Hello. I'm Dr. Dongmin Lee of Ruby Dermatology Clinic, where we bring out your skin's natural beauty through delicate design and safe medical care.

"I'd like to get a thread lift, but I'm afraid my cheekbones will look bigger or my skin will dimple and make my expression look awkward, so I can't quite bring myself to do it."

This is one of the most common reasons patients who come to the clinic to tighten sagging contours hesitate during a thread lift consultation.

Awkwardness or surface indentations (dimpling) after a thread lift occur when the thread is anchored in a layer that doesn't suit the patient's skin thickness, or when the design is inadequate. With an accurate understanding of skin anatomy and precise placement in the correct layer, you can achieve a firm, natural V-line without awkwardness.

💡 [3-Line Key Summary]

Cause of dimpling: When an anchoring cog thread catches in the lower dermis or a shallow fat layer too close to the skin surface, the surface is pulled in, causing temporary or persistent dimpling.

Preventing an awkward expression: Take into account each person's different movement paths of the muscles of facial expression, and use a multi-layer custom design matched to skin thickness and degree of sagging instead of excessive traction.

Combined matching solution: Layering anchoring cog threads with Jamber threads or skin boosters, which provide flexible volume and improved skin texture, creates a smooth, natural contour.

A. The Anatomical Reasons for Dimpling and Awkwardness After a Thread Lift

A thread lift is not simply "pulling up"; it is a refined procedure that requires correctly understanding the anatomical layers and seating the thread properly.

Dimpling from shallow-layer anchoring: When the cog catches in a dermal layer that is too shallow, the skin surface is dragged in unevenly, causing indentations. Conversely, if the thread goes too deep beneath the fat layer, it loses its holding power and slides downward.

Irritation of expression muscles and apparent cheekbone widening: Pulling forcefully in a vertical direction at the cheekbone area interferes with the movement of expression muscles when smiling, making the expression look awkward, or bunches lateral fat so the cheekbones look larger.

B. Is It Right for Me? Who Is It Recommended For, and Who Needs Careful Design

1) Strongly recommended if you:

Want to immediately lift deep cheek (midface) sagging, nasolabial folds, and a collapsed jawline to create a natural contour

Feel that laser devices alone have limits in lifting sagging tissue

2) Cases where precise procedure design is essential:

Those with very thin skin where the outline of the thread may easily show (supplementary layering centered on flexible, soft volume threads/Jamber threads is needed)

C. Three Technical Points for a Thread Lift Without Awkwardness

Placement in the exact target layer (mid-to-deep subcutaneous fat):

The cogs must be hooked by precisely targeting the subcutaneous fat layer above the SMAS while avoiding epidermal damage, so that firm holding power is maintained without dimpling.

Custom vector design:

Rather than simply pulling vertically, a 3D curved vector is designed to match each person's facial movements and cheekbone structure, ensuring natural-looking results when smiling or speaking.

Supplementing volume & elasticity with Jamber threads:

Spring-shaped Jamber threads can be applied flexibly to highly mobile nasolabial folds or hollowed areas, reducing the rigidity of cog threads and stimulating the body's own collagen production to fill in natural volume.

D. Comparison of Thread Lift Types at a Glance

E. Recovery and Longevity

Recovery period (downtime): Mild bruising or swelling may occur for 2–3 days after the procedure, but when threads are placed in the precise layer, results settle naturally within a week without dimpling.

Duration: Depending on the material (PDO/PLLA/PCL), results last around 1 year to 1 year 6 months, and as the threads dissolve, the collagen tissue they stimulated helps maintain skin elasticity.

F. 🔥 Zero Awkwardness! A Synergistic Lifting Combination

Mint/Cog Threads + Jamber Threads Combined Lifting:

After lifting and anchoring the collapsed contour line with cog threads, Jamber threads are layered into the highly mobile nasolabial folds and cheek hollows to create smooth, dimensional volume.

Thread Lift + LDM Hydrating & Soothing Care:

Immediately after the procedure, LDM ultrasound hydrates the dermis and calms the tissue, minimizing swelling and irritation and helping the threads settle smoothly.

G. Dr. Lee's Practical Know-How & Clinical Insights

The success of a thread lift depends not on "how strongly you pull" but on "how naturally it harmonizes."

Before treatment, I carefully observe the patient's skin thickness, fat volume, and the movement paths of the expression muscles they use when smiling. In thin-skinned areas, instead of strong cog threads, I place flexible Jamber threads that reduce friction in an alternating pattern, and I apply the '3D Multi-layer Anchor technique,' which distributes the pulling angle across multiple directions. This delivers a naturally firmed face line without awkwardness or dimpling, even right after the procedure.

📌 [Wrap-Up] Pre- and Post-Treatment Precautions

Avoid exaggerated expressions: For 1–2 weeks after the procedure, avoid opening your mouth too wide or eating foods that require hard chewing, and do not rub your face roughly.

Proper sleeping position: For one week after the procedure, sleep on your back rather than on your stomach or side, so the threads can settle properly.

Avoid heat exposure: For one week, avoid saunas, jjimjilbang (Korean bathhouses), alcohol, and strenuous exercise to support skin regeneration and tissue settling.

Author Bio

Dr. Dongmin LEE

Ruby Dermatology Clinic

A graduate of Korea University College of Medicine, Dr. Lee served as director of U&I Clinic and of Ruby Plastic Surgery, and is now director of Ruby Dermatology Clinic, devoted to restoring each patient's natural skin health and beautiful contours.

Korea University, College of Medicine (M.D.)

Member of Korean Society of Filler

Member of Korean Society of Laser, Dermatology and Hair

Member of Korean Society of Obesity and Aesthetic Medicine

Former Doctor, RUBY Plastic Surgery, U&I Clinic