In short. The support is temporary by design. What a face does as a suture breaks down, and why a second course of threads is not the same as having had them once.
Key points
- When you repeat a thread treatment, you are treating tissue that has already been travelled through, already held and released, and in some cases already operated on or filled.
- It behaves less predictably than it did the first time, and the tissue available to grip has not improved.
- A course that worked once is not a guarantee that the same plan works again.
A suspension suture is designed to be absorbed, and that is not a side effect or a failure. It is the mechanism. The material breaks down and leaves the body, and the support it gave leaves with it. Knowing what happens next is the difference between planning a course of treatment and being surprised by one.
What happens as the suture goes
Nothing dramatic happens on a particular day. The grip that held the gathered tissue weakens gradually, and the tissue moves back toward the position it was heading for before the treatment. Because the change is slow, many patients notice it by comparing photographs rather than by feeling it. What remains is variable: some faces keep a slightly different look, others return close to where they started, and no examination predicts which.
Why the second course is not the first
When you repeat a thread treatment, you are treating tissue that has already been travelled through, already held and released, and in some cases already operated on or filled. It behaves less predictably than it did the first time, and the tissue available to grip has not improved. A course that worked once is not a guarantee that the same plan works again.
What the face does afterwards
Ageing continues whether or not you have been treated, so the face that emerges after absorption is not the face you had before it. It is that face, some months or years older. This is the hardest part to accept: the alternative to a fading thread result is not your old face, but your old face plus the ageing that happened anyway.
What cannot be claimed
It is often said that threads improve the skin by stimulating new tissue as they break down, and that this is a lasting effect. The honest position is that any such change is not something you can rely on, and it does not hold the face in a lifted position after the suture has gone. Planning around it is planning around something that cannot be counted.
Planning a repeat honestly
Ask how many courses are envisaged, over what period, and what the plan is if the second does less than the first. Ask what happens to the tissue after several courses, because the answer is not well established; a clinic that admits that is more trustworthy than one with a confident answer. Ask what the total commitment looks like across several years, not what one appointment costs.
Reasons to stop and reconsider
- A promise that the support persists after absorption, or that the treatment substitutes for an operation.
- A repeat course offered without examining whether the tissue can still hold anything.
- No plan for what happens if a course produces dimpling, tenderness or an uneven result.
None of this makes threads a bad treatment. It makes them a temporary one, chosen by someone who knows they are choosing a course rather than a single event. That is a legitimate decision, and it is better made with the absorption in view from the start.
Frequently asked questions
What happens to my face as the sutures break down?
Nothing dramatic happens on a particular day. The grip weakens gradually and the tissue moves back toward the position it was heading for before the treatment. Many patients notice it by comparing photographs rather than by feeling it happen. What remains afterwards varies: some faces keep a slightly different look, others return close to where they started.
Why is a second thread treatment different from the first?
Because the tissue is different by then. It has already been travelled through, already held and released, and sometimes already operated on or filled. It behaves less predictably than it did the first time, and the tissue available to grip has not improved. A course that worked once is not a guarantee that the same plan works again.
Is there anything I can do to slow the loss of support?
Not in any way that changes the mechanism. The support ends because the suture is absorbed, and no aftercare alters that. What aftercare can do is protect the early weeks, when the tissue is being held, by following the advice on sleep position, facial movement and avoiding vigorous massage or dental work for the period you are given.
Risks & Limitations
- A facelift cannot be undone, and revision is a harder operation than the first.
- Scars are permanent. They mature and soften over 6–12 months but do not disappear.
- Suspension sutures are absorbed, so their support is temporary and varies between people.
- Dimpling, tenderness and palpable sutures are common after a thread treatment.
- Nerve injury and bleeding are the main operative risks; either route can complicate later surgery.
When to Seek Care
- Difficulty breathing or chest pain — seek emergency care immediately.
- Fever with spreading redness, warmth or discharge from a wound or an entry point.
- Bleeding that does not stop with gentle pressure, or a wound that opens.
- A suture that becomes visible through the skin, or pain and swelling that increase.
- Marked asymmetry, or a result that changes suddenly rather than gradually.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
- National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
- Cochrane Library — systematic reviews
- Chinese Medical Association Plastic Surgery Branch — clinical guidance
- Chongqing West District Hospital — departmental clinical standards
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.