Clin Exp Otorhinolaryngol.  2022 Aug;15(3):247-253. 10.21053/ceo.2022.00101.

Presentation Patterns and Surgical Management of the Complications of Thread Rhinoplasty

• Jin HR
• Kim SJ

• KMID: 2532988
• DOI: http://doi.org/10.21053/ceo.2022.00101

Abstract

Objectives
. Nonsurgical rhinoplasty using threads has gained popularity in recent years. While the benefits of this procedure have been emphasized, possible complications and their management are not well-known. This study aimed to present the surgical management and results of the complications of thread rhinoplasty.
Methods
. We retrospectively reviewed the medical records of seven patients who underwent revision rhinoplasty due to the complications of thread rhinoplasty from January 2018 to May 2021. The presentation of complications, detailed surgical procedures, and outcomes of revision rhinoplasty were reviewed.
Results
. Visible or extruded threads at the tip were the most common complication, followed by dorsum irregularity. All the threads were unabsorbed and intact in shape, even several years after insertion. Thread removal necessitated careful tissue dissection, resulting in the loss of tip support and dorsal irregularity. To restore the tip support and camouflage the dorsum shape, an autologous tissue graft was needed.
Conclusion
. Removal of threads at the tip and dorsum was accompanied by structural weakening and partial tissue loss, which required tip support restoration and dorsum camouflage.

Keyword

Rhinoplasty; Minimally Invasive Surgical Procedures; Polydioxanone; Complications; Revision Surgery

Figure

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  Fig. 1. A 26-year-old female patient presented with pain and visible threads at the nasal tip (case 1). Before (A-D) and 6 months after revision rhinoplasty (E-H).

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  Fig. 2. Intraoperative findings of case 1. (A) The threads are visible as a bluish dot at the nasal tip (red arrow). (B) After the skin flap elevation, multiple thick, dyed threads are easily identified between the intermediate crura. (C) Further dissection into the intercrural space shows that the threads are deeply inserted into the anterior nasal spine. (D) Multiple barbed threads are removed from the tip and the dorsum. The threads are intact in their original shape even 7 years after insertion. (E) The dorsum shows a depression with irregularities after the removal of all threads (red line and red arrowheads).

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  Fig. 3. A 27-year-old female patient complained of a bulbous tip with skin dimpling at the tip (case 2). Before (A-D) and 10 months after revision rhinoplasty (E-H).

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  Fig. 4. Intraoperative findings of case 2. (A) Multiple transparent threads incorporated into the soft tissue of the dorsum are observed (black arrowheads). (B) Removed threads.

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