Thread lift gone wrong: dimpling, visible threads, asymmetry and infection

Do thread lifts often go wrong?

Thread lifts usually do not go wrong in a lasting way: most side effects are common, mild and temporary, and serious complications are rare.

Two large reviews give a fair picture of how often problems happen:

• A 2021 meta-analysis of 26 studies estimated pooled rates of swelling at 35%, skin dimpling at 10%, altered sensation (paraesthesia) at 6%, a thread that could be seen or felt at 4%, and infection and thread extrusion at about 2% each.
• A 2021 systematic review of 59 studies covering more than 14,000 people found that asymmetry, swelling and bruising were the most frequently reported effects, and that most were temporary and settled on their own. Serious problems such as nerve or gland injury were rare.

A 2025 systematic review limited to absorbable threads, covering 19 studies and 1,406 patients, found bruising, swelling and tenderness were the most frequent effects, while haematoma, altered sensation and infection were the least frequent. Barbed threads and threads that were not anchored at one end were linked with more complications than smooth or fixed threads.

The 2021 meta-analysis also found that dimpling and infection were reported more often in people over 50, and that absorbable threads were linked with less extrusion and altered sensation than non-absorbable ones. In the 2021 systematic review, contour irregularities, infections and inflammatory reactions were among the few effects that did not settle on their own.

In practice, what looks wrong in the first week is often normal swelling or early puckering; the sections below explain how to tell when it is something more. For background on how threads work, see our thread lift guide.

What is normal in the first two weeks

In the first two weeks after a thread lift, swelling, bruising, tightness, tenderness and small areas of puckering are normal and usually ease day by day. The face can also look slightly over-lifted or uneven at first, because swelling is rarely identical on both sides.

• Days 1 to 3: swelling, bruising and a tight or pulling feeling, especially when you smile, chew or yawn. Small marks at the entry points are expected.
• Days 4 to 7: swelling and bruising fade. Tiny dimples near where threads anchor often soften as the tissue settles around the cogs.
• Weeks 2 to 4: the face looks more natural, and remaining tenderness is usually mild. This is when it becomes fair to judge symmetry.

Aftercare is designed to protect the threads while they grip. SkinRev's own aftercare advice is to sleep on your back with your head raised for the first nights, use cold packs as advised, and avoid wide mouth opening, hard chewing, heavy exercise and saunas in the first week. Facial massage, facials, dental work and energy-based treatments on the area are avoided for two to four weeks unless the doctor agrees.

What is not normal is change in the wrong direction. Swelling that grows after day three, pain that increases rather than eases, redness that spreads, a thread that appears at the skin, or a deep dent that is still obvious after two weeks are all reasons to contact the doctor who treated you.

Dimpling, puckering and lumpy areas

Dimpling is one of the most common visible thread lift problems, and early dimples often settle on their own within one to two weeks. They appear when the barbs or cogs of a thread catch the skin from below, or when a thread sits closer to the surface than intended.

Why it happens. Dimples are more likely where the skin is thin, where the face moves a lot, and where a single thread carries a lot of tension. The 2021 meta-analysis found dimpling reported more often in people over 50, whose skin is usually thinner and less elastic.

What usually helps.

• Time: as swelling subsides and tissue grows around the thread, small dimples often fade.
• Patience with your face: avoid exaggerated expressions and do not press, knead or massage the area yourself unless the doctor shows you how.
• Review: if a dimple is still obvious after two weeks, the doctor may gently release the skin, adjust tension, or wait for an absorbable thread to soften.
• Removal: a thread that keeps causing a deep or tethered dent may need to be removed by a doctor. This is easier soon after placement than months later, once tissue has grown around it.

Lumps along the line of a thread are different from dimples. A firm, tender lump that grows, feels hot or comes with redness can be an inflammatory reaction or an early infection, and should be seen by a doctor rather than watched.

Visible, palpable or extruding threads

A thread end that you can feel or see, or one that pokes out through the skin, is not something to manage at home; it needs the treating doctor. In the 2021 meta-analysis, a visible or palpable thread was reported in about 4% of cases and extrusion in about 2%, with extrusion less common for absorbable threads.

Where it tends to happen. Thread ends most often show near entry points, along thin skin such as the temple or lower eyelid area, and at the nose tip after a nose thread lift. Threads placed too close to the surface are the usual cause, and facial movement can work an end towards the skin over time.

What to do now:

• Do not pull, cut or push the thread back in yourself.
• Keep the area clean and dry, and cover it loosely if it catches on clothing or a pillow.
• Take a clear photo and contact the doctor who placed it, especially if there is redness, discharge or pain.

How doctors usually manage it. A thread end that is simply palpable may settle as the thread absorbs. An end that has come through the skin is usually trimmed or removed under sterile conditions, because an exposed thread can let bacteria track inwards. On the nose, removing a thread can reduce tip support, which is one reason the doctor will plan this carefully. You can read more on our nose thread lift page.

Asymmetry: swelling or a real imbalance?

Most asymmetry after a thread lift is caused by uneven swelling and settles within about two weeks, so it is fair to wait before judging the result. In the large 2021 systematic review, asymmetry was the most frequently reported effect, and most cases were temporary.

Uneven swelling is common because the two sides of the face rarely bruise or swell equally, and because most people sleep, chew and smile slightly differently on each side. Faces are also naturally asymmetric before treatment, and a lift can make an existing difference more noticeable.

