PDO Thread Complications: Recognizing Problems Early

Most problems after a PDO thread procedure are mild and settle with time, but a few need prompt attention. The main ones are a thread that shows or pokes through the skin, dimpling that does not fade, infection, uneven results and irritation of a nerve. Knowing what is normal healing and what is not helps you call your clinic at the right time.

What normal healing looks like

Before looking at complications, it helps to know what to expect. In the first one to two weeks, most people have some swelling, bruising and tenderness along the thread paths. A pulling or tight feeling when talking, chewing or turning the head is common, as are small bumps at the entry points. Mild unevenness between sides is also typical while swelling settles.

These usually improve steadily day by day. The key word is improve. Symptoms that are getting worse rather than better after the first few days deserve a call. Our article on recovery after a PDO thread lift describes the usual timeline in more detail.

Visible, palpable or extruding threads

What it looks like: a faint line or ridge under the skin, a firm strand you can feel, or a tiny end of thread poking out near an entry point. This is more likely in thin skin or when a thread sits too close to the surface.

How it is managed: a thread that can be felt but not seen often becomes less noticeable as swelling settles and the material dissolves. A thread end breaking through the skin should not be pulled or cut at home. It usually needs to be trimmed or removed by your injector in a clean setting, because an exposed thread can let bacteria in.

Dimpling, puckering and bunching

What it looks like: small dents, a puckered patch or an uneven ripple of skin, often most obvious when you smile or move your face. It can happen when a barb grips the skin too close to the surface or tissue bunches as it is repositioned.

How it is managed: early dimpling is common and often fades within one to two weeks as tissues relax. If it persists, your injector may gently massage the area or, in some cases, release or remove the thread. Do not attempt firm massage on your own unless you have been told to, as this can shift threads.

Infection

What it looks like: increasing redness, warmth, swelling or pain after the first few days; pus or discharge from an entry point; a tender lump; or fever and feeling unwell. Infection can appear within days, but delayed infections weeks later are also possible.

How it is managed: infections need prompt medical assessment. Treatment usually includes antibiotics, and sometimes the thread needs to be removed so the infection can clear. Early treatment generally leads to a better outcome, so do not wait to see if it settles on its own.

Asymmetry and unexpected results

What it looks like: one side sits higher than the other, the lift looks uneven, or the face looks pulled in an unnatural direction.

How it is managed: faces are naturally uneven and swelling is rarely equal on both sides, so it is wise to wait about two weeks before judging. If asymmetry remains once healing has settled, options may include adjustment, placement of an additional thread, or in some cases removal. Some differences cannot be fully corrected and may need to fade as the threads dissolve.

Nerve and gland irritation

What it looks like: numbness, tingling, shooting pains or unusual sensitivity along part of the face; less often, weakness in a facial movement. In the cheek area in front of the ear, swelling linked to a salivary gland is a rare possibility, and may be noticeable around meals.

How it is managed: mild numbness or tingling often improves over weeks as swelling settles. Ongoing pain, weakness or gland swelling needs assessment so the cause can be identified. Some cases improve with time and simple measures; others may need the thread removed or a referral.

Prolonged pain or a firm lump

Discomfort usually eases within one to two weeks. Pain that persists, worsens, or comes with a firm, tender lump can signal inflammation around a thread, a small collection of fluid, or infection. Occasionally, a lump called a granuloma, an inflammatory reaction to foreign material, develops weeks to months later. These problems all deserve a medical review rather than waiting.

When to call the clinic

Contact your injector promptly if you notice:

• Swelling, redness or pain that is increasing after the first two to three days
• Warmth, pus, discharge or a tender lump
• Fever or feeling generally unwell
• A thread end visible on or through the skin
• New numbness, weakness or difficulty moving part of the face
• Dimpling or asymmetry that is not improving after two weeks

If you develop severe pain, rapid swelling, difficulty breathing or swallowing, or a high fever, seek emergency care.

Lowering your risk

Not every complication can be prevented, but some steps help. These include choosing treatment only if you are a suitable candidate (our article on who is not a good candidate for PDO threads covers this), sharing your full medical history and medicine list, and following aftercare closely. Typical aftercare includes keeping entry points clean, avoiding wide mouth opening, facial massage, saunas and strenuous exercise for the period advised, and sleeping on your back for the first few nights. Do not stop any prescribed medicine to reduce bruising without speaking to the doctor who prescribed it.

People who are pregnant, have an active infection, have poorly controlled diabetes or an autoimmune condition, or tend to form keloids are generally advised to avoid or postpone threads.

Frequently asked questions

Can threads be removed if something goes wrong?

Often, yes, particularly in the first weeks. Removal becomes harder as tissue heals around the thread, which is another reason to report problems early.

Is a clicking or pulling sound normal?

Some people notice a faint pulling sensation or feel a "catch" when moving in the first days. If it is painful or persists, mention it at follow-up.

How late can complications appear?

Most appear in the first few weeks, but infections, lumps or extrusion can occasionally show up months later, before the threads have fully dissolved.

Keeping follow-up in mind

A planned follow-up visit is part of thread treatment, not an extra. If you have had threads placed and something does not feel right, or you are considering threads and want to understand the risks first, a consultation with HealthPark Medical Aesthetics can talk you through them.