What's old is new again in the world of cosmetic surgery. The Silhouette Instalift, the latest youth-enhancing treatment to receive FDA approval, is an updated version of what you may remember as the "thread lift" from the '90s. Historically deemed disappointing, unscientific, and even barbaric (more on why later), the procedure requires doctors to place and pull threads under the skin to lift everything from the neck and chin to the cheekbones. Now, thanks to innovative techniques and high-tech threads, it's getting a second chance from doctors and their patients who want a face-lift without downtime or surgery.

Promising to painlessly lift sagging skin and deliver natural-looking results, Instalift is a relatively straightforward procedure. Doctors use a fine needle to puncture a hole (the size of a dot) in the cheeks near the nose. From this site, one or more threads equipped with tiny cones is threaded in two directions: up toward the ear and down toward the nasolabial fold, forming a V-shape under the skin. "It's for the same type of patient who would come in for filler, except that this is also able to mechanically lift up the skin where fillers can really only volumize," says Richard Goldfarb, a Pennsylvania cosmetic surgeon and the medical director for Silhouette Lift, the distributor of Instalift. "I think this will be as popular as Botox." Because the threads contain bidirectional cones, they're able to self-attach to tissue, lifting without the need for hooks or anchors. Once in place, they create a controlled injury under the skin, and over time trick the body into producing more collagen. Six to nine months later, the threads and cones dissolve, leaving the face lifted and plump. (Cost: $2,000 and up.) Through his clinical studies, Goldfarb believes that results will last from 12 to 18 months. Like filler, "it's going to have to be repeated because it's not permanent, but it's also less invasive than a face-lift." For Harold Lancer, a celebrity dermatologist in Beverly Hills, that's key. "Lifting and tightening without the knife is a major interest right now," says Lancer, who has added Instalift to his service menu. "This takes 30 minutes, and it doesn't involve any cutting or stitching."

Until now, you'd be hard-pressed to find reputable physicians willing to perform thread lifts in the U.S. During their initial launch in the '90s, training programs consisted of overcrowded demonstrations, which led to poor techniques. Substandard threads would break in the face, causing infections. As a result, certain procedures were banned by the FDA. "About 10 years ago, the Italians brought threading back to life with new approaches, and the French further refined it about five years ago," explains Lancer. Which is why Hollywood A-listers have been making the trip across the pond for sometime. Maurice Dray, a dermatologic surgeon with clinics in London and Paris, is the most buzzed-about doctor. Similar to Instalift, his procedure, the Princess Lift, costs 1,200 euros (around $1,400) and can raise the neck, jawline, or cheekbones. Karen, 52, had one on her neck. "Immediately, my jawline was more pronounced, and the skin on my neck was tighter. It took 15 minutes and didn't cause bruising." While she remembers a slight tugging during the treatment, she says it felt more uncomfortable than painful. Dray expects her results to last for two years.

Still, not all doctors are convinced that thread lifts are the way to go. "We have seen them, tried them, and most of the established plastic surgery community has abandoned them," says New York facial plastic surgeon Jon Turk. Manhattan plastic surgeon Stafford Broumand concurs: "The bottom line is that no new technique or technology can replace the quality and efficacy of a true face-lift by an experienced surgeon." Dray doesn't disagree. "We don't pretend that this will replace a face-lift," he says, "but it's a good alternative for people who don't want face-lifts or are not ready for one." Gigi, 53, is a perfect example. After meeting with three surgeons for face-lift consultations, she decided to try Instalift at Lancer's office. "It took five years off my face," she says, adding, "And when this wears off, I can eventually get a face-lift if I want one."

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This article originally appeared in the November 2015 issue of Harper's BAZAAR.