What to look out for after a thread lift

Why the Period After a Thread Lift Is Different

A thread lift works differently from filler. Filler adds volume to the tissue and has its effect by filling the area where it is placed. A thread lift adds no volume; instead, a barbed thread is placed inside the tissue, and the thread does its job by holding the tissue around it. This is why the rules after the procedure are different from those after filler.

According to the published sources, barbed threads create a supporting structure under the skin and mechanically reposition soft tissue that has shifted. A connective tissue response also develops between the thread and the tissue around it. Fibrosis – the build-up and hardening of connective tissue between the thread and the tissue – is this very response. It is reported that dimpling that is not corrected in the early period can become permanent in this way. In short, both the way the thread holds and the tissue that carries it change over time.

All the restrictions in the early period are there to protect these two processes. While the thread has not yet settled into the surrounding tissue, pressure on the face, tension and large movements can change both where the thread holds and how it holds.

What You May Feel in the First Few Days

Most of the sensations reported in the first few days after a thread lift are an expected result of the procedure. You may feel pain when your mouth moves as you talk or make facial expressions; this pain is reported to be especially noticeable when eating and when smiling broadly. A feeling of tightness, itching and warmth, which can last a few days, may also occur during this period.

Swelling and bruising are the most commonly reported findings in the early period. If a large blood vessel has been affected, the initial swelling and bruising can last longer.

If the thread is placed too deep – into the fat layer beneath the SMAS (superficial musculoaponeurotic system), the face’s superficial layer of muscle and connective tissue – difficulty opening the mouth and tingling or pins and needles, even at rest, can occur; in severe cases, these changes in sensation last longer. This is not the normal course after the procedure; it is related to the depth at which the thread was placed.

Why Facial Expressions and Movement Are Restricted

Facial expression is a repeated force that pulls the soft tissue of the face in the same direction every time. Once a thread has been placed, this force acts not only on the skin but also on the barbs that hold the skin. This is why you are advised to avoid opening your mouth wide and pressing firmly on your face in the early period.

There is, however, a contradiction you should know about: it is also reported that dimpling caused by the barbs gripping the tissue too tightly often improves gradually with normal facial movement and everyday activities. In other words, movement carries a risk but also has a corrective effect.

This contradiction cannot be resolved with a general rule. The doctor who performs your treatment decides which movements are restricted and for how long; you will get the number of days from your doctor’s instructions.

As the swelling goes down and the pain passes, your facial movements become natural again. It is reported that at exactly this stage, as muscle and skin movement increases, the lines of the threads can become visible or able to be felt; for this reason, it is recommended that patients are told about this possibility in advance.

Sleeping Position and Touching the Face

Sleeping face down means continuous pressure on your face from one direction for hours; no movement you make consciously while awake lasts that long. For about one week after the procedure, you are advised to sleep on your back and to keep pressure off the treated areas.

You are also advised to keep your head above the level of your heart so that swelling does not collect in your face. Both recommendations have the same aim: while the tissue settles into place, it should not be under pressure, and fluid collecting there should not increase the tension.

Contact with the face is not only about sleep. For one to two weeks after the procedure, depending on your situation, you are advised not to massage your face or press firmly on it. This advice applies to massaging and rubbing your own face; massage that a doctor performs to correct dimpling is an entirely different procedure, and it is done by the doctor.

Cleansing, Heat and Exercise

The sources say different things about cleansing. According to one source covering preparation before and after the procedure, you can wash your face and have a gentle shower on the evening of the procedure, and make-up and light exercise are possible from the next day. Another source, which looks at the unwanted outcomes of the procedure (complications), recommends not washing the face for the first 48 hours so that the entry points – the points where the thread is inserted through the skin – do not become contaminated.

This difference is not a mistake; it is the same risk being weighed in different ways. Your doctor, who knows where the thread was placed and where the entry points are, will tell you which applies to you.

On heat, the sources are closer to each other. The first source recommends avoiding saunas, spas, swimming pools and alcohol for about one week after the procedure, but does not explain why. Possible reasons are that heat widens the blood vessels and increases swelling, and that in a pool the entry points stay in contact with water.

With exercise, what matters is not the movement itself but the load on the face. The same source considers light exercise possible from the next day; weightlifting, head-down positions and activities with a risk of a blow to the face are things you need to discuss separately with your doctor.