Signs that the imbalance may be real:

• One side still looks clearly higher or tighter after swelling has gone, usually beyond two to four weeks.
• One side has dropped back while the other still holds, which can happen if a thread has slipped or broken.
• There is a fold, bunching or ridge on one side only.

What usually helps. The doctor compares your face with photos from before treatment, checks how each thread is sitting, and decides whether to wait, adjust, add support on the weaker side, or use another treatment to balance the face. Pre-treatment photos are important here, because they show which differences were already present. If you did not have photos taken, older everyday photos taken straight on can still help.

Infection, inflammation and nerve problems

Infection after a thread lift is uncommon, estimated at about 2% in the 2021 meta-analysis, but it needs prompt medical care. Threads are foreign material, so bacteria that reach them can be harder to clear than a simple skin infection.

Warning signs of infection:

• redness that spreads or deepens rather than fades
• heat, throbbing or pain that increases after the first few days
• pus or discharge at an entry point, or a tender swelling that grows
• fever or feeling unwell

Most infections appear in the first days to weeks, but late infections and inflammatory lumps can appear weeks or months later. Treatment is decided by a doctor and may include prescription medicine, draining a collection, and sometimes removing the thread. Do not wait to see whether it settles.

Inflammatory reactions can look like firm, tender lumps along a thread without obvious infection. They also need assessment, because they can look similar to an early infection.

Lasting nerve and gland injuries are rare. Altered sensation, such as tingling or numbness, is relatively common and usually temporary. Weakness of a facial muscle, pain that does not settle, or swelling in front of the ear that comes and goes with eating are unusual and should be checked by a doctor promptly.

Thread lift problems at a glance

The table below matches each common thread lift problem with what it looks like, its usual cause, what tends to help, and how quickly to act.

If more than one row fits, act on the most urgent one. When in doubt, a photo sent to the treating clinic is a quick way to find out whether you need to be seen in person.

What to do now if you think your thread lift has gone wrong

If you think your thread lift has gone wrong, contact the doctor who placed the threads first, because they know which threads, how many and where. Then follow the level of urgency that matches what you see.

1. Check for urgent signs. Spreading redness, heat, discharge, fever or pain that keeps increasing need same-day medical care. So does a thread poking through skin that looks red or wet.
2. Photograph the area. Take photos in the same light each day from the front and both sides. A series of photos shows whether things are improving.
3. Leave the threads alone. Do not massage hard, pull at a thread end or apply heat. Keep entry points clean.
4. Pause other treatments. Avoid facials, massage, energy-based treatments and dental work on the area until a doctor has reviewed it.
5. Give normal healing its time. If there are no urgent signs, mild dimples and unevenness are usually reassessed at around two weeks.
6. Ask for a review or a second opinion. If your provider is not reachable, or you would like another view, a doctor can examine the area and explain options.

Bring whatever you know about the treatment to any review: the date, the type of thread if you were told (PDO, PLLA or PCL), the number of threads and where they were placed. Our guide to common aesthetic treatment mistakes has more on what to keep a record of.

How thread lift problems are assessed and corrected

A doctor assesses a thread lift problem by examining the face at rest and in movement, feeling along each thread line, and asking when the problem started and what was placed. The goal is to work out whether the issue is swelling, a dimple, a superficial or broken thread, an infection or an inflammatory reaction.

From there, the options usually fall into four groups:

• Watch and wait, with a set review date, for mild dimples, mild asymmetry and palpable threads that are likely to soften as an absorbable thread breaks down.
• Adjust, for example gently releasing skin caught by a cog or rebalancing tension, when the problem is mechanical and found early.
• Remove, for a thread that has come through the skin, keeps causing a deep dent, or is involved in an infection. Removal is a medical procedure, and it can be harder once tissue has grown around a thread.
• Treat the tissue, such as managing infection or inflammation first, then deciding later whether any refinement is needed once everything has settled.

At SkinRev Lab, Dr Sin Yong performs face thread lifts using his Bliss Lift protocol and a PDO nose thread lift, and he can examine thread problems from a lift done elsewhere. He will explain what he finds, which option he would suggest, and whether it can be done at the clinic or needs referral to a surgeon. No correction can promise a particular result, and the plan depends on the thread type, how long ago it was placed and how the tissue has healed.

How to lower the risk before a thread lift

You lower the risk of a thread lift going wrong mainly by being a suitable candidate and by choosing a doctor who plans the threads around your anatomy. Threads suit early to moderate sagging where tissue is still mobile; they do not remove skin, tighten heavy laxity or replace lost volume.

A thread lift is usually postponed or avoided with: pregnancy or breastfeeding, active infection or acne in the area, uncontrolled diabetes, a bleeding disorder, or blood thinners that your doctor advises you to keep taking.

Questions worth asking any provider:

• Is a doctor assessing me and placing the threads, and how many thread lifts does the doctor do?
• Which threads will be used, how many, and where will the entry points be?
• What will you do if a thread shows, a dimple does not settle, or I get an infection?
• Is a review visit included, and when?
• Will photos be taken before treatment?

Clear, unhurried answers are a good sign. If a thread lift is not right for you, there are other routes. At our aesthetic centre, SKINLIFT® is a non-medical, non-needle treatment performed by Aesthetic Therapists; it is painless for most people, and SKINLIFT® Face is S$888 per session before GST, excluding eyes and neck. Medical options such as HIFU are assessed by Dr Sin Yong. Our guide to surgical and non-surgical face lifts compares the wider choice.