Seoul
Chief MD, Gangnam
Duk-ha Kim
The trust our patients have placed in this clinic was built on conviction and principle. We intend to hold to both, unchanged, through the next hundred years.
Barbed thread lift guide
Cog Thread Lift
A cog thread lift places a suture with small barbs (cogs) along its length under the skin, so the barbs catch tissue while the thread is pulled into position. Peer-reviewed literature uses "barbed polydioxanone (PDO) cog thread" as a shape descriptor, not a brand name, and separate literature covers barbed PLCL threads and PCL as a material. Because "cog" only names the barb shape, it does not by itself tell you which material, manufacturer or thread specification a clinic plans to use — that is the question this page is built around.
- What "cog" describes
- A barb (hook) shape along a suture, used across more than one thread material — not one company’s product name
- Materials studied separately
- Barbed PDO (case series), barbed PLCL (ex vivo pull-out study) and PCL (FDA-commissioned material review) each have distinct literature
- Regulatory category
- Thread sutures are generally handled as devices where clinical trials are not required before marketing
- What is not published here
- A first-party breakdown timetable by material, and any comparison showing barbed threads outperform smooth threads
What is a "cog" thread, and is Cog a brand?
Cog is not a brand — it is a shape descriptor for a suture with small barbs cut or molded along the thread so the barbs catch tissue when the thread is placed under the skin. A published case series studying this shape describes it plainly as a "barbed polydioxanone (PDO) cog thread," with no brand attached to the term. Because the name only describes the barb shape, asking for "a cog thread lift" does not by itself specify which material, manufacturer or product a clinic will use.
Sources: J Dermatolog Treat 2021;32(2):227-230 — case series of barbed polydioxanone (PDO) cog threads (n=38)
How is a cog (barbed) thread different from a smooth thread?
A cog or barbed thread has small projections along its length designed to catch surrounding tissue, unlike a smooth (mono) thread, which has no such projections. The barb shape is the mechanical feature the literature studies; the case series on barbed PDO cog threads and the ex vivo study on barbed PLCL suspension threads both examine that feature specifically, not a brand. Neither source compares a barbed thread against a smooth thread of the same material, so this page does not state that barbs perform better.
Sources: J Dermatolog Treat 2021;32(2):227-230 — case series of barbed polydioxanone (PDO) cog threads (n=38)Clin Cosmet Investig Dermatol 2026 — ex vivo study of parameters determining pull-out strength of barbed PLCL suspension threads
Why doesn’t the name "cog thread lift" tell you the material?
Barbs can be cut into more than one polymer. The literature cited on this page studies barbed PDO threads in one paper and barbed PLCL threads in another, and a separate review covers polycaprolactone (PCL) as a material without tying it to barb shape at all. Because the barb shape and the base material are two separate variables, the word "cog" fixes only the first one — the material, manufacturer and specification are a second question that has to be asked directly.
Sources: J Dermatolog Treat 2021;32(2):227-230 — case series of barbed polydioxanone (PDO) cog threads (n=38)Clin Cosmet Investig Dermatol 2026 — ex vivo study of parameters determining pull-out strength of barbed PLCL suspension threadsECRI review commissioned by FDA CDRH (2021) — polycaprolactone material performance and safety profile
What does the published case series on barbed PDO cog threads show?
A 2021 case series in the Journal of Dermatological Treatment followed 38 patients treated with barbed polydioxanone (PDO) cog threads. It is a single-arm study — everyone in it received the same treatment — with no comparison group, so it can describe what was observed in that group but cannot show that the barbed design outperforms any alternative. Read it as a description of one cohort, not as proof of a superior result.
Sources: J Dermatolog Treat 2021;32(2):227-230 — case series of barbed polydioxanone (PDO) cog threads (n=38)
What does the pull-out strength study say about how a barbed thread grips tissue?
