to actually increase volume. A common one that many people are familiar with is plumping up the lips. If a patient has a very flat lip and no shape or volume to it, uh, volume can be added with dermal fillers. It's a collagen-like material that takes up space and it's biologically compatible and safe to use, and it gives volume and more beauty to the face. Um, when you can't tell that it's been done, it's a great treatment. So sometimes we've seen patients that look like, yeah, they did it and then they did it again and again. We don't want that. We want them looking natural and beautiful. Uh, we can also do areas uh where there are folds or creases that just won't go away with Botox in other treatments. So uh fillers can be used to plump those areas up or to add volume on the cheekbones. A lot of time patients will have these areas drop. Gravity kind of affects people. So we can plump up these areas. It also takes care of some of the wrinkling in this area. When the skin is stretched a little bit, it's like stretching a drum. It gets tighter. So we don't we don't want them to look like a drum, but we want them to look youthful. And that's how a filler works. 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 a little bit of swelling and and uh possible bruising. But usually at the end of a week, uh that's it. There's no stitches, there's no surgical recovery, uh, and patients are very happy. Lifting threads don't add volume. Lifting threads take loose skin that has dropped and it pulls it in the direction of the thread. So often for uh patients that have the sagging on the side or dropping here, we pull them back and it makes them for a more youthful appearance. It's like a miniature facelift, but without doing the surgery where everything gets pulled back. This is for smaller areas or a little bit of lifting if it's hanging on the side, it goes upwards. And the threads are just that. It's a surgical thread that allows us to go under the skin and tug on the skin from the inside and pull it up. And all we have is a little circle band-aid at the entry site, snip it off, done. Post op is minimal bruising, uh, very comfortable. Uh we do tell patients don't do that 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 small procedure that would be done. The fillers work by taking up space in the tissue layer, and it adds volume to it. So it actually stretches the skin from inside, and uh if we and we do it typically symmetrically to make both sides match. Um they're injectables, so they come out of a syringe, uh, often with anesthesia built in. So we numb the patient up sometimes to do the uh fillers in advance, and then we use our syringe of the filling material to add the volume, and uh that makes it look beautiful. The lifting threads uh are they're a really interesting product. I don't know how they come up with these, but they have little barbs on them. You can't really see them, but you can feel them. And so they slide in and we place them under the tissue. Kind of we always say it's like putting a shower curtain on a curtain rod where we slide it up and over, and we just we work it with its way all the way down under the tissue, and it goes all the way through, but you can't see it. It's just under the skin. And then when we tug on it, it pulls the skin upwards and it holds it there. And then we cut off the extra, and that is inside, and it becomes fibrous tissue like collagen later on, but they last up to a year, holding the tissue in that lifted position. Sometimes we'll do two or three at different angles, depending on what the patient needs. We always check the patients ahead of time. We have them in a sitting position, and we practice. We we look at see if we lift here, if we lift there, do I want to go horizontal, do I need to go vertical? And then we literally draw those lines on their face. We clean the face, prepare it for the procedure, and then we mark on their face with a raceable marker. Um, and then we follow those guidelines. So the patients and the doctor work together to determine the best course of care and uh how many threads would be best. And then we do the treatment. We evaluate a few weeks later to see did we get the results we want, or would it be better if we added another thread? So we can always start small and then expand to meet the patient's needs.

SPEAKER_01:

So speaking of results, you know, what types of results do patients usually expect from each treatment and how do the patient's expectations differ for each treatment?

SPEAKER_02:

Well, patients really love this. They they're not sure about it because 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 what can be done and they say, I don't need surgery, and I don't have like a two-week recovery, uh, it's like, oh, I could give that a try. So not every case is something that we can do. There are times where a plastic surgeon and full-blown facelifts are uh beneficial or or get more of a result uh depending on the patient's condition. But for smaller cases, uh this is a great start to reverse the effects of gravity and aging, where things have dropped down, skin becomes a little bit looser. Everybody has a different skin tone, different facial um consistency. Some are very loose and fall down, and some people have very firm skin and would never even need this. So depending on the condition of the patient at the beginning, we can customize the care to meet their needs.

