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Stitch Lift / Thread Lift

Facial Procedures
  • Significant yet subtle, and natural in appearance
  • Attractive for its simplicity and minimal invasiveness
  • Performed under local anaesthesia and sedation in rooms


As one ages the underlying soft tissues of the face progressively lose their elasticity and volume. This results in the appearance of jowls along the jaw line and deepening of the the grooves extending from the corner of the nose to the corners of the mouth (naso-labial grooves). The Stitch Lift elevates these sagging tissues to refresh / rejuvenate the face. (note ~ stitch=thread=suture and Stitch Lift = Thread Lift = Suture Lift.)

For many years both doctors and potential patients have sought a technique of facial tissue suspension without having to resort to a full open facelift. Several surgeons independently developed techniques of suspending the soft tissues of the face with stitch material (sutures/threads). Des Fernandes, a respected Plastic Surgeon of Cape Town, South Africa, Prof. Greg Ruff of Duke University, North Carolina and Nicanor Isse a senior plastic surgeon in California all were pioneers of this technique. The technique of stitch/suture/thread lifting has the advantages of being a minimally invasive procedure performed in rooms under light sedation and local anaesthesia and producing subtle but significant changes.

Unlike an open facelift, it is not an extensive procedure, does not involve marked surgical interference with tissues or excision of skin and does not have the potential for significant complications that can accompany an open facelift.

However, the degree of elevation of the sagging tissues is about 20% of an open facelift. The initial derogatory title of ‘The 20% Lift’ by some American facelift surgeons was unwittingly a compliment, since patients having a stitch lift can safely be assured that “You will still look like you” and will not be questioned by inquisitive friends and family regarding having had cosmetic surgery. Patients are more like to be complemented on their ‘fresh’ appearance or receive remarks such as "you look well"/ "you look rested".


The Stitch Lift is a minimally invasive procedure carried out under sedation and local anaesthesia, taking around two hours to perform. Through a small incision in the crease behind the ear smooth, fine nonreactive threads (stitches) are inserted in a series of loops, extending towards the corner of the mouth and looping back to the ear. Here they are anchored into the tough fascia over the bone. Other loops extend more vertically from the upper sideburn area from tiny nicks hidden in the hair.

The effect not only lifts the sagging tissues, but also lifts the skin, smoothing the fine lines and wrinkles, the naso-labial folds, the corners of the mouth and the jaw line. The skin tightens into its newly held position. Over time collagen forms around the threads and so maintains traction on the soft tissues.


Apart from the large cheek area (mid/lower face), the Stitch Lift technique can also elevate the brow, upper face and the neck.


It should be noted that the terms 'threads', 'stitches' and 'sutures', all mean the same thing. There are, however, different techniques of thread lifting. The ‘Stitch Lift’ (R) is a registered trademark term coined by Dr. Fox and is basically designed around the technique developed by Des Fernandes. It involves inserting a series of loops of fine suture material to provide the lift. It requires much greater finesse and judgment than procedures using ‘specialist threads’.

Specialist Threads/Sutures for lifting the facial tissues are comprised of suture material designed by various companies. The shape of the suture is specific to the particular company. ‘Contour Threads’ were the first specialist thread used but were eventually replaced by ‘Silhouette Sutures’ which have a greater holding power. Since then a variety of other specialist threads have been developed, none of which Dr. Fox believes have any advantage over Silhouette Sutures (refer to tab ‘Silhouette Sutures Lift’ on this website).

Since his initial training with Des Fernandes in 2003 Dr. Fox has developed a technique that has sometimes combined the Stitch Lift and the Specialist Threads. However, he finds the Stitch Lift alone is the more suitable procedure for most patients and is more time consuming than using specialist threads alone. Dr Fox considers the additional time worth while in producing a superior result.


The recovery period is relatively brief. Most patients can return to social activities within a week and a half. The least one can expect is 1 week and at the most 3 - 4 weeks. There is discomfort at the anchor points of the threads but this is managed by common oral analgesics and anti-inflammatories. Patients will be given simple instructions to avoid particular things that might put stress on the sutures. These are important in the first 4 weeks following the procedure.


Dr Fox was one of the first Australian doctors originally trained in the Stitch Lift by the pioneer of the procedure, South African plastic surgeon Dr Des Fernandes. Dr Fox has been performing the Stitch Lift since 2003.

He was the first Australian doctor to be trained by Prof. Greg Ruff in using Contour Threads, which he introduced to Australia and was the first ‘master’ trainer in the use of these pioneer threads. He also was the first in Australia to use Silhouette Sutures and has conducted training workshops for other doctors.

Before & After Gallery

Please note that all the photographs below are actual patients of Dr. Bruce Fox. They have not been digitally enhanced or altered in any way. The techniques used on these patients include all those mentioned above, that is, Fernandes Loops alone, specialist threads alone and combinations. For more information, please contact Dr Bruce Fox’s rooms.

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