Silhouette Thread Lift result with lumps and dents. Could I use RF to dissolve the cones? (photos)

At 5 weeks the lumps and bumps will continue to improve.  Are they hard?  Tender to the touch?  Can you feel the threads?  Subcisional RF applied underneath the skin and directly into the bumps may be helpful.  If the threads are palpable, probably best to remove them.  In certain cases, injection of a small amount of cortisone (such as kenalog) may be helpful.  Massage may help.  
Best wishes.
Victr Liu, MD

Thank you for your question and I am sorry you have experienced these results from your thread lift. This result is highly atypical in a Silhouette InstaLift as performed in the United States. I am not familiar with the soft thread you describe. It is possible you have an infection, improper placement, or an accumulation of serous fluid. I recommend you schedule an in-person consultation with a board-certified dermatologist as soon as possible to determine the reason for this waviness and for appropriate treatment. . Always work with doctors who are both board certified and have extensive experience in your procedure to ensure your procedure is safe and to reduce your risk for these types of complications. 

Dear regretwithpain,
Thanks for sharing your photos, they are helpful. I’m sorry for your unfortunate experience!

I have had the opportunity to use this great device and technique since Contour Threads were first introduced in 2004. Today, South Korea is a main driver of this technique with newer injectable intradermal and suspension subdermal sutures. Your photos illustrate the same problem that occurred with Contour when performed by physicians who did not fully appreciate the virtues of the procedure. This seemingly easy procedure is an advanced technique using a unique device for very selected patients.

I have found that holding the tissues in place with injectable sutures during the collagen producing phase of the procedure is the true virtue of this device. Placing them too near the skin may cause tissue puckering, buckling and irregular scaring. Thicker tissues and deeper placement of the suspension sutures will “hide” the puckering associated with the lifting properties of Silhouette’s coned sutures. When they cause puckering and do not ease during the first 3 weeks, swelling and collagen formation (ie, scar) will create the irregular surface you show. It can be improved but the longer you wait, the more collagen scar irregularity will develop and the more challenging the improvement.

In my experience, I remove the suture or cut the thread so the tension of the suture is released. If, at this time there remains significant residual deformity, I use a  technique to subcise the scar and fill with fat grafting. If, no subcision / fat grafting is needed, I find that deep scar massage will help smooth the surface thereafter.

At this time, it is best to find a highly experienced and technically skilled Silhouette or Injectable Threads surgeon to assist you in your distress! I wish you all the best during this time.