PDO threads are popular for individuals seeking a non-surgical approach to lifting and tightening sagging skin. These threads function as temporary scaffolding beneath the skin, offering immediate elevation while stimulating natural collagen production. The material is an absorbable suture used in medical settings for decades. While PDO threads are engineered for strength, they can break, though this is rare. Breakage typically results from material limitations combined with external forces applied under specific circumstances.
Understanding PDO Thread Composition
Polydioxanone (PDO) is the synthetic polymer material used to manufacture these threads. This substance is valued for its high biocompatibility and established safety profile as a surgical suture material. The thread’s function is twofold: to provide mechanical support and to trigger a healing response that leads to new collagen formation. PDO threads degrade through hydrolysis, which is the breakdown of the polymer by water within the tissues.
The initial tensile strength provides the immediate lift following the procedure. This strength is maintained significantly through the first few weeks (e.g., threads retain nearly 74% of strength at two weeks and 58% at four weeks post-implantation). Complete metabolic elimination of the thread material usually occurs over approximately six months. During this time, the thread scaffold is gradually replaced by the newly formed collagen matrix.
The degradation process occurs in two main stages. Polymer hydrolysis initially happens only on the surface of the filament. Later, circular cracks appear on the thread’s periphery, allowing water molecules to penetrate deeper into the structure. During this latter phase, the thread experiences a more rapid loss of mechanical integrity, though the lifting effect is secured by the surrounding scar tissue and collagen.
Factors Contributing to Thread Fracture
A physical fracture of a PDO thread is uncommon but is linked to procedural errors or post-treatment trauma. Since threads are strongest when first implanted, immediate breakage often relates to insertion technique. Incorrect placement, such as inserting the thread too superficially or subjecting it to excessive tension during anchoring, creates a weak point leading to structural failure. Clinicians must manipulate tissues carefully to prevent the thread’s cogs or barbs from snapping during the final tightening.
External forces applied shortly after the procedure are a major risk factor for premature fracture. The first one to three weeks are the most vulnerable period, as surrounding tissues have not yet fully secured the thread in place. Aggressive facial movements, such as widely opening the mouth or intense laughing, place undue mechanical stress on the threads. Trauma to the face, forceful rubbing, or sleeping directly on the treated areas can also cause a thread to snap.
Causes of Compromised Integrity
The integrity of the thread can also be compromised before insertion. PDO material is sensitive to environmental factors, and improper storage that exposes the threads to moisture can weaken the polymer. A high-quality thread, combined with proper aseptic technique and correct implantation depth, minimizes the risk of premature fracture. A thread is most likely to break when excessive physical force overcomes its initial high tensile strength or much later, as its structural integrity naturally declines through hydrolysis.
Recognizing and Addressing Breakage
The signs of a broken thread are often subtle and may include a sudden or gradual reduction in the desired lifting effect. Patients may notice a localized loss of tension, or the treated area might appear less lifted than immediately after the procedure. A fracture can sometimes lead to visible skin irregularities, such as dimpling or a slight puckering of the skin at the point of the break.
In rare instances, a broken end of the thread may migrate or protrude through the skin, requiring immediate attention from the clinician.
If a broken thread is suspected, the first step is to consult the medical practitioner who performed the treatment for a professional assessment. If the broken segment is not causing pain, asymmetry, or palpable irregularities, it can often be left in place.
Since the material is fully absorbable, the broken thread will continue its degradation and dissolve safely over time. Even a broken thread continues to stimulate neocollagenesis, meaning the biological benefits are not entirely lost.
If the broken thread results in a visible complication, such as a protrusion or persistent dimpling, the practitioner may need to intervene. Management options range from gently massaging the area to smooth out the irregularity, to performing a minor procedure to remove the symptomatic segment. Corrective action can also involve placing a new thread parallel to the fractured one to restore the lost lift.