A 2026 ex vivo study used turkey breast tissue to measure how much force was needed to pull barbed PLCL suspension threads back out after ten different insertion techniques, each repeated twelve times. Angled insertion methods — described as J-stitch and self-locking — produced significantly higher pull-out force than straight insertion (p<0.001). The authors describe this as a biomechanical proof-of-concept rather than a precise prediction of any individual thread’s clinical performance, and they tested a single material and a single product.
What does the FDA-commissioned review say about polycaprolactone (PCL) as a thread material?
ECRI reviewed the safety and performance evidence for polycaprolactone (PCL) for FDA’s Center for Devices and Radiological Health in 2021. Across the human studies it examined, the evidence for local tissue reactions to PCL sutures was rated low quality — the studies had comparison groups but produced inconsistent results — no study reported on systemic reactions, and no study evaluated PCL by itself as the object of the research; the reviewers list that as an open area for future work. Separately, ECRI surveillance data logged 86 PCL-related reports, 48 of them involving sutures, and 42 of those 48 were device failure or malfunction reports.
How are thread lift sutures classified, and does that require clinical trials?
Surgical sutures, including barbed ones, are generally handled as devices for which the marketing route relies on showing substantial equivalence to an already-marketed product rather than on new clinical trials. Guidance for this device category asks for data such as a suture’s resorption profile rather than a clinical outcome study. That regulatory route explains why a barbed thread can reach the market with published human data limited to something like a 38-patient case series, rather than a larger controlled trial.
Sources: FDA — surgical sutures Class II special controls guidanceJ Dermatolog Treat 2021;32(2):227-230 — case series of barbed polydioxanone (PDO) cog threads (n=38)
What does "temporarily fixate" mean in cleared suture wording?
Suture products in this device category are typically cleared with indication wording describing the intended use as temporarily fixating tissue in an elevated position; PDO, PLCL and PCL are absorbable materials that break down in the body over time rather than staying in place indefinitely. One published clearance record in this category uses exactly that "temporarily fixate" phrase. The word "temporarily" is part of the wording itself, so it describes an intended mechanical function at the time of placement — it is not a statement about how long a visible cosmetic change will be noticeable.
Sources: FDA — surgical sutures Class II special controls guidanceFDA 510(k) K192423 — MINT Product Family (Hans Biomed)
Does "cog thread lift" tell you the manufacturer or thread spec used on you?
No. None of the sources on this page ties the word "cog" to one manufacturer, and the case series, the pull-out study and the material review each examine a different, specific product rather than the category as a whole. A clinic offering "a cog lift" could be using any of several materials and brands sold under that shape description, so the manufacturer and specification are not implied by the treatment name and have to be confirmed directly.
Sources: J Dermatolog Treat 2021;32(2):227-230 — case series of barbed polydioxanone (PDO) cog threads (n=38)Clin Cosmet Investig Dermatol 2026 — ex vivo study of parameters determining pull-out strength of barbed PLCL suspension threadsECRI review commissioned by FDA CDRH (2021) — polycaprolactone material performance and safety profile
How long does the effect last?
None of the sources cited on this page states how long a cog thread lift’s visible result lasts, and the gap is definitional as much as it is a gap in evidence: "temporarily fixate" in cleared suture wording describes the mechanical hold at the moment of placement, not a promise about how long a cosmetic change stays visible, and the pull-out strength study measured a mechanical force on turkey tissue at a single point in time rather than following any result forward. What does decide the answer — the base material (PDO, PLCL and PCL each carry separate literature on this page), how that material is expected to break down in the body, and the technique and area treated — sits on a different axis than how long the lift itself stays noticeable, and clearance filings in this device category ask for a resorption profile rather than a clinical duration outcome. Ask the clinic which specific material and product is planned, what breakdown timeline is documented for that material, and whether the clinic has any of its own follow-up observations beyond the point of placement.
