Thread lift complications: the risks in numbers — what raises the risk and how to lower it
Thread lifting is often introduced as a ‘simple procedure’, but from a clinician’s point of view it is a treatment whose risk changes with where, what and how much is placed. This article looks at the size of the complications through the numbers in a meta-analysis and systematic reviews (three papers in all), and sets out the factors that raise risk and the design choices that lower it.
The short answer
Serious complications of thread lifting are rare, but dimpling, thread extrusion, sensory disturbance and infection are reported at frequencies that cannot be ignored. In a meta-analysis of 26 studies, dimpling was 10%, sensory disturbance 6%, visible or palpable thread 4%, infection 2% and thread extrusion 2%, with higher risk for non-absorbable threads and patients over 50 (Niu 2021). In a review pooling 14,222 patients, most events resolved on their own, with the exceptions of contour irregularity, vascular and salivary gland injury, infection and inflammatory reactions (Pham 2021). Miso Clinic (4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea; +82-53-428-2700) uses absorbable threads only, and checks risk factors before treatment to decide material, anchoring and layer.
How often do complications occur?
| Item | Niu 2021 (26 studies) | Ojha 2025 (19 studies, 1,406 patients) |
|---|---|---|
| Swelling | 35% | 16.79% |
| Bruising | — | 19.49% |
| Skin dimpling | 10% | — |
| Sensory disturbance | 6% | 1.14% |
| Visible or palpable thread | 4% | — |
| Infection | 2% | 2.49% |
| Thread extrusion | 2% | — |
| Haematoma | — | 0.64% |
The numbers differ because the reviews included different thread types (with or without non-absorbable threads), recorded events differently and followed patients for different lengths of time. In the review pooling 14,222 patients, asymmetry, swelling and bruising were the most common (Pham 2021).
What raises the risk?
- Non-absorbable threads — sensory disturbance 11.7% vs 3.1%, thread extrusion 7.6% vs 1.6% (Niu 2021)
- Over age 50 — dimpling 16% vs 5.6%, infection 5.9% vs 0.7% (Niu 2021)
- Barbed threads — more adverse events than smooth or cone threads (Ojha 2025)
- Floating (unanchored) threads — more adverse events than anchored threads (Ojha 2025)
- PCL threads and the midface — more swelling and bruising (Ojha 2025)
Why do dimpling and contour irregularity happen?
If the barbs catch a layer too close to the skin, or the pull is concentrated on one point, the skin can dent or become uneven. Most of this releases as the swelling goes down, but contour irregularity sometimes does not get better on its own, and adjustment or thread removal may be needed (Pham 2021).
That is why our standard approach is to keep the placement layer consistent and spread the pull across several anchoring points (clinical judgement).
Why take care around nerves, blood vessels and salivary glands?
Along the side of the face and under the jaw run branches of the facial nerve, blood vessels, and the parotid gland and its duct. Review studies reported rare vascular and salivary gland injury and sensory disturbance, and these injuries did not always get better on their own (Pham 2021).
The anatomy-based anchoring technique report is, in the end, also an attempt to anchor to ligaments and fascia while avoiding these structures (Yu 2026). Choosing entry points and layers that avoid danger zones is the core of thread lift design.
How are infection and thread extrusion managed?
Infection is rare, at around 2–2.5% (Niu 2021, Ojha 2025), but when it happens the thread sometimes has to be removed along with antibiotic treatment. Extrusion, where the end of a thread comes out through the skin, was far more common with non-absorbable threads (7.6% vs 1.6%, Niu 2021). If a thread end is visible or palpable, we trim or remove it ourselves. Please do not pull or cut it at home; contact us.
What we do to lower the risk
- We use absorbable threads only, and show you the material and approval of the product before treatment
- For people aged 50 and over, with thin skin or with marked sagging, we set the number and layer more conservatively, and first discuss whether a surgical consultation is the better fit
- We design anchoring points and vectors around the anatomy, and use entry points that avoid danger zones
- We disinfect the treatment area, use aseptic technique, and set the follow-up schedule in advance
All of this is clinical judgement, and we also explain that there is no way to reduce the risk to zero. The signs that mean you should contact us during recovery are set out in After a thread lift: swelling, bruising and pulling.
In these cases we do not recommend thread lifting
- When there is infection or inflammation in the treatment area
- When there is an uncontrolled bleeding tendency, or a situation where anticoagulants would have to be stopped without medical advice
- With a history of keloids or foreign-body reactions — please be sure to tell us at the consultation
- When earlier threads or permanent filler remain in the same area and their location is unknown
- When the sagging is severe enough that surgery fits the cause
Thread lift complications: frequently asked questions
How common are side effects of thread lifting?
