I first heard about thread lifts several years ago. At the time, they sounded like a viable alternative for someone looking to tighten up facial skin with a minimally invasive procedure.

A couple years later, as a plastic surgery writer, I learned that most of the board-certified plastic surgeons I wrote for did not think much of the option, and I heard that one brand of threads was being recalled. “There!” I thought. These lifts—which seemed to me to be better suited as a marketing case study than an example of surgical innovation—would soon no longer be out there to tempt patients.

After hearing a snippet about thread lifts the other day, I did some searching. I found not only are thread lifts still around, some cosmetic surgeons and procedure centers are aggressively pushing them. With the economy the way it is, these lower cost alternatives to a traditional facelift may actually be more tempting than ever.

Known by a variety of names and trademarks, the procedure is simple in concept. Several barbed threads are inserted under the facial skin, then pulled upward and secured. Both facelifts and neck lifts can be performed this way. According to some doctors who perform thread lifts, collagen regenerates around the threads and helps to re-support skin from underneath.

The main reason I’m surprised that thread lifts are still so readily available is the sheer volume of patients who are disappointed with the results. If you do a search of blogs and forums, you’ll read comments that include words like “disappointed,” and even “nightmare.” You’ll hear people tell about visible threads under the skin’s surface, threads breaking or even emerging from under the skin, bumps and hollows and results that last only a few weeks or months.

Another aspect of thread lifts should act as a red flag. Many, probably the majority, of places you can get a thread lift include offices of dermatologists and ophthalmologists, medical spas, laser and aesthetic centers and so on. The professionals who perform the procedures are not trained and board certified in plastic surgery, therefore a thread lift may be the most aggressive technique they can offer. Are they honest about what the procedure can and can’t achieve?

Not only that, but training in thread lifting takes only a couple of days. I personally would not want someone altering my appearance who has so little education about the face.

On the other side of that coin, the majority of board certified plastic surgeons do not perform thread lifts and many are highly critical of the option. Before you jump to the conclusion that plastic surgeons want to steer people toward a traditional—and more expensive—facelift, consider that most plastic surgeons these days offer minimally invasive alternatives like injectables, lasers and more.

Finally, the procedure has been around long enough for clinical data to be available. One study, released just this month, concludes that, “Results achieved by threadlift are subtle and short-lived.”

My vote on thread lifts? Time to yank!