For mid-face lifting, you have a non-invasive option (HIFU), a minimally invasive option (PDO thread lift), and the surgical option (deep-plane facelift). Each addresses a different severity of laxity, and the math on which is right depends on age, skin condition, and how much downtime you can absorb.
This guide covers each option's mechanism, candidate fit, recovery, and longevity.
HIFU
Best for: mild-to-moderate laxity, ages 35–55, no downtime tolerance. Results progressive over 3 months. Lasts 12–18 months. Elyzea: S/1,000 (~US$286) full face.
HIFU's advantage: completely non-invasive, no marks, no recovery. The trade-off is gradual onset and modest absolute lifting magnitude.
PDO Thread Lift
PDO (polydioxanone) sutures inserted under the skin, pulled to lift, stimulate collagen as they dissolve over 6 months. Immediate lift + collagen response.
- Best for: moderate laxity, jowl visibility
- Lasts: 12–18 months
- Recovery: 3–7 days bruising/swelling
- Elyzea cost: S/300 (~US$86) per thread; a typical full result uses ~5 threads per side (~10 in total), about S/3,000 (~US$857)
Threads are more aggressive than HIFU but less than surgery. Good for patients between the two extremes.
Surgical Facelift
Definitive lifting via SMAS plication or deep-plane release.
- Best for: severe laxity, ages 55+
- Results last: 8–12 years
- US cost: $15,000–$50,000
- At Elyzea: not on the published list of surgeries — Dra. Geldres confirms whether it is an option for you
- Recovery: 2–3 weeks visible recovery, 6 weeks back to normal
Combining HIFU + threads
Many patients in their 40s combine HIFU (collagen) + threads (immediate lift) for a layered non-surgical result that approaches surgical-look without surgery.
Sequence: threads first for immediate lift; HIFU 6+ weeks later for cumulative collagen response. Combined cost at Elyzea: ~US$286 HIFU + (~10 threads × $86) ~US$857 = ~US$1,143.
Decision matrix
| Factor | HIFU | Threads | Facelift |
|---|---|---|---|
| Invasive | No | Minimally | Yes |
| Anesthesia | None | Local | General/regional |
| Downtime | None | 3–7 days | 2–3 weeks |
| Duration | 12–18 mo | 12–18 mo | 8–12 yr |
| Best age | 35–55 | 40–60 | 55+ |
| Risk profile | Very low | Low | Surgical |
| Lima cost | ~US$286 | ~US$86/thread | Not on Elyzea's list |
| US cost | $2,500-$5,000 | $1,500-$4,500 total | $15,000-$50,000 |
When non-surgical reaches its limits
Non-surgical treatments work best for prevention and moderate lifting. When skin laxity exceeds what HIFU + threads can manage — typically late 50s or early 60s — surgery is the right answer for definitive correction.
A traditional surgical facelift is not on Elyzea's published list of surgeries; Dra. Geldres confirms whether it is an option for you. The math vs. ongoing non-surgical maintenance can favor surgery for patients with significant laxity facing 10+ years of maintenance.
Frequently asked questions
Will HIFU prevent the need for surgery?
It can delay it meaningfully. Annual HIFU starting in your 30s often pushes the facelift decision into the late 60s rather than mid 50s.
Are threads safe?
When properly placed, yes. Migration and visibility are rare complications.
What about silhouette threads or cog threads?
Different thread types: PDO (most common), PLLA, mono vs cog. Choice depends on indication.
Can I have non-surgical lift in my 70s?
Yes but expectations should be realistic. Surgery often produces better results in this age group.
What's the recovery from a deep-plane facelift?
2-3 weeks visible. 6 weeks for full activity. 6 months for final settled appearance.
Can I have HIFU after a facelift?
Yes, after 6+ months recovery. HIFU maintains the surgical result.
What's the cost difference between Lima vs US facelift?
A traditional facelift is not on Elyzea's published list of surgeries, so there is no published price; Dra. Geldres confirms whether it is an option for you. The facial surgeries we do perform, with their prices, are on our facial plastic surgery page.
HIFU at Elyzea — what makes it deliver
HIFU (high-intensity focused ultrasound) only delivers its lifting effect when the energy reaches the SMAS layer at 4.5 mm with calibrated, predictable energy — which depends on who performs it and how the depths and energy are planned more than on the brand of the device. At Elyzea, HIFU is performed by Dra. Geldres herself, and the anesthesia infrastructure (topical + optional nerve block or oral sedation) means we run full SMAS energy comfortably. Per the price list: HIFU full face S/1,000 (~US$286), face + neck S/1,500 (~US$429). Annual maintenance sustains the lifting result. For US patients, this is roughly 80–90% below typical US HIFU pricing.
Thread lifts — how they fit (and don't fit) into modern protocols
Thread lifts (PDO threads, PLLA threads) produce immediate mechanical lift through subdermal placement of dissolvable suture-like threads. The lift is visible immediately and lasts as long as the thread material persists in tissue (typically 6–12 months for PDO, longer for PLLA). After the threads dissolve, residual collagen response provides modest sustained benefit. Threads are best used as a complement to HIFU and Morpheus8, not as a substitute. For patients who want immediate visible lift while waiting for HIFU collagen response to develop (4–12 weeks), threads bridge the gap. For pure structural lifting, surgical facelift remains the only definitive option (a traditional facelift is not on Elyzea's published list of surgeries; Dra. Geldres confirms whether it is an option for you).
Why Elyzea is different in Lima
At Elyzea, every protocol is designed and supervised by a board-certified plastic surgeon, and HIFU is performed by Dra. Geldres herself. See how a visit works.
Bottom line
HIFU first for prevention + early laxity. Threads for moderate cases needing immediate lift. Surgery for severe laxity in 55+ patients. Lima offers all three at meaningfully lower cost than the US.