What are the side effects of a thread lift, and how common are they?
Most thread lift side effects are things like swelling, bruising and a pulling feeling that appear right after treatment and settle on their own within a few weeks. Because threads are placed under the skin, it is fair to expect almost everyone to have a little of this. What deserves concern is not these early reactions but what remains as time passes.
In an analysis that pooled 26 thread lift studies, swelling was the most common at 35%, followed by dimpling, where the skin looks pulled in, at 10%, numbness or tingling at 6%, threads that can be seen or felt at 4%, infection at 2%, and threads poking out through the skin at 2%. A more recent analysis divides them in a similar way. Swelling, bruising and pain appear within the first 4 weeks and settle without separate treatment, whereas visible or palpable threads, dimpling, altered sensation and thread exposure can remain beyond the early period or appear later.
In the same analysis, dissolving threads clearly caused less altered sensation and thread protrusion than non-dissolving threads. Dimpling and infection were also more frequent in people aged 50 and over. This does not mean the treatment is off limits with age, but the thinner and looser the skin, the more care is needed with the depth and direction in which the threads are placed.
How long does swelling last after a thread lift? When does it go down?
By the standard I give patients, thread lift swelling mostly goes down within 1–2 weeks. With Aptos, daily life is not much of a problem after just 2–3 days, and by about one week others can hardly tell. Many studies report swelling resolving within 2–4 weeks, so if your swelling is slow to go down, expect it may take that long. For a day-by-day timeline of Aptos recovery, see Aptos thread lift recovery.
The lifted shape shows right after treatment. At that point, though, swelling and pulling are mixed in, so it is not the final shape, and it settles naturally over 1–2 weeks. If the threads were pulled toward the back of the face, near the hairline, that side can swell a little for the first few days and make the area beside the cheekbones look bigger, but this is swelling and improves quickly.
Apart from swelling, the foreign-body feeling where the threads were placed fades over 4–8 weeks. The lifting effect settles at around 2–3 months, when collagen reorganizes, so the shape after the swelling has gone down keeps changing a little until then.
How bad are the bruising and pain after a thread lift?
Bruising after a thread lift can last about 1–2 weeks. In studies, too, bruising usually disappeared within 1–3 weeks without separate treatment. If you have an important event, I recommend leaving at least 2 weeks.
Pain is usually less than people expect. With Aptos, the anesthetic injection hurts briefly, and while the threads are placed you are numb, so it hardly hurts. Even when only numbing cream is used, it feels more like pulling than pain.
Thread lift precautions: how long should you avoid opening your mouth wide, massage, alcohol and saunas?
How long the precautions last after a thread lift depends on the type of thread, so go by the treatment you had. For all types, avoid alcohol and saunas for 1 week after treatment.
- Aptos thread lift: for 2–3 weeks after treatment, do not open your mouth wide or massage your face.
- dissolving threads (standard cog threads, MINT and similar): for 1 week after treatment, avoid opening your mouth wide.
What does a failed thread lift look like? Why do dimpling and prominent cheekbones happen?
The failures most talked about after a thread lift are dimpling, where the skin looks pulled in, and cheekbones that stand out. Swelling and bruising pass, but these two come down to which layer the threads were placed in and in which direction.
Dimpling is when the skin catches on a thread and looks pulled in. It can happen when threads are placed in a layer that is too shallow, or when threads that grip in only one direction are pulled too hard. This is also why I use Aptos. Aptos threads are much longer and cross about 3 times, giving a force similar to 3 cog threads, and they hold more firmly by pulling across a surface rather than at a point.
In my experience, dimpling usually improves a lot within about 2 weeks. In studies, too, dimpling resolved on its own within 3–6 months in several cases, while some needed massage or a small corrective procedure. Asymmetry, where the two sides look different after treatment, is often dimpling that makes it look that way. When needed, I also reduce the subcutaneous fat layer to even out the two sides.
Prominent cheekbones happen when the pulling direction is set wrong. On the other hand, when threads are pulled toward the back of the face near the hairline, the area beside the cheekbones can look bigger, but that is early swelling and improves quickly.
If a thread lift has no effect, is that a failure? What about faces where the effect falls short?
When there is little difference after a thread lift, the shortfall often comes not from the treatment being done wrong but from threads being placed in a face that threads cannot fix.
- If the skin tissue has stretched so much that there is a lot of it or it is heavy, the threads may not be strong enough. For such faces, we usually reduce fat with another lifting treatment or first improve the firmness of the skin surface.
- A face that looks saggy because of heavy jowls, or one with a lot of flesh sagging over the nasolabial folds, will not fully improve just by pulling. In that case, reducing only the subcutaneous fat layer can make the face look much lighter. How fat is dealt with is covered in a separate guide on how far ONDA can go for a double chin and facial fat.
- A face that looks saggy because it has hollowed, not because it has dropped, needs filling, not pulling. For this case, see the separate guide on whether Ultherapy or ONDA is right for hollow cheeks or nasolabial folds.
- Placing threads in advance as prevention when there is still hardly any sagging is a case where it should not be done. I recommend a thread lift only when tissue has actually dropped, not based on age.
When to have a thread lift, how long the effect lasts, and when to have it again are summarized in a separate guide on Aptos thread lift timing.
Do thread lift threads dissolve? When do they need to be removed?
The dissolving threads used in a thread lift break down completely over time, so there is no need to worry that they will stay behind. In 14 years of performing thread lifts, the only time I have had to remove threads was 1 case of an allergic reaction to the thread, and everyone else had no problems.
Threads need to be removed when they have gone into the wrong layer or position. If they were placed at the correct depth and position, there is almost no reason to worry about removal.
Studies report that thread ends that can be felt or seen sometimes remain for weeks to months, and rarely needed massage, repositioning of the thread or removal. However, when an experienced doctor performs the treatment, you can assume thread ends are almost never exposed.
How long threads take to dissolve depends on the material: PDO threads are absorbed in about 6–8 months, PLLA threads in about 12 months, and PCL threads in about 12–18 months, while polypropylene threads do not dissolve and remain. Aptos is a lactide‑caprolactone copolymer thread with hyaluronic acid added, and collagen forms around it as it dissolves. Still, how long a thread takes to dissolve and how long the effect shows on the face are not the same thing.
Whether a shape or symptom after treatment is just part of the process is something I judge by seeing you in person. How to get here is on the visit page.