Sources: FDA — surgical sutures Class II special controls guidanceFDA 510(k) K192423 — MINT Product Family (Hans Biomed)Clin Cosmet Investig Dermatol 2026 — ex vivo study of parameters determining pull-out strength of barbed PLCL suspension threads
What complication rates are reported for thread lifting, and can they be applied to one product?
An invited discussion in Aesthetic Plastic Surgery pooled complication rates across a meta-analysis of 26 thread-lifting studies: edema in 32.9%, dimpling in 11.7%, paresthesia in 6.8%, infection in 3.1%, thread extrusion in 3.9%, and threads that were visible or palpable in 1.8%. The discussion authors themselves caution that the underlying studies were not uniform and that not every paper reported every complication, and the pooled studies span different materials and techniques — so these figures describe the pooled literature, not a rate you can assign to one specific product.
Does the evidence show barbed threads outperform smooth threads?
No source cited on this page makes that comparison. The PDO cog case series has no control group of any kind, the pull-out study compares insertion techniques within one barbed product rather than barbed against smooth, and the complication figures are pooled across studies using different thread designs. None of that supports a claim that a barbed shape lifts more, lasts longer or performs better than a smooth thread.
Sources: J Dermatolog Treat 2021;32(2):227-230 — case series of barbed polydioxanone (PDO) cog threads (n=38)Clin Cosmet Investig Dermatol 2026 — ex vivo study of parameters determining pull-out strength of barbed PLCL suspension threadsAesthetic Plast Surg 2021 — invited discussion reporting pooled complication rates from a 26-study thread-lift meta-analysis
Why doesn’t this page state how long a cog thread lasts?
None of the sources cited on this page reports an absorption timetable by material — figures sometimes quoted for PDO, PLLA or PCL are not part of what these sources state, so this page does not publish one. What the FDA-commissioned review does state is that the local-reaction evidence for PCL is rated low quality and that no study it reviewed evaluated PCL’s properties on their own, which is a reason for caution rather than a basis for a duration figure. Ask the clinic directly which material is planned and what it bases a duration estimate on.
Is an ex vivo pull-out test the same as a clinical outcome?
No. The pull-out strength study was conducted on turkey breast tissue rather than on patients, which is why its authors describe the result as a biomechanical proof-of-concept rather than a precise prediction of an individual thread’s performance. A higher pull-out force in that setting is a mechanical measurement at the moment of testing; it is not evidence about how a lifted result looks weeks or months after a procedure.
What should you ask before booking a "cog thread lift"?
Ask for the exact product name and manufacturer, the base material (for example PDO, PLCL or PCL), the thread specification and barb design planned for your case, and how that product is regulated where you are treated. Also ask which complications the clinic sees most often for that specific product and how it manages them, since the pooled figures cited on this page cannot be assigned to one product without that context.
Sources: FDA — surgical sutures Class II special controls guidanceAesthetic Plast Surg 2021 — invited discussion reporting pooled complication rates from a 26-study thread-lift meta-analysis
How should you read a quote or menu that just says "cog lift"?
Treat "cog lift" as a shape description on a menu, not as a specification. Two clinics quoting "a cog lift" can mean different base materials, different manufacturers and different thread counts, none of which the name discloses. Ask each quote to spell out the product name and material before comparing prices or thread counts against each other.
Sources: J Dermatolog Treat 2021;32(2):227-230 — case series of barbed polydioxanone (PDO) cog threads (n=38)Clin Cosmet Investig Dermatol 2026 — ex vivo study of parameters determining pull-out strength of barbed PLCL suspension threads
What does this page intentionally leave unanswered?
This page does not state an absorption timetable by material, does not claim barbed threads outperform smooth threads, does not publish a duration or improvement figure for any product, and does not name the manufacturer or specification of the thread your clinic plans to use — that last item has to come from the clinic. What it does document is the shape of the evidence that exists for cog-shaped threads, and the questions that evidence leaves for a consultation.
