Dimpling or puckering can occur when a lifting thread creates excessive or uneven traction on surrounding tissue. Patients may describe a dent, crease, pulled area, ripple, fold, stuck appearance or depression that becomes more visible during movement.
Possible contributing factors include superficial thread placement, a cog or barb engaging tissue too close to the skin, excessive tension, uneven distribution of lifted tissue, skin thickness, thread design, vector of insertion and individual anatomy.
A small amount of temporary puckering or irregularity can occur while swelling and tissue tension settle. Early dimpling does not automatically mean the final result will remain abnormal. Severity and progression matter.
Contact the practitioner if dimpling is severe, very noticeable, painful, getting worse, associated with redness or heat, persisting beyond expected healing, accompanied by visible thread material or associated with facial weakness.
Sometimes careful professional manipulation may be considered in selected early cases. Patients should not aggressively massage a thread lift themselves because thread direction, depth, timing and fixation matter.
In selected cases, excessive local fixation may potentially be released or adjusted. Technique depends on how recently the thread was inserted, thread architecture, depth, location and degree of tissue integration.
Filler may disguise selected contour defects, but it should not automatically be used to cover an unresolved thread complication. If skin is tethered by a thread, filler may camouflage rather than correct the mechanism.
Removal may be considered for persistent severe dimpling, a problematic superficial thread, extrusion, migration, infection involving the thread, persistent pain or significant contour deformity.
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