In a meta-analysis of 26 studies, swelling was 35%, dimpling 10%, sensory disturbance 6%, visible or palpable thread 4%, infection 2% and thread extrusion 2%. Serious complications were rare.
Are dissolving threads safer than non-dissolving threads?
In a meta-analysis, absorbable threads had less sensory disturbance (3.1% vs 11.7%) and thread extrusion (1.6% vs 7.6%) than non-absorbable threads. Miso Clinic uses absorbable threads only.
Are side effects more common in older people?
Over age 50, dimpling (16% vs 5.6%) and infection (5.9% vs 0.7%) were more common. So we set the number and layer conservatively and first discuss whether surgery is the better fit.
What should I do if a thread comes out through the skin?
Please do not pull or cut it at home; contact us. We examine it in person and trim or remove it.
Can a thread lift damage nerves?
Rarely, sensory disturbance and vascular or salivary gland injury have been reported. We reduce the risk by choosing entry points and layers that avoid danger zones.
Where can I have a thread lift consultation in Daegu?
Miso Clinic is at 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, in front of Exit 1 of Kyungpook National University Hospital Station. +82-53-428-2700. Weekdays 11:00–19:00, Saturdays 10:00–16:00 (no lunch break); closed Sundays and public holidays.
Read next
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Who wrote this
Written and reviewed by Lee Chi-Hak, MD, director of Miso Clinic, Daegu. The treatment standards and injection design set out here are the ones we use in practice.
| Medical director | Lee Chi-Hak, MD |
|---|---|
| Address | 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea · Exit 1, Kyungpook National University Hospital Station |
| Phone | +82-53-428-2700 |
| Hours | Weekdays 11:00–19:00 (lunch 13:00–14:00) / Saturday 10:00–16:00 (no lunch break) / Closed Sundays and public holidays |
| Columns | All clinical columns |
| Reference library | All booster and device references |
References
- Meta-analysis of thread lift complications — Niu Z et al., Aesthetic Plast Surg 2021;45(5):2148–2158, PMID 33821308, DOI 10.1007/s00266-021-02256-w. Pooled 26 studies. Swelling 35%, skin dimpling 10%, sensory disturbance 6%, visible or palpable thread 4%, infection 2%, thread extrusion 2%. Absorbable threads had less sensory disturbance (3.1% vs 11.7%) and extrusion (1.6% vs 7.6%) than non-absorbable threads; patients over 50 had more dimpling (16% vs 5.6%) and infection (5.9% vs 0.7%). Satisfaction fell from 98% immediately after treatment to 88% at 6 months.
- Adverse events by absorbable thread material — Ojha AS et al., Dermatol Surg 2025;51(3):272–276, PMID 39442180, DOI 10.1097/DSS.0000000000004466. 19 studies, 1,406 patients. Bruising 19.49%, swelling 16.79%, tenderness 9.96%, infection 2.49%, sensory disturbance 1.14%, haematoma 0.64%. Swelling and bruising were more common with PCL threads, barbed threads and the midface; barbed threads had more adverse events than smooth or cone threads, and floating (unanchored) threads more than anchored threads.
- Systematic review of face and neck thread lift safety — Pham CT et al., Dermatol Surg 2021;47(11):1460–1465, PMID 34699439, DOI 10.1097/DSS.0000000000003189. 59 studies, 14,222 patients (mostly barbed threads). The most common events were asymmetry, swelling and bruising. Serious events were rare (sensory disturbance, hair loss, vascular and salivary gland injury), and most resolved on their own, with the exceptions of contour irregularity, vascular and salivary gland injury, infection and inflammatory reactions.
- PDO thread lifting anchored to anatomical structures — Yu AY, Pu LLQ, Plast Reconstr Surg 2026, PMID 41534851, DOI 10.1097/PRS.0000000000012812. A method that hooks the zygomatic-cutaneous ligament (ZCL), anchors to the superficial layer of the deep temporal fascia, and makes use of the malar fat and the platysma-auricular ligament, applied in 83 patients. The authors themselves wrote that the effect of PDO thread lifting is temporary. A technique report without a comparison group.
- Medical advertising law — Medical Service Act of Korea, Article 56(2), which prohibits testimonial advertising, comparison with other clinics, superlative claims and advertising that guarantees or implies a guaranteed treatment effect.
- Miso Clinic practice guidance — indication criteria, site-by-site design, and the explanation and consent procedure. This is the source for every sentence marked as clinical judgement.
Everything in this column is general information and does not replace medical diagnosis or treatment. Effects and side effects vary with individual skin condition, age and underlying illness, and the same result is not guaranteed for everyone. Any decision to proceed should be made in an in-person consultation with a physician.