Causes of Unevenness and Dimpling After Thread Facelift and Effective Solutions

Hello, if you are concerned about unevenness and dimpling after a thread facelift, or wondering why skin deformities appear after the procedure, the doctor will provide a detailed explanation so you can clearly understand the medical basis, the factors causing this condition, and the safest and most effective treatment options. Identifying the correct cause will help you avoid complications and maintain long-lasting, natural rejuvenation results.

Why Does Unevenness Occur After a Thread Facelift?

The doctor explains as follows: facial rejuvenation using threads resulting in unevenness occurs when the thread placement is technically incorrect or when the skin tissue does not respond well to the threads. Essentially, thread lifting involves inserting barbed or smooth threads beneath the skin to anchor into tissue, creating a lifting force and stimulating collagen production. Therefore, if the threads are placed at the wrong layer, in the wrong direction, or with uneven tension, the skin will develop visible ridges, elevations, and depressions.

The first and most common cause is placing the threads too superficially. When threads are located close to the skin surface, the barbs or thread body can become visible or palpable under the skin, creating raised lines along the thread path. This is also why patients may feel lumps or irregularities when touching the area.

Conversely, if the threads are placed too deep or not anchored properly in the SMAS layer, the lifting force becomes insufficient, resulting in some areas being over-tightened while others are not lifted, causing uneven skin contours.

Another important cause is uneven tension distribution between both sides of the face. Thread lifting requires precise determination of lifting vectors; if miscalculated, the skin may be pulled asymmetrically or excessively, leading to localized indentations.

In addition to technique, thread quality plays a significant role. Poor-quality threads can cause irritation, tissue fibrosis, or incompatibility with the body, leading to firmness, lumps, and irregularities under the skin. Threads of unknown origin may also contract over time, resulting in skin deformation.

Some cases of uneven thread lifting occur due to thin skin with minimal fat tissue, making the threads more visible even when correctly placed. Alternatively, it may result from post-procedural tissue inflammation, which is usually temporary and improves after a few weeks.

Factors Causing Complications After Thread Facelift

There are several factors contributing to unevenness complications, explained clearly as follows:

• First is the doctor’s expertise. This is the most critical factor. Thread lifting is not simply inserting threads into the skin; it requires a deep understanding of facial anatomy, tissue thickness at different areas, and the direction of soft tissue sagging. Inexperienced practitioners have a high risk of incorrect placement and improper lifting direction.
• Second, a non-sterile environment increases the risk of subdermal infection. Inflamed tissue can become swollen and firm, forming uneven lumps and depressions.
• Notably, threads of unknown origin that do not meet FDA/KFDA standards can trigger rejection reactions, leading to fibrosis, nodules, thread exposure, skin indentation, or facial distortion.
• Patients touching their face, massaging vigorously, or lying on their side too soon after the procedure can cause thread displacement, resulting in uneven skin surfaces.

Additionally, choosing the wrong method can also lead to complications. For example, individuals with severe aging (deep folds, significant tissue sagging) who only undergo thread lifting may not achieve sufficient lifting force, leading to uneven tightening or rough skin texture.

Effective Solutions for Uneven Thread Facelift

Treatment depends on the severity, as explained below:

• If the condition is mild swelling-related lumpiness, the doctor may prescribe anti-inflammatory medication combined with proper cold and warm compresses. This mild group usually improves naturally within 2–6 weeks.
• If unevenness is caused by superficial thread placement, the doctor may perform a “thread pressing and smoothing” technique using a nano needle to reposition the thread into the correct tissue layer. This must be done gently to avoid thread breakage or inflammation.
• In cases of uneven tension or incorrect vector placement, the doctor will adjust the tension or add additional threads to balance both sides of the face.
• If the tissue shows fibrosis or rejection reaction, more intensive intervention is required, such as thread removal, inflammation management, and waiting for tissue stabilization before re-treatment with more suitable threads.
• For severe unevenness, significant sagging, or repeated thread lift failures, the optimal solution is switching to SMAS 4K facelift or Deep Plane facelift, which address the root cause of tissue sagging and provide more stable rejuvenation results compared to thread lifting.

At Gangwhoo Cosmetic Hospital, advanced corrective and facelift procedures are performed using Harmonic scalpel systems and 4K endoscopic microsurgery, allowing doctors to precisely operate on each tissue layer, reducing invasiveness, minimizing swelling, and accelerating recovery.

Unevenness after thread lifting is often caused by improper technique or unsuitable thread materials. However, most cases can be corrected with proper assessment and timely treatment.

If you are experiencing unevenness after a thread facelift or wish to reassess your skin condition, the doctor recommends visiting Gangwhoo Cosmetic Hospital for a direct examination using endoscopic evaluation and receiving the safest and most effective treatment plan.