Can I have a Deep Plane Facelift after Infinite Threads (permanent)?

Question

I had permanent threads put in at the end of 2019 (Infinite Threads) and a couple of revisions as the initial threads weren’t great. I’m now considering a Deep Plane Facelift. Are the threads going to be a problem? The Dr who did the threads would be able to give a drawing of where he placed them all.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. In most cases, previously placed permanent threads do not prevent a Deep Plane Facelift, but the surgeon performing the facelift should be fully aware of their locations. Having a drawing or record of where the threads were placed is extremely helpful, as it allows the facelift surgeon to plan dissection planes safely, avoid any entanglement with the threads, and anticipate areas of scar tissue or fibrosis from prior procedures.

Stephen Prendiville, MD · Answer

Can you have a deep plane facelift after permanent threads? Yes.  Will the facelift be more technically complex than it would have in the absence of threads? Yes, of course. This highlights the absolute requirement that you see an expert in facelift surgery, who is experienced in deep plane facelift and revision facelifts.

Guray Yesiladali, MD, FEBOPRAS · Answer

Yes. A deep plane facelift remains feasible after permanent threads. The threads change the plan rather than make surgery impossible.
What the threads change• Threads can leave scar bands and tether points that alter normal planes• Some threads migrate from the original vector, so a drawing is helpful yet not definitive• Dissection may take longer and swelling can last a little longer than usual
Preoperative steps that improve safety• Gather the original thread type, entry points and vectors, plus any revisions or complications• Use high resolution ultrasound mapping to locate remaining threads and dense fibrosis• Plan for intraoperative flexibility. If a segment is heavily scarred, the surgeon may modify the vector or switch to a related SMAS strategy to keep nerves safe
What can happen during surgery• Threads encountered in the dissection plane are usually removed• Release of scar bands restores mobility so the deep plane can move as intended• If scarring is extensive, a targeted release with limited plane changes can still tighten the jawline and neck predictably
When staged removal is considered• History of infection, granuloma or tender nodules along thread paths• Clearly palpable thread segments very close to planned incisions• In those situations a short staged extraction or a modified plane can reduce risk
Scars and recovery• Incisions for a modern deep plane facelift are designed to hide along natural creases and hair bearing skin• Expect similar recovery milestones, with the caveat that prior threads can add a little more edema and firmness early on
What to clarify at consultation• Exact thread type and whether they are non absorbable• Any areas of dimpling, pain or numbness that suggest scar concentration• Whether ultrasound mapping will be used and if thread removal is planned• The backup plan if scarring makes a classic deep plane unsafe in a limited zone
The details here are not enough for a precise plan. Standardized photos and a brief history allow a tailored map and a nerve safe strategy. If a more specific opinion would help a short complimentary conversation with a patient coordinator can be used to collect your records and images before any medical evaluation.
Wishing you clarity, a safe plan and a result that looks refreshed without visible telltales.Güray Yeşiladalı, MD

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