The Facelift After Thread Lifting: Surgical and Aesthetic Complications.

[BACKGROUND] Thread lifting claims to help with facial rejuvenation and skin lifting. However, adverse effects and sequelae may pose a challenge to the plastic surgeon and expose the patient to increased risk of complications during a subsequent surgical facelift.

[OBJECTIVES] To examine the facelifts performed by the author on patients who had undergone thread lifting in the past.

[METHODS] A retrospective analysis of cases who underwent a facelift performed by the author from January 2021 to December 2023 was conducted. Exclusion criteria included a follow-up of less than 12 months after the surgical intervention and any other minimally invasive aesthetic treatments other than thread lifting performed prior to the surgery.

[RESULTS] Ten patients (nine female and one male) aged between 51 and 68 years (average, 59 years) were identified and included in the study. All patients had two or more thread lifting procedures with absorbable threads prior to their facelift surgery. The main pathological consequences found intraoperatively were fibrosis, tissue distortion, symphysis of anatomical layers, and decreased mobility of the SMAS, which made the surgical interventions tedious and increased the operating time. Suboptimal skin redraping and dimpling were visible in seven patients. Temporary paralysis of the mandibular branch of the facial nerve was observed in one case.

[CONCLUSIONS] The thread lifting procedure leads to tissue changes that last much longer than the lifting effect of the threads and their presence in the tissue. A facelift after thread lifting tends to be more difficult to perform with an increased risk of medical and aesthetic complications.

[LEVEL OF EVIDENCE IV] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .