Persistence and Migration of Facial Support Threads After Two Years: Ultrasound-Guided Removal and Structural Rejuvenation

• DOI: https://doi.org/10.22533/at.ed.51572132624061

• Palavras-chave: PDO threads; thread lift; foreign body reaction; persistence of absorbable polymers; ultrasound-guided removal; facial anatomy; structural rejuvenation; complications in aesthetic medicine.

• Keywords: PDO threads; thread lift; foreign body reaction; persistence of absorbable polymers; ultrasound-guided removal; facial anatomy; structural rejuvenation; complications in aesthetic medicine.

• Abstract:

  Background: Absorbable sutures composed of polydioxanone (PDO), poly-L-lactic acid (PLLA), and polycaprolactone (PCL) are widely used in minimally invasive facial aesthetic procedures. Although classified as bioresorbable, clinical and histological evidence demonstrates that their degradation depends substantially on the anatomical plane of insertion, individual patient factors, and the local tissue microenvironment. When inserted into incorrect planes, these polymers may fail to degrade within the expected timeframe, behaving as persistent foreign bodies. (Contreras et al., 2023; Su et al., 2024; Nonhoff et al., 2024)
  Case Report: A 50-year-old female patient presented with palpable, mobile linear structures in the facial subcutaneous plane two years after undergoing a thread lift performed by another practitioner. High-resolution ultrasound, performed by Dr. Sarah Dantas at the MAC Weber Clinic in Campo Belo, São Paulo, confirmed the presence of intact, undegraded threads. Ultrasound-guided removal was successfully performed, followed by a structural rejuvenation protocol using Allergan Aesthetics products. (Perfeito et al., 2025; Park et al., 2024; Savoia et al., 2017; Kim et al., 2020)
  Conclusion: Threads inserted into inappropriate anatomical planes may persist longer than expected, trigger a chronic foreign body inflammatory response, and require surgical intervention for removal. Ultrasound-guided extraction proved to be safe and effective. In-depth anatomical knowledge is essential for the safe practice of thread lifting. (Nonhoff et al., 2024)
  Keywords: PDO threads; thread lift; foreign body reaction; persistence of absorbable polymers; ultrasound-guided removal; facial anatomy; structural rejuvenation; complications in aesthetic medicine.