What causes regret with Tesslift? How "insufficient results" vary with age and thread count

With dissolvable thread lifts like Tesslift, the most common regret is not complications but dissatisfaction with results—"it didn't lift as much as I expected" or "it sagged back quickly."[1]A study of 1,500 people in Japan showed that dissatisfaction is more likely as age increases and as the number of threads increases[1]Before proceeding, it is important to assess whether threads alone are sufficient for the degree of sagging (skin laxity) present.

Who is most likely to regret it?

A rough benchmark is people aged 43 and older, and those who received more than 10 threads. Of 1,500 people who underwent PDO dissolvable thread lift, 51 people (3.4%) returned for follow-up care citing insufficient results[1].

Analysis of these 51 people showed that both increasing age and increasing thread count independently led to dissatisfaction[1]The numbers 43 and 10 threads are presented as threshold markers[1].

However, this study counted only "people who returned due to dissatisfaction," and does not include those who were dissatisfied but did not return[1]Actual dissatisfaction may be somewhat higher. Also note that this is not a study examining Tesslift itself.

Does adding more threads increase the result?

Not necessarily. In the study mentioned earlier, people with more than 10 threads reported more dissatisfaction, showing an inverse relationship between thread count and satisfaction[1].

Three reasons are cited[1]First, people with stronger sagging (skin laxity) tend to receive more threads. Second, more threads create higher expectations. Third, inserting too many threads can create unnatural pulling directions and asymmetry.

Rather than assuming "more threads = better lift," it is more useful to ask why that specific number is recommended. Whether the physician can explain the reasoning behind the thread count is an important point to confirm before treatment.

At what degree of sagging (skin laxity) are threads alone insufficient?

When skin sagging is severe, surgery may be better suited than threads. Previously, if the skin could be pulled toward the ear with 2 cm or more of excess, Facelift surgery was recommended[2].

Even when threads lift only the skin and subcutaneous tissue, these tend to return to their original position over time[2]Pulling too forcefully can lead to other complications[2].

As age increases, skin elasticity decreases and asymmetry becomes more likely, factors thought to lower the upper limit of thread effectiveness[1]In such cases, a combination of volume restoration through injectables, skin treatments, and/or surgery may be more appropriate[1].

When does the result typically begin to reverse?

Planning for reversal to begin around 6 months helps minimize the gap between expectations and results. Past studies showed that within 6 months, sagging returned in 50% of cases, and in 14%, sagging began returning within 8 weeks after the procedure[3].

Multiple reports indicate that the peak effect occurs within the first 6 months, declining gradually thereafter[3]An analysis of approximately 110,000 cases in Japan showed that results generally lasted 6 to 12 months, with PDO threads breaking down within 6 to 8 months[4].

Some marketing claims "lasts 12–18 months," but research data is not yet comprehensive enough to support this[3]It is reassuring to think ahead about how often you would need repeat treatments and the cost involved.

How can you avoid aesthetic complications?

The most common are asymmetry and cheek dimpling. A review of 59 studies (14,222 people) found that the most frequent adverse effect was facial asymmetry[5].

Most adverse effects resolve naturally, but contour irregularities, infection, and inflammation may require treatment[5]Cheek dimpling occurs from over-tightening or thread misplacement, and may be addressed by manual smoothing or filler injection[6].

Long threads fixed above the ears provide strong lifting force, but dimpling has been reported in 12–18% of cases[2]The type of thread and where it is fixed determine which complications are more likely, so be sure to get an explanation of these details.

Does repeated treatment affect future surgery?

Yes, it can. In 10 patients who underwent Facelift surgery after 2 or more Thread lift procedures, tissue became hardened and tissue layers adhered to each other[7].

This made surgical manipulation more difficult, according to reports[7]Although this is a small-sample report, anyone considering future surgery should consult beforehand rather than layering threads repeatedly.

What should you confirm during the consultation before treatment?

Confirm the severity of sagging (skin laxity), the degree of skin excess, the extent of volume loss, and any asymmetry. These factors determine whether threads alone are sufficient or whether combining injectables or surgery is necessary.

Also ask about the thread type and reason for the number chosen, when results will begin to reverse, and how dimpling would be managed if it occurs. To minimize the gap between expectations and results, it is safest to have the physician examine your face in person and discuss options together.