SPEAKER_01:

Gotcha, gotcha. Thanks for that. And would you say um that fillers are better for volume while threads are better for lift, or would you disagree with that?

SPEAKER_02:

You got the lesson 100% grade A on today. Uh that's exactly how it works. So sometimes volume is what's needed, and other times there's plenty of volume, but it's just in the wrong place. So then the lifting is the beneficiary. And sometimes it's a combination. We add to the cheeks a little bit, and then we pull up from the bottom. And sometimes when patients have the the jowls or the gum, the cheeks are dropping, uh, we pull up here, but we also can add Botox underneath so the muscles down below don't pull the skin on the side downwards. So it's often a combination uh therapy of what is needed and then what are our tools that we can use to accomplish that need.

SPEAKER_01:

Mm-hmm. And you did touch on this earlier, but if you can just reiterate, how long do the effects of each typically last?

SPEAKER_02:

Well, good. Both of them I would expect to tell a patient to expect a year. Um, there may be times where they want additional care sooner, or at the end of the year they're plenty happy and they let it go a while. Um, it's not that the treatment doesn't last, it's the patient continues to age. So as we grow and we age, things change. And sometimes they gain weight, they lose weight, uh, and things happen. So we look and evaluate over time. In my dental practice, we typically see patients two times a year, maybe three or four. So when they come in for their routine hygiene preventive care, we're able to look and assess those needs, or the patients tell me, hey, I think I'm ready for one more thread on this side, or uh, I think I need a little bit more filler, and that's how we make our assessments.

SPEAKER_01:

Gotcha, gotcha. And so what factors help you decide, you know, which option is right for a patient?

SPEAKER_02:

Well, we literally just do like I was showing with the the facial marks, we do the practice. If I can push back a little ways and the area that we're we're looking at is improved, then I feel confident I can do that with a thread. If I do that and I do a little lift up and it's still just a lot more skin than I can manage, then we start thinking it's time to talk to a specialist that can do surgery. So this is a non-surgical solution we're looking for. So each patient has to be measured on their merits, on what their current condition is, and then we can compare can we achieve those results? And it's also clinical experience. After doing enough cases, I have a very good feeling of yes, I can help you, or this might get you 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'll be happy. Or they may say, Well, all right, I'll skip this step, we'll go straight to the plastic surgeon. But uh, everybody's different that way. It depends what they bring to the table at the beginning.

SPEAKER_01:

Yeah, gotcha. And you know, the previous question I asked you was about like choosing either or, but do patients ever combine fillers and threads for enhanced results?

SPEAKER_02:

Oh, all the time. We do that uh often. Sometimes it'll be in the same visit, and sometimes we'll do one step, like we might do Botox and then wait two or three weeks, and then we may do the lifting threads and the filler on the same day. It just depends, again, on that patient's needs. So uh, and that's a planned decision that we do at the beginning, that we'll start you know with this with baby steps, and then we'll take it to the next phase and then the next step. We also start with a full series of photographs uh of the patient's face up close from different angles, and then we can do a comparison. So when we sit down at the re-evaluation point a couple weeks out, uh we can put the pictures up side by side to see, all right, this is where we were, this is where we are, and are we happy now? And then we can decide a little tweak here or we're happy.

SPEAKER_01:

Wow. Well, thank you so much for the clear and thorough answers, and thank you for breaking down the differences between fillers and lifting threads. For everyone else tuning in, thank you for joining the journey, and we'll see you all next time.

SPEAKER_02:

Thank you, Frederick. Have a wonderful day.

SPEAKER_00:

That's a wrap for the PSL Dentist Podcast, where smiles are brighter and laughter always cavity-free. To keep your smile in shape, call 772-878-7348 or visit psldentist.com to schedule your appointment with Dr. Stephen Blank, the one-stop doc for smiles, beauty, and everything in between. Until next time, keep flossing, keep smiling, and keep listening.