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Incidence and Predictors of Complications After Polydioxanone Thread Lift: A Multicenter Retrospective Cohort Study
Kohki Okumura1,2, Takahiko Tamura3, Yusuke Funakoshi4
1Tokyo Chuo Beauty Clinic, K's Square Building 3F, 2-8-15 Sonezaki, Kita-ku, Osaka-shi, Osaka-fu, 530-0057, Japan. tcb.okumura@gmail.com.
Aesthetic Plastic Surgery
|June 3, 2026
Summary
This study developed a risk score to predict complications from Polydioxanone (PDO) thread lifts. Higher thread counts and older age increase complication risk, aiding personalized aesthetic treatment planning.
Area of Science:
- Aesthetic Medicine
- Dermatology
- Cosmetic Surgery
Background:
- Polydioxanone (PDO) thread-lift is a popular minimally invasive facial rejuvenation technique.
- High-quality evidence on PDO thread-lift complication incidence and predictors is limited.
Purpose of the Study:
- Determine the incidence of complications after PDO thread-lift.
- Identify independent predictors for these complications.
- Develop a clinically applicable risk-scoring model for PDO thread-lift procedures.
Main Methods:
- A multicenter retrospective study analyzed 2000 PDO thread-lift cases.
- Data included age, sex, thread count, and postoperative complications.
- Multivariate logistic regression and ROC curve analyses identified predictors and validated the risk model.
Main Results:
- The overall complication rate was 12.4%, with skin retraction (6.35%) and asymmetry (2.9%) being most common.
- Thread count (OR: 1.12 per thread) and older age (OR: 2.14-5.08) were independent predictors.
- The risk score showed strong discrimination (AUC=0.747), with a cutoff of 9 points.
Conclusions:
- A large-scale, validated PDO-specific scoring model for predicting thread-lift complications was developed.
- This model enables objective preoperative risk stratification.
- The model supports safe, evidence-based, and personalized aesthetic treatment planning.
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