Facial Thread Lifting Complications in China: Analysis and Treatment

Background: Facial thread lifting technology has been applied for more than 30 years, with relatively few complications. In 2014, China approved polydioxanone thread (an absorbable barbed thread) for large-scale nonsurgical facial lifting. However, due to surgeons’ lack of overall experience, the complications of polydioxanone thread facelift have been relatively high. Methods: From April 2014 to January 2020, a total of 190 patients with postoperative complications of facelifts were treated after they underwent thread lifting in other hospitals. Of these, 189 patients were women and one was a man; the age of patients ranged from 28 to 62 years, with an average age of 37.4 years. Results: Patients were mainly treated in our outpatient clinic for the following complications: skin dimpling (77 cases, 40.5%); contour irregularity (32 cases, 16.8%); visible threads (31 cases, 16.3%); thread extrusion (10 cases, 5.3%); infection (17 cases, 8.9%); swelling (nine cases, 4.7%); incomplete facial paralysis (five cases, 2.6%); hyperpigmentation (four cases, 2.1%); hematoma (four cases, 2.1%); allergy (one case, 0.05%). Follow-up was scheduled 1–24 weeks after treatment. Conclusions: The most common complications of facial thread lifting are, in the following order, skin dimpling, contour irregularity, visible threads, and thread extrusion. The reasons for complications are mainly unfamiliarity with facial anatomy, unskilled surgical operation, and misunderstanding of the facial aesthetics of Asian women.