Facial Thread Lifting Complications in China: Analysis and Treatment

Date 25 June 2025

INTRODUCTION Thread lifting technology is a nonsurgical facial rejuvenation technology that can minimize postoperative recovery period and scar from the incision. In 1989, Sulamanidze first applied APTOS facial thread lifting by using nonabsorbable barbed polypropylene thread.1 Subsequently, Wu also reported on his own polypropylene barbed thread technology.2 The contour thread, also made of nonabsorbable polypropylene, has since been widely applied.3 Silhouette suture is another thread used in the United States.4 It is mainly composed of nonabsorbable polypropylene threads and absorbable cones that are made of copolymers of glycolic and lactic acid (PLGA). Quill suture, first used for wound sutures, has also been used in facelifts.5 Few reports of complications related to facial thread lifting have been reported. Since 2014, China has begun to approve absorbable threads for facelifts, such as polydioxanone (PDO) threads (including Quill and six other types of barbed sutures), and in 2018, PCL/PLA threads (HappyLift) were approved.6 However, due to surgeons’ lack of experience and skills, a relatively high rate of complications has been observed. With this series of retrospective cases, this article aims to discuss the causes, treatments, and precautions of these facelift complications.

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