Is this pouch/pucker showing after silhouette soft 4 thread lift just from swelling? (Photo)

Hi, thank you for your question and I am sorry this has caused you distress. This looks to me like a simple pucker on the skin which can be easily released by manipulation by your treating doctor. Even without that is will likely free itself in the coming days, but if causing concern and cosmetic defect then it is worth popping into see your cosmetic doctor so they can rectify it promptly. 
Don't worry, it will can be fixed in seconds and you will have no long term defect. 
Hope this helps,

Dr Leah Totton (Dr Leah Clinic, London) 

Hi 
Thanks for your question. In my experience the 'swelling' you are referring to is possibly caused by a cone being placed too near to the exit point and is pulling back creating the swollen appearence. I would have expected this to have settled shortly after the procedure, however i would return to your treating doctor for him to release the cone. It is a simple technique to perform, the cone just needs to be released by pulling the tissue back. Please dont be alarmed as this is a common problem but easily rectified.

Dear chandrika,
Thank you for your question. 
Threads can be divided into absorbable and non absorbable sutures. The trend now is for absorbable sutures, of which we have PDO and PLLA.
Threadlift is a minimally invasive treatment, and it appeals to people because of this fact. Removal of a thread is not so straightforward. The tissue trauma, swelling, bruising and pain makes it a rather invasive process so many doctors feel it is much better to give time to allow for the threads to dissolve.
After a threadlift procedure, it is best to wait for swelling to settle, which takes up to a month, before doing any further work. Your pouch is likely to be from swelling. 
After 3 months, neocollagenesis occurs. PDO sutures would have dissolved to a good extent, while for PLLA sutures, there is a core of collagen around the suture, making it extremely traumatic to remove.
In general, it is best to not remove absorbable threads unless there is a strong medical reason, for example infection. Skin irregularities will resolve with time so there is no need for thread removal. 
Please do not worry. Silhouette Soft threads are made of PLLA, so this will not be permanent.