Sources: J Dermatolog Treat 2021;32(2):227-230 — case series of barbed polydioxanone (PDO) cog threads (n=38)Clin Cosmet Investig Dermatol 2026 — ex vivo study of parameters determining pull-out strength of barbed PLCL suspension threadsECRI review commissioned by FDA CDRH (2021) — polycaprolactone material performance and safety profileAesthetic Plast Surg 2021 — invited discussion reporting pooled complication rates from a 26-study thread-lift meta-analysis
What actually determines how a cog thread lift turns out?
The name "cog" only describes the barb shape. These are the variables the cited literature actually studies, and the question each one raises for a consultation.
| Variable | What the literature reports | What to ask at the consultation |
|---|---|---|
| Base material | Barbed PDO, barbed PLCL and PCL each have separate published literature rather than one shared material profile | Which base material is planned for your treatment, and why |
| Insertion technique | An ex vivo study found angled insertion (J-stitch, self-locking) produced significantly higher pull-out force than straight insertion for one barbed PLCL product (p<0.001); the authors call it a biomechanical proof-of-concept, not a clinical prediction | Which insertion technique the clinic plans to use, and on what basis |
| Product and manufacturer | None of the cited literature ties the word "cog" to one manufacturer; the case series, the pull-out study and the material review each study a different, specific product | The exact product name and manufacturer behind the "cog" label |
| Regulatory classification | Sutures in this category are generally marketed by showing substantial equivalence, with indication wording describing temporary fixation | How the specific product is classified and regulated where you are treated |
| Material safety evidence | An FDA-commissioned review rates local-reaction evidence for PCL sutures as low quality and reports zero studies evaluating PCL alone | What safety data the clinic can share for the specific material it plans to use |
| Complication management | A 26-study meta-analysis reports pooled rates for edema, dimpling, paresthesia, infection, extrusion and palpable or visible threads, with the authors cautioning the studies are not uniform | Which of these the clinic sees most often for its product, and how it manages them |
This table organizes what the cited literature studies and the questions worth raising at a consultation. It is not a ranking, a recommendation or a statement about results for any product.
Sources: J Dermatolog Treat 2021;32(2):227-230 — case series of barbed polydioxanone (PDO) cog threads (n=38)Clin Cosmet Investig Dermatol 2026 — ex vivo study of parameters determining pull-out strength of barbed PLCL suspension threadsAesthetic Plast Surg 2021 — invited discussion reporting pooled complication rates from a 26-study thread-lift meta-analysisECRI review commissioned by FDA CDRH (2021) — polycaprolactone material performance and safety profileFDA — surgical sutures Class II special controls guidance
Medical care at Abijou
Care is provided by the medical team at the branch you select. These clinicians lead the three branches linked from this guide; confirm the doctor assigned to your visit with that branch.
Chief MD, Myeongdong
Cheol-su Yoon
I want to be thinking about how the patient feels right up to the last moment of the procedure.
Chief MD, Hongdae
Jae-wook Kim
I will give my best with the attentiveness to catch even the smallest change.
Listed branch medical team — not a medical-review byline for this article.
Frequently asked questions
Is "Cog" a specific product or brand name?
No — peer-reviewed literature uses "cog" as a description of the barb shape on a suture, not a brand. A 2021 case series calls the object of its study a "barbed polydioxanone (PDO) cog thread," attaching no company name to the term, so a clinic offering "a cog lift" could be using any of several materials or brands built around that shape.
What is a cog thread actually made of?
It depends on the specific product, because barbs have been studied on more than one base material. Separate literature cited on this page covers barbed PDO threads, barbed PLCL threads and PCL as a material — the word "cog" by itself does not specify which one a clinic plans to use.
Does the barb shape make a cog thread stronger or longer-lasting than a smooth thread?
That comparison is not shown in the sources on this page. The case series on barbed PDO cog threads has no smooth-thread comparison group, and the pull-out strength study compares insertion techniques within one barbed product rather than barbed against smooth.
What did the 38-patient PDO cog thread study actually study?
