By the team at L’Atelier Aesthetics, checked by Dr Duncan Brennand, Lead Aesthetic Doctor, 101 Harley Street
Silhouette Soft threads and dermal fillers both aim to reverse the visible signs of lower-face ageing, and patients often arrive asking which one is right for them. The two treatments work in quite different ways: threads physically lift tissue and encourage the skin to produce collagen over time; fillers add volume exactly where they are placed. In practice, the right answer depends on what is happening in your face. Here is how we think about the choice at the clinic.
For patients with specific volume loss in the cheeks, chin, lips or jawline, dermal fillers are usually the more predictable choice. For patients with mild to moderate skin laxity and softening along the jawline, Silhouette Soft threads can produce a useful physical lift. For most patients with a mix of concerns, the best answer is a combination plan, or an energy-based tightening treatment like Sofwave alongside filler rather than threads at all.
Silhouette Soft threads are fine absorbable threads with small cones along their length. They are placed under the skin through a very fine needle, and the cones anchor into the soft tissue. When the thread is tensioned, it physically repositions the tissue upward. Over the following 12 to 18 months the threads are absorbed by the body, and during that process they encourage the skin to produce new collagen along the thread path, adding a secondary gradual firming effect.
Dermal fillers are hyaluronic acid gels injected to restore volume. The gel sits in the tissue immediately after injection, holds water, and rebuilds the structural support that has been lost to ageing. Different filler products have different textures suited to different areas of the face, from deep cheek support to fine lip refinement.
Silhouette Soft threads suit patients with mild to moderate jowling and softening along the jawline, where the main issue is tissue position rather than volume loss. They suit patients who specifically want a physical lift and are comfortable with the procedure, the recovery involved and the fact that the result cannot be reversed.
Dermal fillers suit a broader range of patients. Specific hollows, flat cheeks, a less-defined chin or jawline, thin lips and under-eye hollowing are all better served by filler than threads. Filler can also be dissolved quickly if the result is not what the patient wanted, which is an important safety advantage that threads do not share.
Neither treatment is appropriate during pregnancy or breastfeeding, over active skin infection, or in patients with certain autoimmune conditions without specialist input.
Reversibility is the most practical difference. A dermal filler can be dissolved within 24 hours if a patient is unhappy or if a complication needs to be addressed. Silhouette Soft threads cannot be dissolved. They can be removed within the first few weeks if necessary, but that is a small procedure rather than a simple injection. This makes careful planning even more important.
The other meaningful difference is predictability. A skilled injector can place filler in small, adjustable amounts. Threads are a more definite commitment on the day, and the final result depends partly on how the tissue responds in the weeks that follow. In our experience, for most patients a combination of filler and an energy-based tightening treatment like Sofwave or Morpheus8 delivers a better result than threads alone, which is why that is our more common recommendation.
| Variable | Silhouette Soft | Dermal filler |
|---|---|---|
How it works | Physically lifts tissue and stimulates collagen over time | Adds volume directly where it is placed |
Immediate effect | Yes, from physical lift on the day | Yes, from gel placement |
Duration | 12 to 18 months | 12 to 18 months |
Reversible | No | Yes, can be dissolved |
Silhouette Soft threads produce a visible lift from the day of treatment. Swelling and mild bruising can last three to five days. The secondary collagen response builds over three to four months. The full lift typically lasts 12 to 18 months, gradually softening after that.
Dermal filler is visible immediately, with swelling settling over 24 to 48 hours. Most fillers last 12 to 18 months depending on the product, the area and the individual. Lip and lower-face filler tends to break down faster than cheek filler.
“My starting position is usually filler plus an energy-based treatment, not threads. That combination gives a predictable, reversible, adjustable result. Threads have a place for patients who specifically want a physical lift and understand the trade-off on reversibility, and we can offer them where it is the right answer. For most patients, the conversation will start with Sofwave or Morpheus8 plus a modest filler plan, and that is usually where we land.”
Dr Duncan Brennand, Lead Aesthetic Doctor, L’Atelier Aesthetics
At L’Atelier Aesthetics, both dermal filler and Silhouette Soft thread procedures are performed personally by Dr Brennand when recommended. Injectable work is not delegated.
Silhouette Soft threads and dermal fillers both have a place, but they suit different concerns and different patients. For most people, a combination of filler and an energy-based tightening treatment will deliver a more predictable and adjustable result than threads alone. Threads remain a useful option for patients who specifically want a physical lift and understand the commitment involved. Dr Brennand will give you a clear recommendation at consultation based on what your face actually needs. Our clinic is at 101 Harley Street, London W1G 6AH, around five to ten minutes on foot from Bond Street, Oxford Circus or Regent’s Park. Book through the contact page or call us to arrange a time.
Neither is universally better. Silhouette Soft threads suit mild to moderate jawline laxity where a physical lift is wanted. Filler is better for specific volume loss. For most patients, a combination of filler and an energy-based tightening treatment is what Dr Brennand recommends.
The procedure is carried out under local anaesthetic and is well tolerated. Some pressure is felt during placement and tensioning. Bruising and swelling for three to five days afterwards is common, and a mild ache can persist for about a week.
Yes. Hyaluronic acid filler can be dissolved quickly if a patient is unhappy with the result or if a complication needs to be managed. Silhouette Soft threads cannot be dissolved.
Typically 12 to 18 months. The physical lift is visible from day one, and the secondary firming effect from collagen production builds over three to four months as the threads are absorbed.
Yes. When threads are the right choice, they are often combined with filler to restore volume alongside the physical lift. Dr Brennand will plan the sequence at consultation, typically doing one before the other rather than both in the same session.
Not as a default. For jowling, our usual recommendation is energy-based tightening with Sofwave or Morpheus8, with small amounts of filler to refine the result. Silhouette Soft threads have a role in specific cases but are not the routine answer for jowling.
We welcome patients from across Marylebone, Mayfair, Fitzrovia, Regent’s Park, Soho, Knightsbridge, Belgravia, Chelsea and Kensington, as well as visitors travelling to London for specialist aesthetic and skin treatments. Our location benefits from excellent transport links, with Oxford Circus only a 13 minute walk away, Bond Street and Regent’s Park Underground stations are also both within easy reach. The clinic is also conveniently accessible from major London rail stations and Heathrow, Gatwick and London City airports thanks to the Elizabeth line, making visits straightforward for both UK and international patients.
Whether you are travelling from within London or further afield, our Harley Street clinic provides a calm, professional environment for personalised aesthetic and skin health treatments in one of the capital’s most respected medical locations.
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