A needle or a cannula must puncture the skin to implant the thread into the tissue. The following damage causes an immediate wound healing process. This puncturing action causes some localized tissue damage and bleeding. Platelets are automatically released and the normal process of inflammation commences, even though the wound is miniscule. A completely different picture emerges when numerous fine pricks are placed. This promotes the normal post-traumatic release of growth factors and infiltration of fibroblasts. This reaction is automatic and produces a surge of activity that inevitably leads to the fibroblasts being ‘‘instructed’’ to produce more collagen and elastin. Wound healing, or cicatrisation, is an intricate process in which the skin (or another organ-tissue) repairs itself after injury.

According to the study of HELENE M. LANGEVIN, the mechanical stimulation of subcutaneous tissue with acupuncture needles causes active fibroblast cytoskeletal remodeling involving mechanotransduction-based mechanisms. Mechanotransduction refers to the many mechanisms by which cells convert mechanical stimulus into chemical activity. Active fibroblast was also observed as a response to acupuncture needle rotation. Needle rotation causes winding of collagen fibers around the needle and formation of a “whorl” of collagen and fibroblasts in the area immediately surrounding the needle.
The implanted material (threads) can stimulate the surrounding tissues continuously with facial expressions and movements until they are degraded and hydrolised. This stimulation can lead to more proliferation of fibroblasts during wound healing process.

Implanted threads like filling the skin can prevent the skin from generating more wrinkles when inserted in a perpendicularly to wrinkle directions.