Case report of unusual complication following thread lifting: an obstructive stone in the parotid duct

Date 25 June 2025

Abstract Advances in plastic surgery have included a shift toward less invasive procedures. To improve outcomes and avoid incisional surgery, numerous noninvasive face-lifting techniques have been studied. This includes threadlifting, a technique that promises to correct facial aging with limited scarring, rapid recovery, and minimal complications. As the population ages, an increasing number of ordinary people in South Korea are undergoing thread lifting procedures for the purpose of rejuvenation. The procedure involves insertion of a thread under the skin into the subcutaneous tissue, using a long needle as a guide. Dents or barbs prevent the thread from slipping and provide uniform aggregation of soft tissue to create a new volume contour when the thread is lifted. This procedure has gained worldwide popularity and is frequently performed. However, some minor complications have been reported. In this paper, we report an unusual complication: an obstructive stone in the parotid (Stensen) duct after a thread-lifting procedure using nonabsorbable anchoring threads.  INTRODUCTION The thread-lifting procedure using Aptos thread was introduced by Dr. Sulamanidze in the late 1990s. Compared to general incisional surgery, thread lifting is a minimally invasive procedure for facial rejuvenation [1,2]. It became more popular after it was approved by the U.S. Food and Drug Administration in 2005 [3,4]. Since then, various techniques have been developed. Some authors have reported delayed complications, including foreign body granuloma and great auricular nerve neuropathy after thread-lifting procedures using nonabsorbable polypropylene thread. As a result, many doctors adopted the use of absorbable suture materials, assuming this would be a better option for improving skin texture and addressing safety concerns. In South Korea, however, even general practitioners who have not received plastic surgery education can perform this procedure for members of the public. Unfortunately, there have been several reports of acute and delayed complications. Complications can include mild facial asymmetry, erythema, hematoma, swelling, discomfort, eczema, thread exposure, and scarring. We present the case of a 70-year-old man who experienced an unusual complication after undergoing thread lifting with a nonabsorbable anchoring thread.

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