It followed 38 patients treated with barbed polydioxanone (PDO) cog threads in a single-arm design, meaning every patient received the same treatment with no comparison group. That design can describe what was observed in this group; it cannot establish that the result is better than an alternative.
What does the pull-out strength study show about insertion technique?
It shows that, in ex vivo turkey breast tissue, angled insertion techniques such as J-stitch and self-locking produced significantly higher pull-out force than straight insertion (p<0.001), across ten techniques repeated twelve times each. The authors call this a biomechanical proof-of-concept, not a precise prediction of any individual thread’s clinical performance.
Can that pull-out result tell me how long my results will last?
No — the study’s own authors describe it as a proof-of-concept measurement in tissue outside the body, not a model for clinical duration. It also tested a single material and a single product, so it cannot be generalized to other cog threads.
Is polycaprolactone (PCL) a well-studied thread material?
An FDA-commissioned review found the evidence for local tissue reactions to PCL sutures to be low quality, no study reporting on systemic reactions, and no study examining PCL by itself as the focus of the research. Reviewers list PCL’s properties as a material as an open question for future study rather than a settled one.
Do thread sutures need to pass clinical trials before they can be sold?
Generally no — surgical sutures, including barbed ones, are typically marketed by demonstrating substantial equivalence to an already-marketed device rather than through new clinical trials. Guidance for this category asks for data such as a resorption profile instead of a clinical outcome study.
What does "temporarily fixate" mean in a cleared suture’s indication wording?
It describes the intended mechanical function at the time of placement — holding tissue in an elevated position temporarily — rather than a promise about how long a cosmetic change will remain visible. This wording appears in published indication text for products in this device category, with "temporarily" as part of the wording itself.
What complication rates are reported for thread lifting in general?
A pooled analysis across 26 thread-lifting studies reports edema in 32.9% of cases, dimpling in 11.7%, paresthesia in 6.8%, infection in 3.1%, thread extrusion in 3.9%, and threads that were visible or palpable in 1.8%. The authors of that discussion caution that the underlying studies were not uniform and did not all report every complication.
Can I use those percentages to estimate my own risk?
Not reliably — the figures are pooled across studies that used different materials and techniques, and the discussion authors themselves warn that not every paper reported every complication. Ask the clinic what it observes for the specific product and technique planned for your treatment instead.
How long does a cog thread lift last?
This page does not state a duration, because none of the sources cited here report an absorption timetable by material. What the material review does state is that PCL’s local-reaction evidence is rated low quality and that no study evaluated PCL on its own, which argues for asking the clinic directly rather than relying on a number found online.
Should I ask which manufacturer’s thread will be used on me?
Yes — that is the central question this page is built around, because none of the sources cited here ties the word "cog" to one manufacturer. Confirm the exact product name, material and specification before booking, not just the shape description.
What should I ask at the consultation before booking a "cog thread lift"?
Ask for the exact product name and manufacturer, the base material and thread specification planned for your case, how that product is regulated where you are treated, and which complications the clinic sees most often for that specific product. General figures for thread lifting as a category cannot substitute for those specifics.
What answers at a consultation should raise concern?
Treat a refusal or inability to name the material, manufacturer or specification of the thread as a reason to ask more questions, since that information is something the clinic can supply directly. A promised fixed duration or a claim that barbed threads are proven superior to smooth threads also goes beyond what the cited literature supports.
Is a "cog lift" the same treatment everywhere, regardless of the quote?
No — the same shape description can cover different base materials, manufacturers and thread counts, so a quote for "a cog lift" is not a specification by itself. Compare the product name and material behind each quote before comparing price or thread count.
How Abijou works
We started in Gangnam in 2006 and the network now runs 17 branches across Korea. The line we work to is skin transformation woven into everyday life — care you can keep up with, rather than one dramatic change.
- Across the 17 branches in Seoul, Gyeonggi, Incheon and Busan: over 1,000 medical professionals and more than 350 certified medical devices
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