Opening the Mouth Wide, Hard Foods and the Dentist’s Chair

Opening your mouth wide is the movement that stretches the tissue in the lower half of the face the most in a single moment. For one to two weeks after the procedure, you are advised not to open your mouth wide and to avoid hard foods. Chewing also falls into this category: hard foods make the jaw muscles work for a long time and with great force.

Dental treatment is not covered separately in the sources, but why it matters is clear: in the dentist’s chair your mouth stays wide open for a long time, so the movement you are advised to avoid in the early period lasts for minutes. If you have dental treatment planned, it is a good idea to tell your doctor before the procedure so that the order of the two can be decided.

Jaw clenching is a separate issue. In the source that looks at complications, the patient clenching their teeth or moving involuntarily during the procedure is mentioned together with the risk of injury to a salivary gland. This warning relates to the time of the procedure itself; even so, if you have a habit of clenching your jaw, that is reason enough to tell your doctor.

The inside of the mouth matters for another reason too: it is reported that thread ends can work their way out over time, through the skin or inside the mouth. So if you feel a hard tip inside your mouth, do not ignore it.

Side Effects Reported in the Early Period

A 2026 meta-analysis (an analysis that combines the results of many studies) divides side effects after a thread lift into two groups according to timing. The early group includes those that appear within the first four weeks: swelling, pain and bruising (ecchymosis). These are expected and mostly settle on their own.

The figures from two separate meta-analyses are close to each other. Swelling was reported at a rate of 34% in the 2026 study; in a 2021 meta-analysis covering 26 studies, the rate was 35%. Bruising was reported at a rate of 26% in the 2026 study. In other words, the most common finding is not a complication but the usual early response to the procedure.

What really matters about the early period is that a problem noticed at this stage is easier to correct. The sources recommend that patients are asked back for a follow-up visit a day or two after the procedure, and that any signs appearing as the swelling goes down are assessed at that visit.

Side Effects Reported in the Late Period

According to the 2026 meta-analysis, problems that continue beyond four weeks or appear after that point belong to the late group, and these can be more important clinically: a thread becoming visible or able to be felt, skin dimpling and the thread shifting position. In this study, a thread that could be seen or felt was reported at a rate of 10%, and skin dimpling at 7%.

In the 2021 meta-analysis the rates are slightly different: dimpling 10%, altered sensation such as tingling or pins and needles (paraesthesia) 6%, a thread being visible or able to be felt 4%, infection 2%, and thread extrusion (a thread working its way out through the skin) 2%. In the same study, satisfaction was 98% immediately after the procedure but fell to 88% in the long term.

One finding from this study relates directly to the type of thread: with permanent (non-absorbable) threads, paraesthesia was reported at a rate of 11.7% and extrusion at 7.6%; with dissolvable threads, these rates were 3.1% and 1.6% respectively. Rates of dimpling and infection were also higher in people over the age of 50. According to a comprehensive review of thread lifting, early studies reported high rates of corrective procedures (revision) and complications with treatments using permanent threads; with newer techniques using dissolvable threads, side effects have decreased, but long-term effectiveness remains uncertain.

There is another side to the picture. In a study using permanent silicone threads, in which 51 patients were monitored with ultrasound, no thread shifting (migration) was found in any patient; the thickness of the threads stayed stable within a certain range after the sixth month. The most commonly reported side effect in this study was swelling. In short, no one-sentence conclusion can be drawn about permanent threads; the material, technique and follow-up are assessed together.

Dimpling and Irregularities: Causes and What Can Be Done

Dimpling is the concern raised most often in the sources. Its cause is clearly described: when the barbs grip the skin and soft tissue too tightly, a sunken mark forms where the thread runs. These marks can appear immediately after the procedure or gradually over days and weeks; some of them are reported to resolve on their own.

But there is a limit to waiting for them to resolve on their own. It is recommended that these irregularities are dealt with without delay; the reason given is that fibrosis develops between the thread and the tissue and the depression becomes permanent. When massage and moulding from the surface are not enough, skin caught on a barb can be released by injecting saline (a salt-water solution) into the sunken area; in pronounced cases, improvement takes longer.

