J Cosmet Med.  2023 Jun;7(1):49-52. 10.25056/JCM.2023.7.1.49.

Ways of prevention of thread extrusion after insertion of polydioxanone thread for nasal tip projection

• Kang K
• Hong J
• Shin Y

• KMID: 2561178
• DOI: http://doi.org/10.25056/JCM.2023.7.1.49

Abstract

Cogged polydioxanone (PDO) thread, which is inserted into the blunt cannular, is cosmetically used for non-surgical projection of the nasal tip. However, thread extrusion is a frequently occurring side effect despite the production technology of the thread has improved. To prevent this, we changed the location of the insertion site from the middle of the tip to 0.5 cm above the supratip break point and applied the cannular, which was manually bent about 30°, 1.5 cm from the cannular tip. The bent cannular was located in the supraperichondral layer of the upper lateral cartilages, moved down to middle of the tip, rotated 180°, and the columella inserted inwards to the nasal spine by holding the nose in the desired position of tip projection with the non-dominant hand. For tip projection, 4 threads were inserted. For dorsal augmentation, 1.0 ml hyaluronic acid (HA) filler was injected as a single approach, and both 8 threads and 1.3 ml HA filler were used as a combination approach. The effect was maintained for at least 2 years after the procedure, without any thread extrusion. The patient was greatly satisfied with the natural appearance. This method is an easy and reliable technique for both tip projection and preventing thread extrusion.

Keyword

extrusion; hyaluronic acid filler; nasal augmentation; polydioxanone thread; tip projection