Recognizing and Managing Early Complications in Absorbable Thread Lifting: Lessons from MINT Lift® Cases
- Admin
- May 15
- 4 min read
Updated: May 16
Based on Seung Hun Yeo et al. | Archives of Aesthetic Plastic Surgery, 2017
The Expanding Role of Absorbable Threads in Aesthetic Lifting
Absorbable thread lifting has become a widely accepted minimally invasive facial rejuvenation technique, offering quicker recovery, lower risks, and avoiding general anesthesia. With growing patient demand for non-surgical facelift options and procedures with minimal downtime, the use of barbed PDO threads—especially those utilizing anchoring methods—has significantly increased.
Despite the rising popularity of PDO thread lifts, few clinical studies have thoroughly evaluated the early complications of absorbable anchoring sutures. In their retrospective study, Dr. Seung Hun Yeo and colleagues analyzed outcomes in 144 patients who underwent cheek lifts using MINT Lift® barbed threads, providing valuable insight into potential risks, causes, and prevention strategies for early complications in thread lifting.
Surgical Approach: Anchoring with MINT Lift® PDO Threads
This clinical study evaluated 144 female patients treated from July 2013 to December 2015, all of whom underwent bilateral cheek thread lifts using absorbable barbed sutures. The technique employed was the temporal anchoring method, utilizing MINT Lift® polydioxanone (PDO) threads, which are known for their mechanical strength, safety, and predictable bioresorption. Two thread types were utilized:
PMC (Press Molding Cog): Features molded barbs for uniform grip and gentle traction on soft tissue.
PCC (Press Cutting Cog): Contains cut-in barbs for aggressive tissue grip and enhanced lifting power.
This figure compares PMC and PCC threads. PMC threads integrate smoothly with reduced trauma, while PCC threads offer stronger lifting but a higher risk of complications.
Thread insertion was initiated with a 2 cm slit above the ear into the deep temporal fascia. A long curved needle was used to tunnel threads subcutaneously through the mid- and lower face, following a lift vector from the lateral canthus to the mandibular angle.
This schematic illustrates thread trajectory, entry/exit points, and vector planning for optimal results using the temporal lifting approach.
On average, 6.6 threads per patient were used. In 70.8% of cases, thread lifting was combined with facial liposuction, especially in patients presenting with moderate facial fat or tissue laxity.
Key Highlights for Practitioners:
MINT Lift® was chosen for its durability, FDA/CE approval, and reliable lifting strength.
PMC threads had fewer complications, while PCC threads carried a higher risk of asymmetry or undercorrection.
Anchoring to the deep temporal fascia provided firm support, but precise thread depth and angulation were critical to minimize complications.
Complications Observed and Management Strategies
Of the 144 cases reviewed, 16 patients (11.1%) experienced early complications. Most were mild and resolved without long-term effects, offering important lessons in technical execution and post-operative care for PDO thread lifting.
Dimpling (2.1%)
Three patients developed palpable or visible dimpling, most often due to superficial or uneven thread placement. Manual massage resolved most cases. One patient with a history of zygomatic reduction and fat removal showed persistent dimpling for three months.
This case demonstrates the importance of accurate thread depth in avoiding long-term dimpling.
Thread Exposure (3.5%)
The most common issue was thread palpability or visibility within 1–2 months post-procedure. Minor excision under local anesthesia resolved all cases, preserving the lifting effect. Most exposures involved superficially placed PCC threads, reinforcing the need for consistent thread depth.
Alopecia at Anchor Site (2.1%)
Three patients developed temporary hair loss near the anchoring zone. One progressed to full alopecia by month two but recovered by month five.
The likely cause was ischemia from overtension and limited shaved area. Preventative strategies include wider shaving and tension reduction.
Undercorrection (2.1%) and Asymmetry (0.7%)
Undercorrection typically occurred when thread vectors were too shallow, or PCC threads failed to sustain tension. One asymmetry case was corrected with a second-stage lift after complete healing.
Parotid Gland Injury (0.7%)
A rare but serious complication occurred when a thread penetrated the parotid gland, identified by ultrasound after swelling and infection signs. The condition was managed conservatively over five months.
Images document parotid swelling and ultrasonographic confirmation of thread trajectory through glandular tissue.
Interpreting the Data: Key Clinical Lessons
Most complications occurred within the first 6 months, aligning with the degradation timeline of PDO threads. Outcomes were excellent when proper depth, tension, and vector planning were observed, but this analysis underscores the importance of meticulous anatomical planning in thread lifting procedures.
Observations for Clinical Practice:
Superficial thread placement is the most frequent technical error, leading to dimpling and exposure.
PMC threads are better suited for thin-skinned patients or those with minimal fat.
Avoid over-tensioning to reduce ischemia and alopecia risk.
Always mark anatomical landmarks to avoid proximity to glands and vessels.
Conclusion
Dr. Yeo and his team’s findings confirm that MINT Lift® absorbable PDO threads are a safe, effective solution for midface lifting, provided the technique is executed with precision and anatomical awareness. Although early complications occurred in 11.1% of patients, most were minor, temporary, and did not impact long-term aesthetic outcomes.
For practitioners offering non-surgical facelift treatments with PDO threads, this study highlights the importance of:
Selecting appropriate thread types based on patient anatomy (PMC vs. PCC)
Maintaining consistent thread depth and vector angulation
Monitoring patients closely during the critical first 3–6 months post-procedure
Reference:
Yeo, S. H., Baek, R. M., Kwon, S. Y., & Oh, K. S. (2017). Early complications from absorbable anchoring suture following thread-lift for facial rejuvenation. Archives of Aesthetic Plastic Surgery, 23(1), 18–23. https://doi.org/10.14730/aaps.2017.23.1.18
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