There is an important distinction here. In the early period you are advised not to massage your face; here, though, massage appears as a treatment method. This is not a contradiction: one is random pressure that a person applies to themselves, the other is a procedure that a doctor carries out on a specific spot for a specific purpose. If you notice skin dimpling, do not press on it yourself; contact the clinic.

Not every irregularity has the same cause. Some irregularities at the edges of the area the thread runs through are said to result from the structural difference between areas with and without a thread, even when the skin is not caught on a barb; this is more noticeable in skin that has lost its elasticity. Linear depressions along the line of the thread, on the other hand, are linked to the thread being placed too close to the skin surface or to the tissue being thin.

The rates vary depending on which group of patients is looked at. In a series of 190 patients who had been treated elsewhere and were referred because of complications, the breakdown was: skin dimpling 40.5%, uneven contours (contour irregularity) 16.8%, visible thread 16.3%, infection 8.9% and thread extrusion 5.3%. These percentages do not show the situation across all treatments; they show the breakdown among people who came forward because they already had a problem, so they cannot be read as a risk rate.

Signs of Infection and When to Call the Clinic

Infection is reported only rarely after a thread lift, but it needs attention without delay. Signs of inflammation along the line of the thread, such as redness, increased warmth and swelling, suggest an infection in the skin.

What usually distinguishes normal swelling after the procedure from swelling caused by infection is how it spreads and how it changes over time. Normal swelling spreads across the treated area and goes down over time; signs of inflammation, by contrast, are concentrated along the path of the thread and increase instead of going down. The definite distinction is made at an examination.

On prevention, the sources are clear. Together, they recommend cleaning the skin before the procedure with a suitable antiseptic (a germ-killing solution), following the rules for germ-free working throughout the procedure (aseptic technique), using preventive antibiotics after the procedure and keeping the entry points free from contamination for the first 48 hours. Your doctor decides whether you will take any medicine and for how long; this information is not a recommendation to take medicine but an explanation of what prevention is based on.

Contact the clinic without waiting for your next follow-up visit if you have any of the following:

• Swelling that increases instead of going down.
• Redness and increased warmth along the line of the thread.
• Fever.
• A thread end that you can feel through the skin or inside your mouth.
• New asymmetry, or weakness in facial expression on one side.

How to Read the Figures in the Research

When you read a rate, it is important to know which study it comes from. The 2026 meta-analysis reports that variation between studies is very high: the measure of this variation (heterogeneity) is 92% for swelling, 88% for a visible thread and 76% for dimpling. This means the same side effect is seen at very different rates from one study to another.

Assessments in this field point in the same direction. A study reviewing a ten-year period of thread lifting carried out through the skin (percutaneous) states that no new evidence supporting the use of the method was added during that time, and stresses that patients should be well informed about side effects, how long the effect lasts and the limits of the data.

Older studies widen the picture further. In a retrospective review of 29 patients who had a lift with barbed threads, the side effect rate was reported as 69% and the rate of sagging returning early (early recurrence) as 45%. This study reflects the technique of its time and cannot be compared directly with current practice; but it shows why the data on this subject cannot be summed up in a single figure.

In follow-up, however, there has been progress: high-frequency ultrasound is reported to be usable for imaging how the thread looks under the skin, how deep it lies and possible complications. In other words, locating a problem no longer depends only on examination by hand.

In short, these percentages do not show your personal likelihood; they show how scattered the data on this subject are today. The only assessment that applies to you is the one made at a consultation, based on what your doctor finds at the examination.

The Source of Your Instructions and the Limits of This Page

Thread lifts at the clinic are carried out with dissolvable threads. After treatment, the only valid source of your instructions is the doctor who placed the threads, because which restrictions apply, and for how long, depends on the area, the layer and the direction in which the thread was placed. Nothing on this page replaces those instructions.

This article has a more limited aim: to show the reasons behind the instructions. Someone who knows why a rule exists follows it more accurately; a number of days given without knowing why facial expressions should be avoided is abandoned the first time things get difficult.

For detailed information about the treatment itself, when it is considered and its limits, see the French Thread Lift page. This article does not describe how the procedure is done; it describes what happens in the tissue afterwards.

Reading about what happens after a treatment does not mean deciding to have it. You have the right to keep the two separate; your doctor assesses your findings, and you make the choice.