Thread Lift Complications and How They Are Avoided

Most thread lift complications are minor and temporary: bruising, swelling, tenderness, small skin dimples and a tight feeling when opening the mouth. Less common problems include asymmetry, threads that can be seen or felt, a thread working its way out, and infection. Rarely, nerves or the salivary gland are irritated. Most are managed by waiting, adjusting or removing the thread.

What can go wrong with a thread lift?

Searches for “thread lift gone wrong” usually come from one of two groups: people considering threads who want to know the risks, and people who have had threads and are worried by what they see in the mirror. This page is written for both. It explains which problems are common and temporary, which need attention, and how a careful plan makes most of them less likely.

Systematic reviews of thread lifting report that complications are frequent but mostly minor and short-lived. Larger case series of barbed sutures describe a similar pattern: bruising, swelling and dimpling in the first weeks, with a smaller number of threads becoming visible, extruding or becoming infected. Serious harm is uncommon. That is reassuring, but it is not a reason to be casual about technique or aftercare.

Which effects are normal in the first two weeks?

Bruising and swelling. The needle or cannula passes through soft tissue, so some bruising and swelling along the tracks is expected. Swelling is often greater on one side for a few days, which can look like asymmetry. Tenderness and tightness. Barbed threads hold tissue under tension, so the face can feel tight or sore, especially when opening wide, chewing or yawning. A soft diet and avoiding wide mouth opening for a week or two help.

Dimpling and puckering. Where barbs grip close to the surface, small dimples can appear, more often near the entry points or along the cheek. Most smooth out within days to two weeks as swelling settles and the tissue relaxes around the thread. A dimple that persists can usually be released gently at a review rather than left.

These effects are part of recovery rather than signs that something has gone wrong. The time to judge the result is at about two weeks, when most of the swelling has gone.

Some people also notice a faint bump or ridge where a thread ends, a slightly uneven smile in the first few days because of swelling, or tenderness when lying on one side. These usually settle with time. What is not expected is pain that increases after the first two or three days, spreading redness, heat or discharge, which may be signs of infection and should be reported straight away.

Which complications need attention, and how are they managed?

Asymmetry is usually from uneven tension or uneven swelling. If one side is still clearly different at two weeks, tension can sometimes be adjusted, or a thread added on the lower side. Visible or palpable threads happen when a thread lies too close to the surface or the skin is thin. A thread that can only be felt on pressing may soften as it absorbs; one that shows as a ridge is usually removed through a small opening.

Extrusion means a thread end has worked its way through the skin, most often at an entry point, near the hairline, or in the nose at the tip or inside the nostril. It is trimmed or removed and the small wound heals. Infection shows as increasing redness, warmth, swelling, pain or discharge along a track, usually within days to weeks. It is treated with antibiotics, and the thread is often removed because bacteria can persist on it.

What are the rare but more serious complications?

Branches of the facial nerve run through the cheek and along the jaw. A thread placed too deep, or significant swelling, can irritate a branch, causing temporary weakness of part of a smile or lip movement. This is uncommon and usually recovers over weeks, but it should be assessed promptly.

In front of the ear lies the parotid salivary gland and its duct, which runs across the cheek. Threads placed through this area at the wrong depth can, rarely, cause pain on eating, swelling or a collection of saliva. Firm, inflamed lumps (granulomas) can also form around a thread months later. These problems need medical review, sometimes imaging, and occasionally referral.

Threads in the nose have their own pattern. The tip skin is thin and moves a great deal, so extrusion and redness over a thread under tension are more likely there than in the cheek. The HIKO nose thread lift article covers these in detail.

How are thread lift complications avoided?

Choosing the right face. Threads suit mild to moderate descent in skin of reasonable thickness. Very heavy, thick skin pulls threads loose; very thin, lean faces show threads and dimples more easily. Heavy laxity may need a surgical opinion instead. Planning vectors and depth. Threads are placed in the correct plane along lines that respect the anatomy, away from the main course of nerves and the parotid duct.

A sensible number of threads. More threads do not mean more lift; beyond a point they add tension, dimpling and extrusion risk. Sterile technique and registered threads. The skin is prepared carefully, the threads come from authorised suppliers, and entry points are kept clean. Aftercare. Avoiding wide mouth opening, facial massage, dental work and strenuous exercise for the first weeks reduces movement while the tissue settles around the threads.

Reviews of the published evidence also make the case for honest expectations: the lift from absorbable threads is temporary, and over-correcting to make it last longer is a common route to problems.

Previous treatments matter too. Threads placed through areas with old filler, collagen stimulators or earlier threads behave less predictably, and scar tissue from earlier procedures can change the plane. Dr Sin Yong asks what has been done before and, where useful, checks with ultrasound before planning new threads.

What should you do if you think your thread lift has gone wrong?

Contact the clinic that placed the threads first, because they know what was used and where. Seek prompt care for increasing pain, redness, warmth, discharge, fever, a thread end coming through the skin, or new weakness of facial movement. Do not try to pull or cut a thread yourself.

If you had threads elsewhere and are concerned, Dr Sin Yong can assess the face at IN Eternity Clinic, explain what he finds and whether to wait, adjust or remove, and coordinate with your original clinic where that helps. If a thread lift was not the right fit, alternatives are discussed once the tissue has settled: the VF Lift – Vertical Facelift for leaner faces and Time Freeze Laser LCLR® for fuller lower faces. Dr Sin Yong’s own thread protocol is described on The Bliss Lift page.

Common myths, answered

• Myth: A dimple after a thread lift means it has failed.
  Fact: Small dimples are common in the first days and usually smooth out as swelling settles. Persistent ones can often be released.
• Myth: More threads give a stronger and longer lift.
  Fact: Beyond a point, more threads add tension, dimpling and extrusion risk without lasting benefit.
• Myth: Threads cannot be removed once placed.
  Fact: A thread that is visible, extruding or infected can usually be removed through a small opening.
• Myth: Thread complications are always serious.
  Fact: Most are minor and temporary. Nerve and salivary gland problems are rare but need prompt assessment.
• Myth: Absorbable threads cannot cause problems later.
  Fact: Lumps, visible threads or extrusion can appear weeks to months later, before the thread has fully absorbed.